Date: April 9, 2024
TO: Parents/Guardians of Rising 12th Grade Students
FROM: Gloucester County Public Schools and the Three Rivers Health District
SUBJECT: Meningococcal Vaccination for rising 12th Graders
Virginia Code § 22.1-271.2. requires all students who are entering the 12th grade to receive a booster dose of the MenACWY meningococcal vaccine. If your child has already received their booster vaccination, please send a copy of the vaccination record to the school.
The Three Rivers Health District will provide Meningococcal vaccines during the school day on
Monday, May 6, 2024, from 9:30 am – 10:30 am.
If your child has private insurance/FAMIS/Medicaid, please enter the coverage information on the consent form as requested along with a copy of the front and back of your insurance card. Please return a completed vaccination consent form to school by Friday, May 3, 2024, to ensure adequate vaccine supply is ordered.
Attached are two forms for your review:
1. 2024 Student Vaccination Consent Form
2. Meningococcal Vaccine Information Statement
English- https://www.immunize.org/vis/meningococcal_acwy.pdf
Spanish- https://www.immunize.org/vis/spanish_meningococcal.pdf
Ensure your child is wearing clothing that allows his/her arm to be easily accessible.
If you have any questions, please contact your school nurse.
Carol Tassone, (804) 693-2641
Sandra (Nicole) Hollingsworth, RN (804) 693-7855