Shot Record
 

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Updated 4/19

     IMMUNIZATIONS STATUS            RED = Needs to be addressed prior to deadline  Orange = Expires during course
ID TB Hep B HEP B MMR Mo/Yr MMR Mo/Yy TDAP Pox Varicella Seasonal
Number (Neg) Series Titer Child/Adult Child/Adult Td   Vaccine Flu
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
159 PPD    Shot 1/  3/1995 If 3rd shot  Mar-96 Feb-18 tdap Have had Shot 1/ 2/2018 Jan-18
  X-Ray Shot 2/  1/1995 over 22yrs need titer. Titer Rubella   Jan-18 Chickenpox? Shot 2/ 3/2018  
  Shot 3/  8/1995 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
278 PPD    Shot 1/  4/1998 If 3rd shot  Apr-99 Apr-02 tdap Have had Shot 1/ 4/1999  
Need 2nd vaicella shot X-Ray Shot 2/  5/1998 over 22yrs need titer. Titer Rubella   Jun-10 Chickenpox? Shot 2/  
  Shot 3/  10/1998 Date/Result Titer Mumps     yes Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
387 PPD   3.2018 Shot 1/  10/1998 If 3rd shot  Sep-99 Sep-02 tdap Have had Shot 1/ 9/1999 Oct-17
  X-Ray Shot 2/  6/1999 over 22yrs need titer. Titer Rubella   Sep-09 Chickenpox? Shot 2/ 7/2008  
  Shot 3/  8/2009 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
441 PPD   2/2018 Shot 1/  6/1996 If 3rd shot  Apr-01 Jun-97 tdap Have had Shot 1/ Feb-18
  X-Ray Shot 2/  5/2001 over 22yrs need titer. Titer Rubella   Feb-18 Chickenpox? Shot 2/  
  Shot 3/  10/2001 Date/Result Titer Mumps     yes Titer: 2/2018  
      Titer Measles     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
589 PPD    Shot 1/   If 3rd shot      tdap Have had Shot 1/ 11/2007  
  X-Ray Shot 2/   over 22yrs need titer. Titer Rubella     Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
659 PPD    Shot 1/  3/2000 If 3rd shot  Mar-01 Mar-05 tdap Have had Shot 1/ 3/2001  
  X-Ray Shot 2/  4/2000 over 22yrs need titer. Titer Rubella   Jul-12 Chickenpox? Shot 2/ 7/2012  
  Shot 3/  9/2000 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
872 PPD    Shot 1/   If 3rd shot      tdap Have had Shot 1/  
  X-Ray Shot 2/   over 22yrs need titer. Titer Rubella   May-11 Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
718 PPD    Shot 1/  1/1999 If 3rd shot  Oct-00 Jan-03   Have had Shot 1/ 10/2000 Jan-18
Need tdap shot or proof within 10 yrs X-Ray Shot 2/  10/2000 over 22yrs need titer. Titer Rubella     Chickenpox? Shot 2/ 8/2010  
  Shot 3/  8/2000 Date/Result Titer Mumps     no Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
900 PPD    Shot 1/  12/1997 If 3rd shot  Oct-99 May-02 tdap Have had Shot 1/ 8/2002 Feb-18
  X-Ray Shot 2/  1/1998 over 22yrs need titer. Titer Rubella   Aug-10 Chickenpox? Shot 2/ 8/2010  
  Shot 3/  7/1998 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
178 PPD   3/2018 Shot 1/  5/1999 If 3rd shot  Jan-89 Oct-91 tdap Have had Shot 1/ Sep-17
  X-Ray Shot 2/  6/1999 over 22yrs need titer. Titer Rubella   Mar-18 Chickenpox? Shot 2/  
  Shot 3/  12/1999 Date/Result Titer Mumps       Titer: 3/2018   
      Titer Measles     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
234 PPD   2/2018 Shot 1/  2/2018 If 3rd shot  Feb-18 n/a tdap Have had Shot 1/ 2/2018 Feb-18
  X-Ray Shot 2/  n/a over 22yrs need titer. Titer Rubella 2/2018 imune Feb-18 Chickenpox? Shot 2/  
