Annex 6 — Vaccination, prophylaxis and related certificate Internationale Gezondheidsregeling (2005)
Vaccination, prophylaxis and related certificate
1 Vaccines or other prophylaxis specified in Annex 7 or recommended under these Regulations shall be of suitable quality; those vaccines and prophylaxis designated by WHO shall be subject to its approval. Upon request, the State Party shall provide to WHO appropriate evidence of the suitability of vaccines and prophylaxis administered within its territory under these Regulations.
2 Persons undergoing vaccination or other prophylaxis under these Regulations shall be provided with an international certificate of vaccination or prophylaxis (hereinafter the “certificate’’) in the form specified in this Annex. No departure shall be made from the model of the certificate specified in this Annex.
3 Certificates under this Annex are valid only if the vaccine or prophylaxis used has been approved by WHO.
4 Certificates must be signed in the hand of the clinician, who shall be a medical practitioner or other authorized health worker, supervising the administration of the vaccine or prophylaxis. The certificate must also bear the official stamp of the administering centre; however, this shall not be an accepted substitute for the signature.
5 Certificates shall be fully completed in English or in French. They may also be completed in another language, in addition to either English or French.
6 Any amendment of this certificate, or erasure, or failure to complete any part of it, may render it invalid
7 Certificates are individual and shall in no circumstances be used collectively. Separate certificates shall be issued for children.
8 A parent or guardian shall sign the certificate when the child is unable to write. The signature of an illiterate shall be indicated in the usual manner by the person’s mark and the indication by another that this is the mark of the person concerned.
9 If the supervising clinician is of the opinion that the vaccination or prophylaxis is contraindicated on medical grounds, the supervising clinician shall provide the person with reasons, written in English or French, and where appropriate in another language in addition to English or French, underlying that opinion, which the competent authorities on arrival should take into account. The supervising clinician and competent authorities shall inform such persons of any risk associated with non-vaccination and with the non-use of prophylaxis in accordance with paragraph 4 of Article 23.
10 An equivalent document issued by the Armed Forces to an active member of those Forces shall be accepted in lieu of an international certificate in the form shown in this Annex if:
a) it embodies medical information substantially the same as that required by such form; and
b) it contains a statement in English or in French and where appropriate in another language in addition to English or French recording the nature and date of the vaccination or prophylaxis and to the effect that it is issued in accordance with this paragraph.
Vaccine or prophylaxis | Date | Signature and professional status of supervising clinician | Manufacturer and batch No. of vaccine or prophylaxis | Certificate valid from ....... until ............ | Official stamp of administe-ring centre
1.
2.
This certificate is valid only if the vaccine or prophylaxis used has been approved by the World Health Organization.
This certificate must be signed in the hand of the clinician, who shall be a medical practitioner or other authorized health worker, supervising the administration of the vaccine or prophylaxis. The certificate must also bear the official stamp of the administering centre; however, this shall not be an accepted substitute for the signature.
Any amendment of this certificate, or erasure, or failure to complete any part of it, may render it invalid.
The validity of this certificate shall extend until the date indicated for the particular vaccination or prophylaxis. The certificate shall be fully completed in English or in French. The certificate may also be completed in another language on the same document, in addition to either English or French.
- Regeling
- Internationale Gezondheidsregeling (2005)
- Soort
- Verdrag
- Geldend vanaf
- 11-07-2016
- BWB-id
- BWBV0006969
- Versie
- 2016-07-11_0