COVID-19 IMMUNIZATION SIGN UP

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COVID-19 IMMUNIZATION SIGN UP - READ CAREFULLY

Harrington HealthCare System is currently offering vaccination for all those who qualify for vaccination under

Phase 1

Phase 2/Group 1 includes all those 75 and older

Phase 2/Group 2 includes:
Adults 65 and over
Adults who live or work in public and private low income and affordable senior housing
People with 2 or more certain medical conditions that cause individuals to be at an increased risk of severe
illness from COVID-19:
-Asthma (moderate-to-severe)*
-Cancer
-Chronic kidney disease
-COPD (chronic obstructive pulmonary disease)
-Down Syndrome
-Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
-Immunocompromised state (weakened immune system) from solid organ transplant
-Obesity (body mass index [BMI] of 30 kg/m2 or higher but < 40 kg/m2)
-Severe Obesity (BMI ≥ 40 kg/m2)
-Pregnancy
-Sickle cell disease
-Smoking
-Type 2 diabetes mellitus

Please refer to https://www.mass.gov/covid-19-vaccine-in-massachusetts for more details

***You must qualify under Phase 1 or Phase 2/Groups 1 or 2 to be eligible for vaccination, no exceptions.

***At your appointment, you may be asked for the following information:

Insurance card. Vaccination is free whether you have insurance or not, if you have insurance, please bring that information with you.

Identification, examples include:
-Employer-issued ID card that includes your name and title; or
-Government-issues identification or license; or
-Recent pay stub

You may get a vaccination even if you do not have a driver’s license of social security number

***Visit this link to ensure you qualify for vaccination under Phase 1or Phase 2/Groups 1 or 2 of the COVID-19 Vaccine Distribution Timeline https://www.mass.gov/info-details/covid-19-vaccine-distribution-timeline-phase-overview#phase-1-

***This is for initial immunization sign-up only. If you have already received the initial vaccine you would have been given your return appointment. An appointment reminder for your 2nd vaccine dose will be sent via call/text message to your phone number on file.***

***For those who have a history of anaphylactic reactions, please contact the vaccination center at 508-765-8160, as your visit may need to be vaccinated in a hospital setting.

***Vaccination is only offered to those 18 years of age and older

***Vaccination Center Location: Southbridge Community Center - 153 Chestnut St, Southbridge MA. 01550

Select which criteria in Phase 1 or Phase 2, Step1 that qualifies you for vaccination: More detailed descriptions available here: https://www.mass.gov/info-details/covid-19-vaccine-distribution-timeline-phase-overview#phase-1- *

65 years old or older - Phase 2, Step 1

Have 2 or more certain medical conditions (answer next question)

Live or work in public and private low income and affordable senior housing

Clinical and non-clinical health care workers doing direct and COVID-facing care

Long term care facilities, rest homes and assisted living facilities

Emergency medical services, police, and fire

Congregate care settings

Home-based health care workers

Health care workers doing non-COVID-facing care

Other:

Required

If you qualify based on medical conditions, please specify two or more certain medical conditions that cause you to be at risk for severe illness. For more info visit: https://www.mass.gov/info-details/covid-19-vaccinations-for-individuals-with-certain-medical-conditions

Option 1

Cancer

Chronic Kidney Disease

COPD (chronic obstructive pulmonary disease)

Down Syndrome

Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies

Immunocompromised state (weakened immune system) from solid organ transplant

Obesity and severe obesity (body mass index [BMI] of 30 kg/m2 or higher)

Pregnancy

Sickle cell disease

Smoking

Type 2 diabetes mellitus

Asthma (moderate-to-severe)

Occupation - skip if 75 or older

Please describe your specific job function that qualifies you under Phase 1:

Name and Town of Employer - skip if 75 or older

Please list your employer and town. Vaccination staff may verify your employment.

Employer Telephone Number - skip if 75 or older

Employment Status - skip if 75 or older

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