Pneumococcal Decline

If you have been contacted by the Practice or are eligible to receive a free Pneumococcal vaccination for this year’s campaign (eligibility below) and wish to decline please complete the following information.

If you change your mind during the campaign, you can still have the vaccine and can arrange this by contacting the Practice.
Full Name
Date of Birth
DD slash MM slash YYYY

Who should have the pneumococcal vaccination?

A pneumococcal infection can affect anyone. However, some people are at higher risk of serious illness and can be given the pneumococcal vaccination on the NHS.

These include:
  • Babies
  • adults aged 65 or over
  • anyone from the ages of 2-64 with a health condition that increases their risk of pneumococcal infection
  • anyone at occupational risk, such as a welder

Learn more at: