COVID-19 Vaccination Eligibility and Scheduling

Person Getting Vaccinated
El Camino Health Mountain View Outpatient Pharmacy is Now Offering COVID-19 Vaccination to the General Public.
  1. 1st doses of the COVID-19 vaccine. You are eligible if you are:
    1. 12 years of age or older
  2. Pfizer COVID-19 Vaccine Booster shots after 6 months of receiving your 2nd dose. You are eligible if you are:
    1. 65 years of age and older OR
    2. 18 through 64 years of age at high risk of severe COVID-19 OR
    3. 18 through 64 years of age whose frequent institutional or occupational exposure to SARS-CoV-2 puts them at high risk of serious complications of COVID-19 including severe COVID-19

    Please Note: Boosters are currently not approved for those who received Moderna or Johnson and Johnson (Janssen) COVID-19 vaccines.
    Please Note: If you are unsure if you qualify, talk with your primary care provider or specialist. More information can be found here.
  3. Pfizer/Moderna COVID-19 additional doses. You are eligible if you are:
    1. 12 years of age and older AND
    2. Moderately to severely immunocompromised.

    Please Note: If you are unsure if you qualify, talk with your primary care provider or specialist. More information can be found here.

Please note: If you are scheduling for a minor or another individual who is legally unable to provide consent for their vaccination, a person legally authorized to make healthcare decisions for the individual must be present at the appointment to sign the consent form, or the forms need to be printed and signed by the legal representative ahead of time and brought to the vaccination appointment. In addition, if the legal representative is not present at the appointment, the legal representative must be available by phone at the time of the appointment if discussion is needed with the decision-maker.

Which best describes what you would like to schedule?
How old are you, or if you are scheduling for someone else, how old is the person you are scheduling an appointment for?

Have you received antibody therapy (monoclonal antibodies or convalescent serum) to treat COVID-19 in the last 90 days?
If you have been treated with antibody therapy (monoclonal antibodies or convalescent serum) for COVID-19, you should delay your COVID-19 vaccination until 90 days after the treatment was completed.
Have you ever had an allergic reaction to:
  1. A component of the COVID-19 Vaccine including either of the following:
    1. Polyethylene glycol (PEG), which is found in some medications, such as laxatives and preparations for colonoscopy procedures.
    2. Polysorbate, which is found in some vaccines, film coated tablets, and intravenous steroids.
  2. A previous dose of COVID-19 vaccine.
  3. A vaccine or injectable therapy that contains multiple components, one of which is a COVID-19 vaccine component, but it is not known which component elicited the immediate reaction.

This would include a severe allergic reaction (e.g., anaphylaxis) that required treatment with epinephrine or EpiPen® or that caused you to go to the hospital. It would also include an allergic reaction that occurred within 4 hours that caused hives, swelling, or respiratory distress, including wheezing.
If you have had an allergic reaction to one of the above items, then you should discuss your risk of allergic reaction with your primary care physician or a clinician at the vaccination site who may recommend the Johnson & Johnson vaccine or an mRNA vaccine (Pfizer or Moderna) depending on your situation and vaccine availability.
You are not currently eligible to schedule a COVID-19 vaccine due to your age. Currently, only those 12 and older can receive the COVID-19 vaccine.
Pfizer is the only COVID-19 vaccine authorized for people aged 12-17.

The Pfizer Vaccine Information sheet can be found here. A parent, guardian, or other person legally authorized to make healthcare decisions for the person being vaccinated must be present at the vaccination site and sign the consent form, or you need to print out a copy of the form, have a parent or guardian sign it, and then bring it to the vaccination appointment. In addition, if the parent, guardian, or other legal representative is not present at the appointment, they must be available by phone at the time of the appointment if discussion is needed with the decisionmaker.
Have you received antibody therapy (monoclonal antibodies or convalescent serum) to treat COVID-19 in the last 90 days?
If you have been treated with antibody therapy (monoclonal antibodies or convalescent serum) for COVID-19, you should delay your COVID-19 vaccination until 90 days after the treatment was completed.
Have you ever had an allergic reaction to:
  1. A component of the COVID-19 Vaccine including either of the following:
    1. Polyethylene glycol (PEG), which is found in some medications, such as laxatives and preparations for colonoscopy procedures.
    2. Polysorbate, which is found in some vaccines, film coated tablets, and intravenous steroids.
  2. A previous dose of COVID-19 vaccine.
  3. A vaccine or injectable therapy that contains multiple components, one of which is a COVID-19 vaccine component, but it is not known which component elicited the immediate reaction.

