The Evanston Health & Human Services Department and Illinois Department of Public Health are adopting CDC Guidance regarding second boosters and a first booster for 5 to 11 year olds.
 
Second Booster Eligibility:
- Adults ages 50 years and older
- People ages 12 years and older who are moderately to severely immunocompromised.

First booster Eligibility for 5 - 11 year olds:
- Most children 5-11 yeas of age with at least 5 months after the final dose in primary series
- Children who are moderately or severly immunocompromised, at least 3 months after the final dose in primary series.

It is  recommended to schedule an appointment by visiting vaccines.gov. You can select a time and location that is most convenient to you.

However, if you would like to receive a booster dose from the City of Evanston's Health & Human Services Department, please fill out this short survey. By completing this form you are not scheduling an appointment but will be added to a list to receive updates on the booster shot process.

This survey is HIPAA compliant, meaning your health information will be protected.

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Email

Question Title

* 4. Phone Number

Question Title

* 5. Date of Birth

Date

Question Title

* 6. Which vaccine/booster have you received? (Check all that apply)

Question Title

* 7. What date did you receive your last booster?

Date

Question Title

* 8. What date did you complete your final dose of primary series for 5-11 year olds?

Date
( Privacy & Cookie Notice

T