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Supporting Adult Health Preventive Screenings Matter The CCHD Nurse of the Day offers blood pressure checks, cholesterol screenings, and diabetes testing to help adults stay on top of their health. Immunizations for Adults Vaccines aren't just for kids. We provide adult vaccines like Tdap, shingles, flu, RSV, and COVID-19 to protect against serious illness. Support for Quitting Nicotine Ready to quit? We offer one-on-one support, free nicotine patches or gum, and resources to help you succeed. Referrals and Resource Navigation Not sure where to start? We can connect you to local healthcare providers and programs that fit your needs. Call 845-8518 and ask for the Outreach Program or checkout the Resource Guide .

Maternal, Child & Family Health Car Seat Safety Checks Get your car seat checked or installed by a certified technician - becuase safety on the road starts with a properly fitted seat. Developmental Milestones and Early Support We offer health screenings and connection to early intervention services through the Health Tracks program. Childhood Immunizations Vaccination is safe and it works! CCHD offers childhoold immunizations to protect against serious illness. WIC WIC helps income-eligible familes with healthy foods, nutrition tips, and support during pregnancy, infancy and early childhood. Referrals and Resource Navigation Not sure where to start? We can connect you to local healthcare providers and programs that fit your needs. Call 845-8518 and ask for the Outreach Program or checkout the Resource Guide .

City-County Health District Immunizations - vaccine schedules, expert guidance for all ages. Immunizations 701.845.8518 City-County Health District provides immunizations to children and adults. Vaccines help prevent illnesses that have serious effects, such as cancer, pneumonia, blindness, deafness or even death. Vaccines can prevent or minimize the worst effects of illness and reduce the spread to those at the highest risk. You are the ultimate decision-maker about your vaccine plan. Experiences with these illnesses can be more serious than you might expect and symptoms and outcomes vary for everyone. You can review many trusted resources to find more information that can help you feel confident in your decision about vaccines. Vaccine Schedule City-County Health District offers immunizations to children and adults: Children's Immunizations Parents want to do all they can to be sure their children are healthy and protected from diseases. Vaccination is the best way to do that. 2025 Recommended Immunizations for Birth through 6 Years Old Adolescent Immunizations As your children continue to grow, you want to continue to make sure your adolescents stay healthy and protected from disease. 2025 Recommended Immunizations for 7 through 18 Years Old Adult Immunizations Vaccines help adults stay healthy and able to meet their many obligations. Adults need to stay healthy so they can work, take care of their families and themselves, and fulfill other commitments in their lives. Vaccine Preventable Diseases City-County Health District offers vaccines to prevent the following diseases: Chickenpox What is Chickenpox? Chickenpox (varicella ) is a disease caused by a virus. Most people with chickenpox get very itchy blisters and sores all over their body. Chickenpox is spread person-to-person through the air. It is very contagious. Chickenpox can be a serious disease, especially in babies and adults. The disease can cause serious skin infections, pneumonia, brain damage, and even death. Chickenpox is especially dangerous for people whose immune systems are weak because of illness or medications. Chickenpox is still infecting people in the U.S. and the rest of the world. It is extremely contagious and can be spread by an infected person before they even know they’re sick. Vaccination is the most effective step you can take to be protected from this serious disease. Chickenpox Vaccine Schedule All children should get 2 doses of chickenpox vaccine starting at age 1. Some teens and adults may also need this vaccine if they didn’t get 2 doses of the vaccine or chickenpox disease when they were younger. How can I learn more? Varicella (Chickenpox): Questions & Answers Varciella Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. COVID-19 What is COVID-19? COVID-19 (coronavirus disease 2019) is a disease caused by a virus named SARS-CoV-2. It can be very contagious and spreads quickly. Over one million people have died from COVID-19 in the United States since early 2020. COVID-19 most often causes respiratory symptoms that can feel much like a cold, the flu, or pneumonia. COVID-19 may attack more than your lungs and respiratory system. Other parts of your body may also be affected by the disease. Most people with COVID-19 have mild symptoms, but some people become severely ill. Some people including those with minor or no symptoms will develop post-COVID conditions that may last for months or longer, these conditions are also called “long COVID.” Vaccination is the best way to protect yourself from serious COVID-19 illness. Vaccination also reduces the risk of long COVID. COVID-19 Vaccine Schedule All people age 6 months and older should be vaccinated against COVID-19. Children younger than age 5 years being vaccinated for the first time need