This would include a severe allergic reaction (e.g., anaphylaxis) that required treatment with epinephrine or EpiPen® or that caused you to go to the hospital. It would also include an allergic reaction that occurred within 4 hours that caused hives, swelling, or respiratory distress, including wheezing.
If you have had an allergic reaction to one of the above items, then you should discuss your risk of allergic reaction with your primary care physician or a clinician at the vaccination site who may recommend the Johnson & Johnson vaccine or an mRNA vaccine (Pfizer or Moderna) depending on your situation and vaccine availability.
How old are you, or if you are scheduling for someone else, how old is the person you are scheduling an appointment for?

You are not currently eligible to schedule a COVID-19 vaccine due to your age. Currently, only those 12 and older can receive the COVID-19 vaccine.
Have you received antibody therapy (monoclonal antibodies or convalescent serum) to treat COVID-19 in the last 90 days?
If you have been treated with antibody therapy (monoclonal antibodies or convalescent serum) for COVID-19, you should delay your COVID-19 vaccination until 90 days after the treatment was completed.
Have you ever had an allergic reaction to:
  1. A component of the COVID-19 Vaccine including either of the following:
    1. Polyethylene glycol (PEG), which is found in some medications, such as laxatives and preparations for colonoscopy procedures.
    2. Polysorbate, which is found in some vaccines, film coated tablets, and intravenous steroids.
  2. A previous dose of COVID-19 vaccine.
  3. A vaccine or injectable therapy that contains multiple components, one of which is a COVID-19 vaccine component, but it is not known which component elicited the immediate reaction.

This would include a severe allergic reaction (e.g., anaphylaxis) that required treatment with epinephrine or EpiPen® or that caused you to go to the hospital. It would also include an allergic reaction that occurred within 4 hours that caused hives, swelling, or respiratory distress, including wheezing.
If you have had an allergic reaction to one of the above items, then you should discuss your risk of allergic reaction with your primary care physician or a clinician at the vaccination site who may recommend the Johnson & Johnson vaccine or an mRNA vaccine (Pfizer or Moderna) depending on your situation and vaccine availability.
Pfizer is the only COVID-19 vaccine authorized for people aged 12-17.

The Pfizer Vaccine Information sheet can be found here. A parent, guardian, or other person legally authorized to make healthcare decisions for the person being vaccinated must be present at the vaccination site and sign the consent form, or you need to print out a copy of the form, have a parent or guardian sign it, and then bring it to the vaccination appointment. In addition, if the parent, guardian, or other legal representative is not present at the appointment, they must be available by phone at the time of the appointment if discussion is needed with the decisionmaker.
Have you received antibody therapy (monoclonal antibodies or convalescent serum) to treat COVID-19 in the last 90 days?
If you have been treated with antibody therapy (monoclonal antibodies or convalescent serum) for COVID-19, you should delay your COVID-19 vaccination until 90 days after the treatment was completed.
Have you ever had an allergic reaction to:
  1. A component of the COVID-19 Vaccine including either of the following:
    1. Polyethylene glycol (PEG), which is found in some medications, such as laxatives and preparations for colonoscopy procedures.
    2. Polysorbate, which is found in some vaccines, film coated tablets, and intravenous steroids.
  2. A previous dose of COVID-19 vaccine.
  3. A vaccine or injectable therapy that contains multiple components, one of which is a COVID-19 vaccine component, but it is not known which component elicited the immediate reaction.

This would include a severe allergic reaction (e.g., anaphylaxis) that required treatment with epinephrine or EpiPen® or that caused you to go to the hospital. It would also include an allergic reaction that occurred within 4 hours that caused hives, swelling, or respiratory distress, including wheezing.
If you have had an allergic reaction to one of the above items, then you should discuss your risk of allergic reaction with your primary care physician or a clinician at the vaccination site who may recommend the Johnson & Johnson vaccine or an mRNA vaccine (Pfizer or Moderna) depending on your situation and vaccine availability.
Please Note: Please bring a copy of your COVID-19 vaccine card or other proof of vaccination so that we can ensure you receive the correct vaccine.
Which COVID-19 vaccine did you previously receive?
Booster shots are currently not approved for those who previously received the Moderna COVID-19 Vaccine.
Booster shots are currently not approved for those who previously received the Johnson and Johnson (Janssen) COVID-19 Vaccine.
Has it been at least 6 months from your last dose?
Booster shots for the COVID-19 Pfizer vaccine must be at least 6 months from your 2nd dose.
Can you attest, under penalty of perjury, that you meet one of the following criteria:
  1. You are 65 years of age and older OR
  2. You are 18 through 64 years of age at high risk of severe COVID-19 OR
  3. You are 18 through 64 years of age whose frequent institutional or occupational exposure to SARS-CoV-2 puts them at high risk of serious complications of COVID-19 including severe COVID-19
COVID-19 booster shots are currently only for individuals who meet these criteria.
How old are you, or if you are scheduling for someone else, how old is the person you are scheduling an appointment for?

