(Please select below)
Are you younger than 13 years of age?
Are you 65 years of age or older?
If aged 65 years or older, you are eligible for a funded vaccination.
Are you allergic to eggs or egg products?
Are you allergic to chicken proteins?
Are you allergic to Neomycin or other vaccine components?
Are you currently taking Warfarin?
Have you ever had a severe reaction to any vaccine?
Are you taking immunosuppressant medicines?
Have you had a severe allergic reaction from any cause?
(Excluding insect bites and bee stings)
Do you have any neurological conditions?
(Potential risk of recurrence of Guillain-Barre syndrome, neuritis, encephalomyelitis and other)