2023年水痘带状疱疹疫苗接种知情同意声明英文版
2023 Varicella Zoster Vaccine Informed Consent Statement
建议尽早带爸妈接种带状疱疹疫苗I acknowledge that I have been informed about the risks and benefits of receiving the Varicella Zoster vaccine in 2023. I understand that the vaccine is intended to protect me from contracting the varicella zoster virus, which can cause chickenpox and shingles.
I understand that there may be potential side effects associated with the vaccine, such as redness, swelling, or soreness at the injection site, as well as fever, headache, or fatigue. I acknowledge that these side effects are typically mild and resolve on their own.
I am aware that there is a small risk of more serious side effects, such as allergic reactions, but I understand that these are rare. I understand that the benefits of receiving the vaccine outweigh the risks of potential side effects.
I understand that the Varicella Zoster vaccine is recommended for individuals who have not previously had chickenpox or received the vaccine. I acknowledge that by receiving the vacci
ne, I am contributing to the prevention of the spread of varicella zoster virus in the community.
I understand that the vaccine may not provide 100% protection against varicella zoster virus, but it can reduce the severity of the illness if I do contract it. I acknowledge that it is still important to practice good hygiene and follow public health guidelines to prevent the spread of the virus.
I have had the opportunity to ask questions and have received satisfactory answers regarding the Varicella Zoster vaccine. I understand that I have the right to refuse the vaccine or seek further information before making a decision.
By signing this informed consent statement, I acknowledge that I have been fully informed about the Varicella Zoster vaccine and consent to receive it in 2023.
Signature: _______________________
Date: ___________________________