You are not currently eligible to schedule a COVID-19 vaccine due to your age. Currently, only those 18 and older can receive the COVID-19 booster vaccine.
You are not currently eligible to schedule a COVID-19 vaccine due to your age. Currently, only those 18 and older can receive the COVID-19 booster vaccine.
Have you received antibody therapy (monoclonal antibodies or convalescent serum) to treat COVID-19 in the last 90 days?
If you have been treated with antibody therapy (monoclonal antibodies or convalescent serum) for COVID-19, you should delay your COVID-19 vaccination until 90 days after the treatment was completed.
Have you ever had an allergic reaction to:
  1. A component of the COVID-19 Vaccine including either of the following:
    1. Polyethylene glycol (PEG), which is found in some medications, such as laxatives and preparations for colonoscopy procedures.
    2. Polysorbate, which is found in some vaccines, film coated tablets, and intravenous steroids.
  2. A previous dose of COVID-19 vaccine.
  3. A vaccine or injectable therapy that contains multiple components, one of which is a COVID-19 vaccine component, but it is not known which component elicited the immediate reaction.

This would include a severe allergic reaction (e.g., anaphylaxis) that required treatment with epinephrine or EpiPen® or that caused you to go to the hospital. It would also include an allergic reaction that occurred within 4 hours that caused hives, swelling, or respiratory distress, including wheezing.
If you have had an allergic reaction to one of the above items, then you should discuss your risk of allergic reaction with your primary care physician or a clinician at the vaccination site who may recommend the Johnson & Johnson vaccine or an mRNA vaccine (Pfizer or Moderna) depending on your situation and vaccine availability.
Please bring a copy of your COVID-19 vaccine card or other proof of vaccination so that we can ensure you receive the correct vaccine. At the vaccination site, you must attest that you qualify for an additional dose as someone who is moderately or severely immunocompromised as defined by the CDC. If you are unsure if you qualify, talk with your primary care provider or specialist. More information can be found here.

The CDC defines moderately or severely immunocompromised as people who have:
  • Been receiving active cancer treatment for tumors or cancers of the blood
  • Received an organ transplant and are taking medicine to suppress the immune system
  • Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
  • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response
Which COVID-19 vaccine did you previously receive?
Additional doses are currently not approved for those who previously received the Johnson and Johnson (Janssen) COVID-19 Vaccine. Please check back later to see if you qualify.
Has it been at least 28 days from your last dose?
Additional doses of the COVID-19 vaccine must be at least 28 days from your 2nd dose
How old are you, or if you are scheduling for someone else, how old is the person you are scheduling an appointment for?

You are not currently eligible to schedule a COVID-19 vaccine due to your age. Currently, only those 12 and older can receive the COVID-19 vaccine.
Pfizer is the only COVID-19 vaccine authorized for people aged 12-17.

The Pfizer Vaccine Information sheet can be found here. A parent, guardian, or other person legally authorized to make healthcare decisions for the person being vaccinated must be present at the vaccination site and sign the consent form, or you need to print out a copy of the form, have a parent or guardian sign it, and then bring it to the vaccination appointment. In addition, if the parent, guardian, or other legal representative is not present at the appointment, they must be available by phone at the time of the appointment if discussion is needed with the decisionmaker.
Have you received antibody therapy (monoclonal antibodies or convalescent serum) to treat COVID-19 in the last 90 days?
If you have been treated with antibody therapy (monoclonal antibodies or convalescent serum) for COVID-19, you should delay your COVID-19 vaccination until 90 days after the treatment was completed.
Have you ever had an allergic reaction to:
  1. A component of the COVID-19 Vaccine including either of the following:
    1. Polyethylene glycol (PEG), which is found in some medications, such as laxatives and preparations for colonoscopy procedures.
    2. Polysorbate, which is found in some vaccines, film coated tablets, and intravenous steroids.
  2. A previous dose of COVID-19 vaccine.
  3. A vaccine or injectable therapy that contains multiple components, one of which is a COVID-19 vaccine component, but it is not known which component elicited the immediate reaction.