two or three doses, depending upon the brand of vaccine used. People with moderate to severe immunocompromise for the first time need 2 or 3 doses, depending upon the brand of vaccine, and they may need to be revaccinated more frequently than most people. CDC updates its COVID-19 vaccination recommendations periodically. Ask your healthcare provider if you are up to date. How can I learn more? COVID-19 Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Diphtheria What is Diphtheria? Diphtheria is a serious disease caused by bacteria. The actual disease is caused when the bacteria release a toxin, or poison, into a person’s body. Diphtheria bacteria live in the mouth, throat, and nose of an infected person and can be passed to others by coughing or sneezing. Occasionally, transmission occurs from skin sores or through articles soiled with oozing from sores of infected people. Diphtheria can lead to severe breathing problems, heart problems, and paralysis. Death occurs in 5%–10% of people infected with diphtheria. Diphtheria was once a greatly feared illness in the United States. In the 1920s, there were between 100,000 and 200,000 cases of diphtheria each year with 13,000–15,000 deaths. Because of widespread immunization and better living conditions, diphtheria is now rare in the United States. Vaccination is the most effective step you can take to be protected from this serious disease. Outbreaks still occur around the world and typically coincide with a drop in immunization rates. Diphtheria Vaccine Schedule All children should get 5 doses of DTaP (diphtheria, tetanus, pertussis) vaccine, beginning at 2 months old. If your child misses a dose or gets behind schedule, make sure they get the next dose as soon as possible. For people age 7 years or older, diphtheria vaccine is found in Tdap (tetanus-diphtheria-pertussis) or Td (tetanus-diphtheria) vaccines. A dose of Tdap is needed for all children at age 11 or 12 years. Older teens and adults who have never had Tdap should receive one dose of Tdap vaccine and, after that, a Td or Tdap booster dose every 10 years. How can I learn more? Diphtheria: Questions & Answers DTaP (Diphtheria, Tetanus, Pertussis): Vaccine Information Sheet Tdap (Tetanus, Diphtheria, Pertussis): Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Hib (Haemophilus influenzae type B) What is Hib (Haemophilus influenzae type B) Hib (Haemophilus influenzae type b) is a serious disease caused by bacteria. Hib usually infects children younger than 5 years old. Hib is spread person-to-person through the air. Your child can get Hib disease from being around children or adults who have Hib bacteria in their nose or throat. These people may or may not appear sick. Hib can cause meningitis (infection of the brain and spinal cord). This can lead to permanent deafness and brain damage. Hib infection can also cause pneumonia, blood infections, and severe swelling in the throat that can block breathing and lead to death. Hib is common throughout the world. Each year, Hib sickens millions of children worldwide and kills about 200,000. The number of children infected by Hib has greatly declined in the U.S. because of vaccination, but an unvaccinated child can still get infected. Vaccination is the most effective step you can take to be protected from this serious disease. Hib ( Haemophilus influenzae type B) Vaccine Schedule You can protect your child from Hib with vaccination. All children should get 3 or 4 doses of Hib vaccine (depending on brand), starting at 2 months of age. If your child misses a dose or gets behind schedule, make sure they get the next dose as soon as possible. Some adults with certain high-risk conditions need vaccination with Hib. Talk to your healthcare provider to find out if you need this vaccine. How can I learn more? Haemophilus influenzae type b (Hib): Questions & Answers Haemophilus influenzae type b (Hib): Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Hepatitis A What is Hepatitis A? Hepatitis A is a serious liver disease caused by a virus. The virus is found in the feces (poop) of infected people. The hepatitis A virus is spread when invisible particles of feces (poop) get into your mouth. You can get hepatitis A by eating contaminated food or water, during sex, or just by living with an infected person. If you get infected with hepatitis A, your skin and eyes can turn yellow. You can get very sick for weeks and may need to be hospitalized, and even die. Some people don’t feel sick, but they can still spread the virus to others. You are more likely to be infected with the virus if you travel or work outside the U.S., use recreational drugs, have sex with an infected person, are homeless or have unstable housing arrangements, or care for a recently arrived unvaccinated child from a country where hepatitis A is common. You are more likely to have severe illness if you have chronic liver disease or HIV infection. Vaccination is the best way to prevent hepatitis A. Hepatitis A Vaccine Schedule Two doses of the hepatitis A vaccine are recommended for all children beginning at age 12 months. The two doses should be separated by at least 6 months. Children and adolescents through 18 years old who have not previously been vaccinated should be vaccinated routinely at any age. If you didn’t get the vaccine as a child, you should get vaccinated now if you are in a group at risk for hepatitis A, or just if you want to be protected. How can I learn more? Hepatitis A: Questions & Answers Hepatitis A: Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Hepatitis B What is Hepatitis B? Hepatitis B is a serious liver disease caused by a virus. You can get infected with hepatitis B if you have contact with an infected person’s blood or other body fluids. This can happen during sex, or just by sharing personal items like a toothbrush or razor. Babies can get infected from their mother during birth. If you get infected, you can be sick for weeks or months, be hospitalized, and even die. Some people don’t feel sick but can still spread the virus to others. For some people, the virus remains in their body for years. During this time, the virus can attack the liver and cause serious problems like liver failure or cancer. You are more likely to become infected with the virus if you have diabetes, are exposed to blood on your job, have sex with an infected person, travel to certain countries, or use recreational drugs. However, many people are not sure how they got infected. Vaccination is the best way to prevent hepatitis B. Hepatitis B Vaccine Schedule All children and teens in the U.S. should get 3 doses of hepatitis B vaccine. Infants should receive the first dose within 24 hours of birth. All adults through age 60 who have not previously been fully vaccinated should be vaccinated with 2 or 3 doses (depending upon brand). Adults age 60 and older who want to be protected from infection or who are at risk of hepatitis B should also be vaccinated. How can I learn more? Hepatitis B: Questions & Answers Hepatitis B: Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. HPV What is HPV? Human papillomavirus (HPV) is the most common sexually transmitted disease (STD) in the United States. HPV can lead to cervical cancer in women, as well as other oral, anal, and genital (sex organ) cancers in men and women. HPV also causes genital warts. HPV is usually spread during close skin-to-skin contact, such as during sex. You can spread (or get) the virus without knowing it. Sometimes babies become infected from their mothers during birth. HPV causes about 21,500 cases of cancer in women and about 15,500 cases of cancer in men every year in the United States. If you ever have sex, you are at risk. At least half of sexually active people get infected with HPV at some point in their lives. Vaccination is the best way to prevent HPV infection. However, HPV vaccination does not cure current HPV infections and it does not treat or cure existing pre-cancers or cancers caused by HPV. HPV Vaccine Schedule The vaccine is most effective if you get it before becoming sexually active. However, if you are already sexually active and age 26 or younger, you should still get vaccinated. Both girls and boys should complete the 2-dose HPV vaccine series before turning 13. Your child’s doctor may prefer to start at 9 years, while others start the series at 11–12 years. If the first dose is not given before age 15, 3 doses are needed. The vaccine may be helpful for some adults 27 through 45 years of age, and anyone in this age group should talk with their doctor about whether the vaccine would be helpful for them. The HPV vaccine series is given over 6 months. How can I learn more? Human Papillomavirus (HPV): Questions & Answers Human Papillomavirus (HPV): Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Influenza What is Influenza (flu)? Influenza is a serious disease caused by a virus. Influenza can make you feel miserable! Fever, cough, shaking chills, body aches, and extreme weakness are common symptoms. You can catch influenza from people who cough, sneeze, or even just talk around you. It is very contagious. Tragically, every year infants, children, teens, and adults die from influenza. Influenza is very unpredictable. No one knows how deadly influenza will be each year. Even if you have a mild case of influenza, you can still pass the virus on to your friends, family, and coworkers who could get very sick or even die. Influenza is most dangerous for people with health conditions like heart and lung disease, the very young and very old, and during pregnancy. But anyone can become seriously sick from influenza—even young, healthy people. Vaccination is the most effective step you can take to be protected from this serious disease. Influenza Vaccine Schedule Every person, beginning at age 6 months and continuing throughout their lifetime, should receive an annual vaccination against influenza. How can I learn more? Influenza: Questions & Answers Influenza: Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Measles What is Measles? Measles is a serious disease caused by a virus. Measles is spread person-to-person through the air. Measles can cause pneumonia, seizures, brain damage, and even death. The measles virus is very contagious, so when one person gets infected, it’s easy for the disease to spread. Measles is common around the world. Measles outbreaks occur each year due to infected people bringing the disease into the United States from other countries. Vaccination is the best way to prevent measles. Measles Vaccine Schedule In the United States, measles vaccine is part of the MMR (measles-mumps-rubella) vaccine. All children should get 2 doses of MMR (measles-mumps-rubella) vaccine