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
259 PPD    Shot 1/  10/1995 If 3rd shot  May-97 Nov-00 tdap Have had Shot 1/ 5/1997 Nov-17
  X-Ray Shot 2/  1/1996 over 22yrs need titer. Titer Rubella   Nov-17 Chickenpox? Shot 2/ 6/2008 Need lot # for flu
  Shot 3/  11/2000 Date/Result Titer Mumps     unk Titer:
      Titer Measles      
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
731 PPD    Shot 1/  8/1997 If 3rd shot  Nov-98 Jul-17 td Have had Shot 1/10/2000 Not 2017/18
  X-Ray Shot 2/  9/1997 over 22yrs need titer. Titer Rubella   Nov-17 Chickenpox? Shot 2/11/2009  
  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
504 PPD    Shot 1/  11/2017 If 3rd shot      tdap Have had Shot 1/ Oct-17
  X-Ray Shot 2/  n/a over 22yrs need titer. Titer Rubella 10/2017 imune Oct-17 Chickenpox? Shot 2/  
  Shot 3/  n/a Date/Result Titer Mumps 10/2017 imune   yes Titer: 10/2017  
    10/2017 low Titer Measles 10/2017 imune     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
100 PPD   11/2017 Shot 1/  10/1999 If 3rd shot  Nov-96 Jul-99 tdap Have had Shot 1/ Nov-17
  X-Ray Shot 2/  6/2000 over 22yrs need titer. Titer Rubella   May-10 Chickenpox? Shot 2/  
  Shot 3/  8/2006 Date/Result Titer Mumps     yes Titer: 11/2017  
      Titer Measles     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
821 PPD   11/2017 Shot 1/  10/2017 If 3rd shot  Oct-17 Nov-17 tdap Have had Shot 1/ Oct-17
  X-Ray Shot 2/  11/2017 over 22yrs need titer. Titer Rubella   Oct-17 Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps     yes Titer: 11/2017  
    11/2017 imune Titer Measles     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
357 PPD    Shot 1/  3/1996 If 3rd shot  Jul-97 Oct-00   Have had Shot 1/ 10/2000  
  X-Ray Shot 2/  6/1996 over 22yrs need titer. Titer Rubella     Chickenpox? Shot 2/  
  Shot 3/  2/1997 Date/Result Titer Mumps     unk Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
179 PPD   11/2017 Shot 1/  8/2009 If 3rd shot  Dec-08 Nov-17 tdap Have had Shot 1/ 11/2017 Oct-17
  X-Ray Shot 2/  1/2009 over 22yrs need titer. Titer Rubella   Apr-14 Chickenpox? Shot 2/ 12/2017  
  Shot 3/  12/2008 Date/Result Titer Mumps     yes Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
808 PPD    Shot 1/  10/2017 If 3rd shot  Oct-17 n/a tdap Have had Shot 1/ 10/2017 Oct-17
  X-Ray Shot 2/  n/a over 22yrs need titer. Titer Rubella 10/2017 imune Oct-17 Chickenpox? Shot 2/ n/a  
  Shot 3/  n/a Date/Result Titer Mumps 10/2017 low   unk Titer: 10/2017  
    10/2017 low Titer Measles 10/2017 low     low  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
944 PPD    Shot 1/  3/1994 If 3rd shot  Apr-95 Mar-98 tdap Have had Shot 1/ Oct-17
  X-Ray Shot 2/  3/1994 over 22yrs need titer. Titer Rubella   Jul-16 Chickenpox? Shot 2/  
  Shot 3/  12/1994 Date/Result Titer Mumps     unk Titer: 1/2017  
      Titer Measles     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
816 PPD    Shot 1/  4/1996 If 3rd shot        Have had Shot 1/ 8/2001  
Need varicella titer or 2nd shot X-Ray Shot 2/  5/1996 over 22yrs need titer. Titer Rubella     Chickenpox? Shot 2/  
  Shot 3/  2/1997 Date/Result Titer Mumps     yes Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
102 PPD   10/2017 Shot 1/   If 3rd shot  Jun-12   tdap Have had Shot 1/ 6/2012 Oct-17
  X-Ray Shot 2/   over 22yrs need titer. Titer Rubella 10/2017 imune Jun-12 Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps 10/2017 imune   unk Titer: 10/2017  
    10/2017 imune Titer Measles 1/2017 imune     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
126 PPD    Shot 1/  10/2002 If 3rd shot  Aug-96 Feb-90 tdap Have had Shot 1/ Nov-17
  X-Ray Shot 2/  11/2017 over 22yrs need titer. Titer Rubella   Nov-17 Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps     unk Titer:  
    Waiver Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
