VACCINE REPORT

WARREN COUNTY DAILY VACCINATION REPORT

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Date: *

Reporting Individual: *

Vaccine Site: *

Number of 1st Dose Vaccines Administered (Moderna): *

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Number of 2nd Dose Vaccines Administered (Moderna): *

Booster Vaccine Dose (Moderna): *

Additional Vaccine Dose (Moderna): *

Number of J&J Vaccines Administered: *

Booster Vaccine Dose (J&J): *

Number of 1st Dose Vaccines Administered (Pfizer): *

Number of 2nd Dose Vaccines Administered (Pfizer): *

Booster Vaccine Dose (Pfizer): *

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Phone: 908-835-2047

Fax: 908-835-2063

Email: wcoem@co.warren.nj.us