  Shot 3/  n/a Date/Result Titer Mumps 2/2018 low   yes Titer: 2/2018  
    2/2018 low Titer Measles 2/2018 low     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
384 PPD   3/2018 Shot 1/  6/1997 If 3rd shot  Dec-98 Jul-01 tdap Have had Shot 1/ 12/1998 n/a
  X-Ray Shot 2/  8/1997 over 22yrs need titer. Titer Rubella   Aug-09 Chickenpox? Shot 2/ 8/2009  
  Shot 3/  2/1998 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
443 PPD    Shot 1/   If 3rd shot        Have had Shot 1/  
  X-Ray Shot 2/   over 22yrs need titer. Titer Rubella     Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
532 PPD    Shot 1/  8/1999 If 3rd shot  Jan-92 Jan-95 tdap Have had Shot 1/ Feb-18
Need Varicella Titer blood test. Not the shots X-Ray Shot 2/  9/1999 over 22yrs need titer. Titer Rubella   Mar-18 Chickenpox? Shot 2/  
  Shot 3/  1/2000 Date/Result Titer Mumps     unk Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
631 PPD   2/2018 Shot 1/  2/1996 If 3rd shot  Oct-98 Oct-00 tdap Have had Shot 1/ Feb-18
Need Varicella Titer blood test. Not the shots X-Ray Shot 2/  12/1995 over 22yrs need titer. Titer Rubella   Feb-18 Chickenpox? Shot 2/  
  Shot 3/  7/1996 Date/Result Titer Mumps     yes Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
767 PPD   3/2018 Shot 1/  1/1998 If 3rd shot  Mar-99 Mar-02 tdap Have had Shot 1/ 3/1999 Mar-18
  X-Ray Shot 2/  6/1998 over 22yrs need titer. Titer Rubella   Jul-10 Chickenpox? Shot 2/ 7/2010  
  Shot 3/  11/1998 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
827 PPD    Shot 1/  6/1996 If 3rd shot  Oct-90 Jun-97   Have had Shot 1/ Jan-18
Need tdap shot or proof within 10 yrs X-Ray Shot 2/  8/1996 over 22yrs need titer. Titer Rubella     Chickenpox? Shot 2/  
  Shot 3/  4/1997 Date/Result Titer Mumps       Titer: 1/2018  
      Titer Measles     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
991 PPD    Shot 1/  10/1997 If 3rd shot  Nov-98 Aug-02 tdap Have had Shot 1/ 2/2018  
  X-Ray Shot 2/  2/1998 over 22yrs need titer. Titer Rubella   Feb-18 Chickenpox? Shot 2/ 4/2018  
  Shot 3/  5/1998 Date/Result Titer Mumps     yes Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella n/a
177 PPD   2/2018 Shot 1/   If 3rd shot      tdap Have had Shot 1/ Feb-18
  X-Ray 2/2018 Shot 2/   over 22yrs need titer. Titer Rubella 2/2018 imune Oct-10 Chickenpox? Shot 2/ Need lot #
  Shot 3/   Date/Result Titer Mumps 2/2018 imune     Titer: 2/2018 
    2/2018 imune Titer Measles 2/2018 imune     imune
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
445 PPD   3/2018 Shot 1/  5/1998 If 3rd shot  Mar-99 Aug-02 tdap Have had Shot 1/ 3/1999 Mar-18
  X-Ray Shot 2/  7/1998 over 22yrs need titer. Titer Rubella   Apr-10 Chickenpox? Shot 2/ 4/2010  
  Shot 3/  9/1998 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
242 PPD   2/2018 Shot 1/  11/1996 If 3rd shot  Nov-98 Nov-00 tdap Have had Shot 1/ 1/1998 Jan-18
  X-Ray Shot 2/  1/1997 over 22yrs need titer. Titer Rubella   Jan-18 Chickenpox? Shot 2/ 8/2009  
  Shot 3/  6/1997 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
339 PPD    Shot 1/   If 3rd shot        Have had Shot 1/  
  X-Ray Shot 2/   over 22yrs need titer. Titer Rubella     Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