765 PPD   7/2017 Shot 1/  11/2016 If 3rd shot  Jul-17 Aug-17 tdap Have had Shot 1/ 7/2017 Sep-17
  X-Ray Shot 2/  7/2017 over 22yrs need titer. Titer Rubella   Jul-17 Chickenpox? Shot 2/ 8/2017 need flu lot number documentation
  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
827 PPD   9/2017 Shot 1/  7/2016 If 3rd shot  Apr-12 May-10 tdap Have had Shot 1/ 9/2017 Sep-17
  X-Ray Shot 2/  10/2001 over 22yrs need titer. Titer Rubella   Sep-17 Chickenpox? Shot 2/ 3/1997  
  Shot 3/  5/2002 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
103 tspot 8/2017 Shot 1/   If 3rd shot      tdap Have had Shot 1/ Oct-17
  X-Ray Shot 2/   over 22yrs need titer. Titer Rubella 5/2011 imune Jan-10 Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps 5/2011 imune     Titer: 8/2013  
    5/2011 imune Titer Measles 5/2011 imune     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
401 PPD   12/2017 Shot 1/  9/2017 If 3rd shot      tdap Have had Shot 1/ 10/2017 Sep-17
  X-Ray Shot 2/  10/2017 over 22yrs need titer. Titer Rubella 9/2017 imune Sep-17 Chickenpox? Shot 2/  
  Shot 3/  12/2017 Date/Result Titer Mumps 9/2017 imune   no Titer: 9/2017  
      Titer Measles  9/2017 imune     Low  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
858 PPD    Shot 1/  12/2005 If 3rd shot  Mar-97 Mar-02 tdap Have had Shot 1/ 12/2005 Oct-17
  X-Ray Shot 2/  2/2006 over 22yrs need titer. Titer Rubella   Oct-17 Chickenpox? Shot 2/ 10/2017  
  Shot 3/  10/2017 Date/Result Titer Mumps     unk Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
458 PPD   10/2017 Shot 1/   If 3rd shot  Oct-17   tdap Have had Shot 1/ Oct-17
  X-Ray Shot 2/   over 22yrs need titer. Titer Rubella   Oct-17 Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps     yes Titer: 10/2017  
    10/2017 imune Titer Measles     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
180 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
831 PPD    Shot 1/  7/1992 If 3rd shot  Oct-93 Jun-97 tdap Have had Shot 1/ 11/2017 Nov-17
  X-Ray Shot 2/  9/1992 over 22yrs need titer. Titer Rubella   Mar-17 Chickenpox? Shot 2/ 7/1996  
  Shot 3/  7/1993 Date/Result Titer Mumps     unk Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
625 PPD    Shot 1/  6/2017 If 3rd shot  Jun-93 May-97 tdap Have had Shot 1/ Nov-17
  X-Ray Shot 2/  9/2017 over 22yrs need titer. Titer Rubella   Jun-17 Chickenpox? Shot 2/  
  Shot 3/  7/1992 Date/Result Titer Mumps     yes Titer: 11/2017  
      Titer Measles     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
838 PPD   11/2017 Shot 1/   If 3rd shot      tdap Have had Shot 1/ Sep-17
  X-Ray Shot 2/   over 22yrs need titer. Titer Rubella 8/2017 imune Apr-15 Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps 8/2017 imune     Titer: 8/2017  
    8/2017 imune Titer Measles 8/2017 imune     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
797 PPD    Shot 1/  7/1998 If 3rd shot  Jul-99 Aug-92   Have had Shot 1/ 10/1999  
  X-Ray Shot 2/  9/1998 over 22yrs need titer. Titer Rubella     Chickenpox? Shot 2/  
  Shot 3/  5/1999 Date/Result Titer Mumps     unk Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
156 PPD    Shot 1/  4/1993 If 3rd shot  Mar-94   tdap Have had Shot 1/ 4/2000  
  X-Ray Shot 2/  5/1993 over 22yrs need titer. Titer Rubella   Feb-11 Chickenpox? Shot 2/ 7/2009  
  Shot 3/  9/1993 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
510 PPD   9/2017 Shot 1/  8/2001 If 3rd shot  Sep-90 Jun-93   Have had Shot 1/ Nov-17
  X-Ray Shot 2/  9/2001 over 22yrs need titer. Titer Rubella     Chickenpox? Shot 2/  
  Shot 3/  6/2002 Date/Result Titer Mumps     yes Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
889 PPD   10/2017 Shot 1/   If 3rd shot      tdap Have had Shot 1/ Oct-17
  X-Ray Shot 2/   over 22yrs need titer. Titer Rubella 10/2017 imune Oct-17 Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps 10/2017 imune   unk Titer: 10/2017  