This would include a severe allergic reaction (e.g., anaphylaxis) that required treatment with epinephrine or EpiPen® or that caused you to go to the hospital. It would also include an allergic reaction that occurred within 4 hours that caused hives, swelling, or respiratory distress, including wheezing.
If you have had an allergic reaction to one of the above items, then you should discuss your risk of allergic reaction with your primary care physician or a clinician at the vaccination site who may recommend the Johnson & Johnson vaccine or an mRNA vaccine (Pfizer or Moderna) depending on your situation and vaccine availability.
Have you received antibody therapy (monoclonal antibodies or convalescent serum) to treat COVID-19 in the last 90 days?
If you have been treated with antibody therapy (monoclonal antibodies or convalescent serum) for COVID-19, you should delay your COVID-19 vaccination until 90 days after the treatment was completed.
Have you ever had an allergic reaction to:
  1. A component of the COVID-19 Vaccine including either of the following:
    1. Polyethylene glycol (PEG), which is found in some medications, such as laxatives and preparations for colonoscopy procedures.
    2. Polysorbate, which is found in some vaccines, film coated tablets, and intravenous steroids.
  2. A previous dose of COVID-19 vaccine.
  3. A vaccine or injectable therapy that contains multiple components, one of which is a COVID-19 vaccine component, but it is not known which component elicited the immediate reaction.

This would include a severe allergic reaction (e.g., anaphylaxis) that required treatment with epinephrine or EpiPen® or that caused you to go to the hospital. It would also include an allergic reaction that occurred within 4 hours that caused hives, swelling, or respiratory distress, including wheezing.
If you have had an allergic reaction to one of the above items, then you should discuss your risk of allergic reaction with your primary care physician or a clinician at the vaccination site who may recommend the Johnson & Johnson vaccine or an mRNA vaccine (Pfizer or Moderna) depending on your situation and vaccine availability.
Has it been at least 28 days from your last dose?
Additional doses of the COVID-19 vaccine must be at least 28 days from your 2nd dose
How old are you, or if you are scheduling for someone else, how old is the person you are scheduling an appointment for?

You are not currently eligible to schedule a COVID-19 vaccine due to your age. Currently, only those 12 and older can receive the COVID-19 vaccine.
Pfizer is the only COVID-19 vaccine authorized for people aged 12-17.

The Pfizer Vaccine Information sheet can be found here. A parent, guardian, or other person legally authorized to make healthcare decisions for the person being vaccinated must be present at the vaccination site and sign the consent form, or you need to print out a copy of the form, have a parent or guardian sign it, and then bring it to the vaccination appointment. In addition, if the parent, guardian, or other legal representative is not present at the appointment, they must be available by phone at the time of the appointment if discussion is needed with the decisionmaker.
Have you received antibody therapy (monoclonal antibodies or convalescent serum) to treat COVID-19 in the last 90 days?
If you have been treated with antibody therapy (monoclonal antibodies or convalescent serum) for COVID-19, you should delay your COVID-19 vaccination until 90 days after the treatment was completed.
Have you ever had an allergic reaction to:
  1. A component of the COVID-19 Vaccine including either of the following:
    1. Polyethylene glycol (PEG), which is found in some medications, such as laxatives and preparations for colonoscopy procedures.
    2. Polysorbate, which is found in some vaccines, film coated tablets, and intravenous steroids.
  2. A previous dose of COVID-19 vaccine.
  3. A vaccine or injectable therapy that contains multiple components, one of which is a COVID-19 vaccine component, but it is not known which component elicited the immediate reaction.

This would include a severe allergic reaction (e.g., anaphylaxis) that required treatment with epinephrine or EpiPen® or that caused you to go to the hospital. It would also include an allergic reaction that occurred within 4 hours that caused hives, swelling, or respiratory distress, including wheezing.
If you have had an allergic reaction to one of the above items, then you should discuss your risk of allergic reaction with your primary care physician or a clinician at the vaccination site who may recommend the Johnson & Johnson vaccine or an mRNA vaccine (Pfizer or Moderna) depending on your situation and vaccine availability.
Have you received antibody therapy (monoclonal antibodies or convalescent serum) to treat COVID-19 in the last 90 days?
If you have been treated with antibody therapy (monoclonal antibodies or convalescent serum) for COVID-19, you should delay your COVID-19 vaccination until 90 days after the treatment was completed.
Have you ever had an allergic reaction to:
  1. A component of the COVID-19 Vaccine including either of the following:
    1. Polyethylene glycol (PEG), which is found in some medications, such as laxatives and preparations for colonoscopy procedures.
    2. Polysorbate, which is found in some vaccines, film coated tablets, and intravenous steroids.
  2. A previous dose of COVID-19 vaccine.
  3. A vaccine or injectable therapy that contains multiple components, one of which is a COVID-19 vaccine component, but it is not known which component elicited the immediate reaction.

This would include a severe allergic reaction (e.g., anaphylaxis) that required treatment with epinephrine or EpiPen® or that caused you to go to the hospital. It would also include an allergic reaction that occurred within 4 hours that caused hives, swelling, or respiratory distress, including wheezing.
If you have had an allergic reaction to one of the above items, then you should discuss your risk of allergic reaction with your primary care physician or a clinician at the vaccination site who may recommend the Johnson & Johnson vaccine or an mRNA vaccine (Pfizer or Moderna) depending on your situation and vaccine availability.

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