Following extensive assessment of the risks and benefits of vaccinations for 5 to 11 year olds, the JCVI has updated its advice for this age group. Children aged 5 to 11 who are living with someone (of any age) who is immunosuppressed, should be offered a primary course of COVID-19 vaccination. If you are a parent or guardian of a child living in North Wales who fits into the above age group and criteria, please fill in the following form to request a COVID-19 vaccination for the child.
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1. Full name of parent/ guardian requesting for the child to be vaccinated *
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2. Parent/ Guardian's telephone number *
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3. Full name of at least one person who is immunosuppressed and living in the same household as the child. *
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4. Following on from the previous question - date of birth of the immunosuppressed person living with the child: *
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5. Full name of the 5-11 year old child *
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6. Date of birth of the 5-11 year old child *
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7. Address of the 5-11 year old child *
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8. Postcode of the 5-11 year old child *