starting at age 12 months. Some teens and adults may also need MMR vaccine if they didn’t get 2 doses when they were younger. How can I learn more? Measles: Questions & Answers MMR (Measles, Mumps & Rubella): Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Meningococcal Disease What is Meningococcal Disease? Meningococcal disease is a rare but life-threatening illness. It is caused by bacteria that infect the blood, brain, and spinal cord. It is one of the most serious causes of meningitis. The disease is spread from person to person. It is easily spread in crowded settings. You can catch meningitis from a person who looks healthy. Even with proper treatment, 10% to 15% of people with meningococcal disease die. Of the people who survive, as many as 20% suffer from some serious complication, such as loss of an arm or leg, brain damage, or permanent hearing loss. Meningitis can cause shock, coma, and death within hours of the first symptom. The disease is more likely to occur in older teens and young adults than in most other age groups. If you travel internationally or have certain medical conditions, you may also be at increased risk. Vaccination is the best way to prevent meningitis. Meningococcal Vaccine Schedule Vaccination is the best way to prevent meningitis. There are two different types of meningococcal vaccine: MenACWY (conjugate), and MenB (serogroup B) vaccines, as well as one combination vaccine, MenABCWY, that may be used when MenACWY and MenB vaccines are both needed. MenACWY is given to preteens and teens at 11 or 12 years old, and a booster dose is needed at 16 years old. Teens and young adults 16–23 years old may also be given MenB. People of all ages with certain medical conditions (particularly those without a properly functioning spleen) should be vaccinated and may need to receive booster doses throughout life. Travelers to certain countries should also get vaccinated. How can I learn more? Meningococcal: Questions & Answers Meningococcal Conjugate MCV4: Vaccine Information Sheet Meningococcal B: Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Mumps What is Mumps? Mumps is a serious disease caused by a virus. It is spread person-to-person through the air. Mumps typically causes painful swelling of the salivary glands near the cheeks, but it can also lead to deafness, brain or spinal cord infection, and painful swelling of the testicles. Mumps virus is very contagious, so when one person gets infected, it’s easy for the disease to spread. Mumps outbreaks can start when infected people bring the disease into the United States from other countries. Vaccination is the best way to prevent mumps. Vaccinated people who contract mumps because of very close contact with an infected person typically have a milder illness than unvaccinated people. Mumps Vaccine Schedule In the United States, mumps vaccine is available as part of the MMR (measles-mumps-rubella) vaccine. All children should get 2 doses of MMR vaccine starting at age 12 months. Some teens and adults may also need MMR vaccine if they didn’t get 2 doses when they were younger. How can I learn more? Mumps: Questions & Answers MMR (Measles, Mumps & Rubella): Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Pneumoccoccal Disease What is Pneumococcal Disease? Pneumococcal disease is a leading cause of serious illness throughout the world. Pneumococcal disease is caused by bacteria, which can lead to serious infections in the lungs, blood, and brain. You can catch the pneumococcal bacteria from people who cough or sneeze around you. Even if you get good medical care, pneumonia can be deadly. The disease is hard to treat because the bacteria have become resistant to antibiotics. Anyone can get pneumococcal disease. You are at greater risk if you are 65 or older, very young, have heart, lung, kidney, or liver disease, your spleen does not work, or your immune system is weakened. Vaccination is the best way to prevent pneumococcal infection. There are two types of pneumococcal vaccine—pneumococcal conjugate (two kinds, PCV20 [Prevnar 20] or PCV15 [Vaxneuvance]) and pneumococcal polysaccharide (PPSV [Pneumovax]). People who receive PCV20 do not need any other type of pneumococcal vaccine. Some people at high risk of pneumococcal disease who receive PCV15 may also need PPSV later. Pneumococcal Vaccine Schedule Children Children should receive 4 doses of PCV15 or PCV20 before age 2. The first dose should be given at 2 months, the second dose at 4 months, the third dose at 6 months, and the fourth dose at 12–15 months. Older children (through 4 years old) who were not vaccinated as infants need 1 or 2 doses of PCV15 or PCV20. Pneumococcal vaccines are not recommended for healthy children 5 years or older. Some children 2 years and older with certain health conditions (such as heart, lung, kidney, or liver disease or treatment with certain medications) may also need a dose of PCV20 alone or PCV15 followed later by PPSV. Adults Pneumococcal vaccine is not recommended for healthy adults 19–64 years old who do not smoke cigarettes. Adults 65 years and older should receive a dose of PCV20 alone or a dose of PCV15 followed a year later by a dose of PPSV. If you received a dose of PPSV before age 65 you should wait until after age 65 to receive a dose of PCV20 or PCV15. If you are older than 65 and after turning 65 you received