418 PPD   2/2018 Shot 1/  2/2017 If 3rd shot  Feb-17 Feb-18 tdap Have had Shot 1/ 2/2017 Jan-18
  X-Ray Shot 2/  3/2017 over 22yrs need titer. Titer Rubella   Feb-17 Chickenpox? Shot 2/ 2/2018  
  Shot 3/  9/2017 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
554 PPD    Shot 1/  8/2007 If 3rd shot  Aug-07   tdap Have had Shot 1/ Nov-17
Need 2nd MMR shot, Need Vaicella Titer test X-Ray Shot 2/  9/2007 over 22yrs need titer. Titer Rubella   Jun-14 Chickenpox? Shot 2/  
  Shot 3/  3/2009 Date/Result Titer Mumps     unk Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
618 PPD    Shot 1/  4/1999 If 3rd shot  Nov-91 Aug-94 tdap Have had Shot 1/ 8/1992 Mar-18
  X-Ray Shot 2/  5/1999 over 22yrs need titer. Titer Rubella   Mar-18 Chickenpox? Shot 2/ 3/2018  
  Shot 3/  10/1999 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
746 PPD   2/2018 Shot 1/  1/2018 If 3rd shot  Jan-18 Feb-03 tdap Have had Shot 1/ 7/2010 Jan-18
  X-Ray Shot 2/  2/1998 over 22yrs need titer. Titer Rubella   Jul-10 Chickenpox? Shot 2/ 3/1999  
  Shot 3/  4/1998 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
886 PPD   1/2018 Shot 1/  10/1992 If 3rd shot  Jan-18 Mar-92 tdap Have had Shot 1/ Jan-18
  X-Ray Shot 2/  12/1992 over 22yrs need titer. Titer Rubella   Jan-18 Chickenpox? Shot 2/  
  Shot 3/  8/1993 Date/Result Titer Mumps       Titer: 1/2018  
      Titer Measles     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
916 BCG hx Shot 1/  2/2000 If 3rd shot  Feb-00 Jan-99 tdap Have had Shot 1/ Sep-17
  TB Gold 2/2018 Shot 2/  1/2000 over 22yrs need titer. Titer Rubella   Feb-18 Chickenpox? Shot 2/  
  Shot 3/  3/2018 Date/Result Titer Mumps     yes Titer: 2/2018  
    2/2018 low Titer Measles     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
167 PPD    Shot 1/  12/2012 If 3rd shot  Mar-18   tdap Have had Shot 1/ 6/2012 Mar-18
Nee 2nd MMR shot X-Ray Shot 2/  6/2012 over 22yrs need titer. Titer Rubella   Jun-12 Chickenpox? Shot 2/ 7/2012  
  Shot 3/   Date/Result Titer Mumps       Titer:  
    3/2018 imune Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
299 PPD   2/2018 Shot 1/  1/2018 If 3rd shot  Jul-97 Oct-01 DTP Have had Shot 1/ Jan-18
  X-Ray Shot 2/  9/1996 over 22yrs need titer. Titer Rubella   Sep-11 Chickenpox? Shot 2/  
  Shot 3/  1/1997 Date/Result Titer Mumps     unk Titer: 3/2018   
      Titer Measles     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
371 PPD    Shot 1/  10/1995 If 3rd shot  Nov-96 Jul-01 tdap Have had Shot 1/ 4/1996 n/a
  X-Ray Shot 2/  12/1995 over 22yrs need titer. Titer Rubella   Sep-11 Chickenpox? Shot 2/ 10/1997  
  Shot 3/  5/1995 Date/Result Titer Mumps     no Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
865 PPD    Shot 1/   If 3rd shot        Have had Shot 1/ n/a
  X-Ray Shot 2/   over 22yrs need titer. Titer Rubella     Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
308 PPD   3/2018 Shot 1/   If 3rd shot      tdap Have had Shot 1/ Nov-17
  X-Ray Shot 2/   over 22yrs need titer. Titer Rubella 2/2018 imune Mar-18 Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps 2/2018 imune   yes Titer: 2/2018  
    2/2018 imune Titer Measles 2/2018 imune     imune  

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