Vaccine Recommendation Assessment EN ID We’ll ask a few short questions and build a quick plan for you. Takes ~2 minutes Contact Full name Please enter a valid name (letters only, 2–80 characters). Email Please enter a valid email (e.g., name@example.com). WhatsApp / Phone i Please enter a valid phone number (9–12 digits). About you Date of birth (YYYY-MM-DD) Sex at birth Select… Male Female Intersex Prefer not to say Pregnant / planning (next 1 month)? No Yes Helps us avoid certain vaccines if needed. Conditions (select any that apply) Choose None if none apply. Heart disease Lung/asthma Diabetes Kidney disease Liver disease Asplenia Immunosuppressed None of the above Select at least one condition (or choose "None"). Severe allergies (select any) Choose None if none apply. Egg Yeast Gelatin Latex Neomycin Streptomycin None Select at least one allergy (or choose "None"). Work, living, lifestyle Occupation Select… Healthcare Lab Teacher/Childcare Animal handler/Vet Food handler Public-facing Other Living situation Select… Dorm/Barracks With newborn With elderly/immunocompromised Standard household Lifestyle risks Multiple sexual partners MSM (Male-sex-Male) Injection drug use None Select at least one lifestyle option (or choose "None"). Travel (next 1–6 months) & Residence Hajj/Umrah NoYes Yellow-fever country i NoYes Rural SE Asia/South Asia in ≥1 mo i NoYes Animals / trekking / caving NoYes Polio-risk / booster required NoYes SEA/South Asia/LatAm in ≥1 mo i NoYes Consent I agree this tool provides general recommendations and does not replace a clinician’s assessment. Please complete all required fields. ✓ All required fields have been answered. Get my recommendations Clear Your plan opens on the next page. You can download a PDF there.