a dose of an earlier pneumococcal conjugate vaccine, PCV13 (Prevnar13) in addition to PPSV, you may choose to get a dose of PCV20 at least 5 years after your most recent pneumococcal vaccine. If you are younger than 65 and are a smoker or have certain long-term chronic medical conditions, you might need PCV20 alone or a dose of PCV15 followed later by a dose of PPSV. Talk to your healthcare provider to find out if you need pneumococcal vaccination. How can I learn more? Pneumococcus: Questions & Answers Pneumococcal Conjugate Vaccine (Prevnar 20): Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Polio What is Polio? Polio is a disease caused by a virus. People have feared polio for hundreds of years because it can paralyze arm, leg, and breathing muscles. Polio virus is spread when invisible particles of feces (poop) get into your mouth. You can get polio by swallowing contaminated food or water or by putting contaminated objects in your mouth. Polio often causes no visible symptoms, but it can be very serious. Sometimes the infected person’s legs or arms become permanently paralyzed from the virus. Polio can also paralyze the breathing muscles and cause death. Polio has been eliminated from the United States and all parts of the Western Hemisphere, thanks to vaccination. But the virus is still present in some parts of the world, so your child would be at risk of infection if they traveled to certain countries without being vaccinated. The virus could also be brought into the U.S. by a traveler. Vaccination is the best way to prevent paralytic polio disease. Polio Vaccine Schedule You can protect your child from polio with vaccination. All children should get 3 doses of polio vaccine as babies (starting at 2 months of age) and a booster dose at 4-6 years old. If your child misses a dose or gets behind schedule, make sure they get the next dose as soon as possible. Adults in the United States age 18 years and older who are known or strongly suspected of being unvaccinated or incompletely vaccinated should also complete a 3-dose series. A single lifetime booster dose of polio vaccine may be given to some vaccinated adults who travel to areas where polio disease still exists. How can I learn more? Polio: Questions & Answers Polio: Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Rotavirus What is Shingles (Zoster)? Rotavirus is the most common cause of severe diarrhea in infants and young children. The virus can live on surfaces for months. It spreads when contaminated hands, toys, or other objects touch the mouth. Common symptoms of rotavirus disease include high fever, vomiting, and diarrhea. Children often stop eating and drinking and become dehydrated (lose fluids). Around the world, rotavirus kills about a half million infants and young children every year. Rotavirus is a very common disease in infants and young children. Almost all unvaccinated children get infected with rotavirus before they are 5 years old. Even if you wash your hands and keep everything really clean, your child can still get infected if not vaccinated. Vaccination is the best way to prevent rotavirus. Rotavirus Vaccine Schedule You can protect your child from rotavirus with vaccination. All children should get 2 or 3 doses (depending on the brand) of rotavirus vaccine starting at 2 months of age. They should not get any doses after reaching 8 months of age. The vaccine is a liquid that is swallowed. How can I learn more? Rotavirus: Questions & Answers Rotavirus: Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. RSV What is RSV (Respiratory Syncytial Virus)? Respiratory syncytial virus (RSV) is a common respiratory virus that usually causes mild cold-like symptoms. Almost all children have had their first RSV infection by their second birthday. People can be infected with RSV several times over a lifetime. Most people recover in a week or two, but RSV can be serious. RSV is a seasonal virus. Most cases occur between October and March each year in the continental United States. In parts of the United States with different weather patterns, such as Alaska or Hawaii, RSV may occur at different times of year. Infants and older adults are more likely to develop severe RSV and need hospitalization. RSV is the most common cause of hospitalization of infants younger than one year of age, usually because of difficulty breathing and dehydration. About one in 50 babies are hospitalized for RSV in the United States each year. Among older adults, those who are frail, elderly, or have chronic health conditions (especially heart or lung disease) are most likely to develop severe RSV disease. RSV causes about 6,000 to 10,000 deaths in older adults in the United States each year. There is no specific treatment or cure for RSV infection, but RSV vaccines and immunizations to prevent infection became available in 2023 to protect people at risk of severe disease. RSV in infants can be prevented in two ways. At certain times of year, RSV vaccine may be given during pregnancy. The mother’s immune system makes preventive antibodies against RSV that go through the placenta to the fetus and continue to protect the baby after birth. If the mother is not vaccinated, the baby may be protected by giving them RSV preventive antibodies in an injection after they are born, the same way vaccines are given. These antibodies help protect the