    10/2017 imune Titer Measles 10/2017 imune     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
416 PPD    Shot 1/  3/2017 If 3rd shot      tdap Have had Shot 1/ Oct-17
  X-Ray Shot 2/  11/2017 over 22yrs need titer. Titer Rubella   Nov-17 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
687 gold   9/2017 Shot 1/   If 3rd shot      tdap Have had Shot 1/ Sep-17
  X-Ray Shot 2/   over 22yrs need titer. Titer Rubella 9/2017 imune Sep-17 Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps 9/2017 imune   yes Titer: 9/2017  
    9/2017 imune Titer Measles 9/2017 imune     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
874 PPD    Shot 1/  10/2017 If 3rd shot      tdap Have had Shot 1/10/2017 Oct-17
Need 2nd varicella in 30 days X-Ray Shot 2/  11/2017 over 22yrs need titer. Titer Rubella 10/2017 imune Oct-17 Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps 10/2017 imune   unk Titer:  
    waiver Titer Measles 10/2017 imune        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
375 PPD    Shot 1/  2/1996 If 3rd shot  Jan-97 Feb-00 tdap Have had Shot 1/ 8/2001 Nov-17
  X-Ray Shot 2/  3/1996 over 22yrs need titer. Titer Rubella   Nov-09 Chickenpox? Shot 2/ 12/2016  
  Shot 3/  12/1996 Date/Result Titer Mumps     unk Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
994 PPD   8/2017 Shot 1/  8/2003 If 3rd shot  Aug-92 Jul-95 tdap Have had Shot 1/ Sep-17
  X-Ray Shot 2/  11/2003 over 22yrs need titer. Titer Rubella   Aug-17 Chickenpox? Shot 2/  
  Shot 3/  8/2017 Date/Result Titer Mumps       Titer: 8/2017  
      Titer Measles     lmune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
496 PPD   1/2017 Shot 1/  10/2017 If 3rd shot      tdap Have had Shot 1/ Oct-17
  X-Ray Shot 2/   over 22yrs need titer. Titer Rubella 10/2017 imune Aug-15 Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps 10/2017 imune   yes Titer: 10/017  
    10/2017 low Titer Measles 10/2017 iomune     imune  
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
883 PPD    Shot 1/  6/2003 If 3rd shot  Jun-03 Jun-03 tdap Have had Shot 1/  
  X-Ray Shot 2/  6/2003 over 22yrs need titer. Titer Rubella   Oct-09 Chickenpox? Shot 2/  
  Shot 3/  12/2003 Date/Result Titer Mumps       Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
355 PPD   6/2017 Shot 1/  1/1995 If 3rd shot  Feb-00 Dec-00 tdap Have had Shot 1/ 3/1999  
  X-Ray Shot 2/  2/1995 over 22yrs need titer. Titer Rubella   Jun-17 Chickenpox? Shot 2/ 6/2010  
  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
355 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
729 PPD   11/2017 Shot 1/  7/1997 If 3rd shot  Jun-98 Jun-01 tdap Have had Shot 1/ 5/2000 Oct-17
  X-Ray Shot 2/  3/1999 over 22yrs need titer. Titer Rubella   May-10 Chickenpox? Shot 2/ 6/2007  
  Shot 3/  6/1997 Date/Result Titer Mumps     unk Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
116 PPD    Shot 1/  11/1999 If 3rd shot  Aug-00 Sep-03 tdap Have had Shot 1/ 8/2000 Nov-17
  X-Ray Shot 2/  1/2000 over 22yrs need titer. Titer Rubella   Sep-10 Chickenpox? Shot 2/ 9/2010  
  Shot 3/  6/2000 Date/Result Titer Mumps     unk Titer:  
      Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
110 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
911 PPD   7/2017 Shot 1/  11/1995 If 3rd shot  Feb-97 Mar-00 tdap Have had Shot 1/ 3/1998 Sep-17
need lot # X-Ray Shot 2/  12/1995 over 22yrs need titer. Titer Rubella   May-17 Chickenpox? Shot 2/ 2/2014  
  Shot 3/  4/1996 Date/Result Titer Mumps     unk Titer:  
    5/2017 imune Titer Measles        
ID TB Hep B Hep B Titer MMR MMR TDAP/Td Pox Varicella Flu
223 PPD    Shot 1/   If 3rd shot        Have had Shot 1/  
Transfer from Aug 2017 class X-Ray Shot 2/   over 22yrs need titer. Titer Rubella     Chickenpox? Shot 2/  
  Shot 3/   Date/Result Titer Mumps       Titer:  
      Titer Measles        

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