infant from RSV infection for several months. Some young children at high risk of serious RSV infection may need RSV preventive antibodies during their second RSV season. Adults age 60 and older may be vaccinated against RSV after discussing their personal health risks, the benefits of vaccination, and their preferences with their healthcare provider. RSV Immunization Schedule To protect infants from severe RSV disease, people who are pregnant and in their third trimester, between 32 and 36 weeks, 6 days gestation, between September and the end of January may be given the Pfizer RSV vaccine (brand name Abrysvo). Infants younger than 8 months of age whose mothers were not vaccinated should be immunized with RSV preventive antibodies before or during their first RSV season, typically between October and March. Certain older infants aged 8 months through 19 months at high risk of severe RSV disease should be immunized before or during their second RSV season. Adults age 60 or older may be vaccinated against RSV with a single dose of RSV vaccine (two brands of vaccine are available for this age group), based on a conversation about their risks and benefits with their healthcare provider. Currently, only one dose of vaccine is recommended. How can I learn more? RSV (Respiratory Syncytial Virus): Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Rubella What is Rubella? Rubella (sometimes called German measles) is a disease caused by a virus. It is spread from person-to-person through the air. Children with rubella usually first break out in a rash. Older children and adults have a mild fever, swollen glands in the neck or behind the ears, and an upper respiratory infection before they develop a rash. Adults, especially women, often suffer from aching joints. Many people infected with rubella virus have no symptoms at all. Rubella can cause miscarriage or serious birth defects, including heart defects, deafness, and blindness, if the infection occurs during pregnancy. It is very contagious, so when one person gets infected, it’s easy for the disease to spread. Rubella outbreaks still occur around the world. Vaccination is the best way to prevent rubella. Rubella Vaccine Schedule In the United States, rubella vaccine is part of the MMR (measles-mumps-rubella) vaccine. All children should get 2 doses of MMR vaccine starting at age 12 months. Some teens and adults may also need MMR vaccine if they didn’t get 2 doses when they were younger. How can I learn more? Rubella: Questions & Answers MMR (Measles, Mumps & Rubella): Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Shingles What is Shingles (Zoster)? Shingles is a painful disease caused by the same virus that causes chickenpox. It is also called herpes zoster or just zoster. Shingles usually includes a painful rash with blisters that can occur anywhere on your body, even the face and eyes. The main symptom of shingles is severe pain. Some people have compared it with the pain of childbirth or kidney stones. For some people with shingles, severe pain can continue for months, or even years. This long-lasting pain can be so bad that it interferes with eating, sleeping, and activities of normal life. Although some medicines can help treat shingles, there is no cure. The likelihood of long-lasting pain complications increases as you age, and reaches nearly 1 in 5 among people who get shingles after age 80. Anyone who has ever had chickenpox can get shingles. You are more likely to develop shingles as you get older, or if you have a weakened immune system as a result of disease or medication. The best way to prevent shingles and its serious complications is to get vaccinated. You should get the shingles vaccine if you are age 50 years or older, even if you’ve already had shingles. It is possible to get the disease more than once. You should also get the shingles vaccine if you are age 19 years or older and have a weakened immune system as a result of disease or medication. Shingles (Zoster) Vaccine Schedule One shingles vaccine, Shingrix, is available in the United States. If you are age 50 years or older, or age 19 years and older with a weakened immune system, you should get the 2-dose series of Shingrix vaccine. People who received an earlier shingles vaccine called Zostavax should also get Shingrix. How can I learn more? Shingles (Zoster): Questions & Answers Shingles (Zoster): Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Tetanus What is Tetanus (Lockjaw)? Tetanus (sometimes called lockjaw) is a serious disease caused by bacteria. The actual disease is caused when the bacteria release a toxin, or poison, into a person’s body. Tetanus gets into the body through cuts or wounds. Tetanus can also infect someone in less commonly considered wounds, such as skin ulcers, scrapes, or insect or animal bites. Tetanus can cause extremely painful muscle cramps all over the body. This disease can be deadly. In the most common form of tetanus, the first sign is spasm of the jaw muscles, followed by stiffness of the neck, and difficulty in swallowing. Tetanus bacteria are in the soil, so people who work, garden or play outside can get infected even from a minor injury, such as a puncture from a thorn. Vaccination is the most effective step you can take to be protected from this serious disease. Tetanus Vaccine Schedule All children should get 5 doses of DTaP (diphtheria-tetanus-pertussis) vaccine, beginning when they are 2 months old. If your child misses a dose or gets behind schedule, make sure they get the next dose as soon as possible. Older children, teens, and adults should receive the Tdap (Tetanus-diphtheria-pertussis) vaccine designed for people age 7 years and older, and after that, a Td or Tdap booster dose every 10 years. Consult your healthcare provider if you have a deep or dirty wound: you may need an additional tetanus vaccine booster dose if it has been more than 5 years since your most recent dose. How can I learn more? Tetanus: Questions & Answers DTaP (Diphtheria, Tetanus, Pertussis): Vaccine Information Sheet Tdap (Tetanus, Diphtheria, Pertussis): Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Whooping Cough What is Whooping Cough (Pertussis) Whooping cough (also called pertussis) is a serious disease caused by bacteria. It is called whooping cough because of the “whoop” heard when a person who has it gasps for breath between coughing fits. Whooping cough is spread through the air by coughing and sneezing. It is very contagious. Whooping cough can trigger coughing so severe that it results in vomiting and broken ribs. The cough can last for weeks or months, even when the person is no longer contagious. More than half of babies younger than one year old who get whooping cough are hospitalized because the infection can cause them to stop breathing. Young babies are the most likely to die from whooping cough or have complications such as seizures and brain damage. Whooping cough is most dangerous for babies, but anyone can become seriously ill from it. You can protect yourself by getting vaccinated. The best way to protect newborn babies is to vaccinate mothers during each pregnancy. Whooping Cough (Pertussis) Vaccine Schedule All infants, children, and teens should be vaccinated against whooping cough. The vaccine for infants and children is combined with diphtheria and tetanus vaccine as DTaP. The schedule is 4 doses at 2, 4, 6 and 15–18 months of age. A DTaP booster dose is recommended at 4–6 years. The adolescent and adult vaccine is called Tdap. A dose of Tdap is recommended at 11–12 years of age. A dose of Tdap is needed during the third trimester of each pregnancy to allow the mother’s immune system to give pertussis immunity to the newborn infant. Adults who have not had Tdap should get a dose of Tdap to protect themselves, then a Tdap or Td booster every 10 years thereafter. How can I learn more? Pertussis (Whooping Cough): Questions & Answers DTaP (Diphtheria, Tetanus, Pertussis): Vaccine Information Sheet Tdap (Tetanus, Diphtheria, Pertussis): Vaccine Information Sheet Appointments or Questions? Appointments: Walk-ins are welcome. Scheduling an appointment helps ensure you’re seen in a timely manner. To schedule, call City-County Health District at 845-8518. Questions: Have questions about vaccines? Contact your healthcare provider or call our nursing team at City-County Health District: 845-8518. Frequently Asked Questions Vaccines for Kids Vaccine Records Paying for Vaccines Vaccinations can be billed though our partnering insurance companies. Children who are 18 and under, may qualify for free vaccine through the Vaccine for Children (VFC) program. They must meet one of the following criteria: No health insurance Medicaid eligible Native American or Alaskan Native Underinsured *Some adult vaccines are available through the 317 vaccine to adults uninsured or underinsured. Please call to find out which vaccines are available and eligibility requirements. Questions? Please call City-County Health District at 701.845.8518 if you have any questions. How can I get my immunization record? North Dakota residents can get their immunization record by calling City-County Health District at 845.8518 following the steps on the North Dakota Health & Human Services Immunization Record Request If you were born outside of North Dakota and need to locate your immunization records, here are a few helpful tips: Contact the local public health unit where you resided Contact your previous clinic or healthcare provider If you need additional help locating records, please give us a call. Once you locate your records, you can bring a copy to City-County Health District and we will create a North Dakota immunization record for you. Where can I find my childhood vaccine records? North Dakota residents can get their immunization record by calling City-County Health District at 845.8518 following the steps on the North Dakota Health & Human Services Immunization Record Request If you were born outside of North Dakota and need to locate your immunization records, here are a few helpful tips: Contact the local public health unit where you resided Contact your previous clinic or healthcare provider If you need additional help locating records, please give us a call. Once you locate your records, you can bring a copy to City-County Health District and we will create a North Dakota immunization record for you. Am I due for any vaccines? City-County Health District can review your immunization records and help you determine when you are due for vaccines. What Questions do Parents Ask about Vaccinations for Babies? Why are Vaccines Safe? What if You Don't Vaccinate Your Child? What are the School and Childcare Required Vaccines in North Dakota?

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Stronger Together - Your Guide to Local Healthcare & Community Support Barnes County Health & Wellness Resources Certified Home Care Home Health & Hospice Resource Information Certified home care providing care to clients in their homes. For more information about eligible insurance or self-pay options, contact directly. Is a Referral Required? Yes Eligibility: Referral from physician or hospital discharge planning team. Contact Office Phone: 701.845.8518 Fax: 701.845.8542 www.citycountyhealth.org Contact Office Phone: 701.845.8518 Fax: 701.845.8542 www.citycountyhealth.org Previous Item Next Item

Recovery Adult Health, Behavioral Health 701.845.8518 Recovery PRIORITY Ensuring equitable access to rural treatment and recovery systems. Bridges connect people who are in different places. They offer a more efficient way of getting to another point. Bridges reduce isolation, enable help to be connected, and open up the opportunity for people to be helped. A bridge provides support and reach, increasing the range of options available. The Bridges to Rural Recovery (BRR) project is a federally funded grant program using evidence-based practices to improve outcomes for individuals at risk for addiction and/or co-occurring mental disorders, their families, and communities. Project Goals increase prevention activities to reduce behavioral health disorders and their negative outcomes. integration of behavioral health in rural primary care, hospitals, emergency rooms, and other settings. develop recovery-orientated systems of care in the eight-county area (total population 54,331) The eight-county area includes Barnes County, Dickey County, Foster County, LaMoure County, Logan County, McIntosh County, Stutsman County, and Wells County. There are structural and systems-level barriers that prevent rural residents from accessing quality, integrated behavioral health care services. Working across the spectrum of behavioral health , the Bridges to Rural Recovery project seeks to improve rural service delivery. The project’s overarching priority is to increase equitable access to and utilization of rural-centered prevention, treatment and recovery services for those affected by behavioral health conditions. Bridges to Rural Recovery Contact To learn more, contact City-County Health District at 845-8518 . Previous Item Next Item

Family Planning Women's Health, Men's Health, Family Planning 701.252.8130 Family Planning is offered at City-County Health District 2nd Tuesday of every month from 9:00 AM to 12:00 PM Available Services Central Valley Health District offers a range of family health services, including Birth control & family planning. Find the method that's right for you, from oral contraceptives to IUDs. STI testing & treatment. Get screened and treated for sexually transmitted infections to protect your health and that of your partners. Pregnancy testing and counseling. Accurate, confidential pregnancy testing and counseling services are available. HPV vaccinations. Protect yourself with the HPV vaccine, reducing the risk of certain cancers and genital warts. Annual wellness exams. Comprehensive check-ups to assess reproductive health, including pap test, pelvic exams, and more. As a collaborating partner, City-County Health District provides limited services on a daily basis. Call (701) 845-8518 to schedule an appointment for: Pregnancy Testing Emergency Contraceptive Pills (ECP, also known as the morning after pill) About CVHD Services Central Valley Health District offers family planning in collaboration with City-County Health District. We guarantee our services are always Confidential & judgement free. Your privacy is our priority. All services are strictly confidential. Inclusive support. We welcome people of all backgrounds and identities, ensuring a safe space for everyone. Affordable care. All services are provided on a sliding fee scale and based on income and household size. Your appointment may be filed through your medical insurance, if you choose. Schedule An Appointment Call Central Valley Health at 701.252.8130 *Evening hours are available in Jamestown on the first and third Wednesday of each month for those who can't visit during the day. At-Home STI & HIV Testing Need sexually transmitted infection (STI) or HIV testing? Order a FREE home test collection kit to your door today. Benefits of at-home testing Anytime, Anywhere testing Private Free! Order a at-home test kit today. For more information, Central Valley Health Di strict Reproductive Health Services . Previous Item Next Item

Home Care Adult Health, Aging Services 701.845.8518 Certified Home Care Care for All. Infancy through Aging. Your Choice. Your Home. Since 1982, City-County Health has been providing high quality care to clients in the comfort of their own home. Services are available to residents of Barnes County under the care and direction of their medical provider. Our home care team includes Registered Nurses, Home Health Aides and a Physical Therapist. We coordinate services and care with Doctors, Pharmacists, equipment providers and other resources. City-County Health District is a Medicare certified, licensed member of the North Dakota Association of Home Care. Who needs home care? Individuals who: have a difficult time leaving the house, typically with a taxing effort are in need of skilled nursing care on an intermittent basis are returning home after a nursing home or swing bed stay are recovering from surgery or other ailments Who pays for home care? Medicare Medical Assistance Veterans Administration Private Insurance Services: Skilled Nursing Home Care Aides Physical Therapy Other Service Coordination Assessment and Education How do I get home care? Request from your physician or hospital discharge planning team that you be visited by City-County Health District’s Home Care Team. When you choose our Home Care team, you’re helping to ensure that Public Health can continue to provide essential services for the community and those who need us most. Resource: VA Community Care – Eligibility Public Health Home Care Previous Item Next Item

Emergency Preparedness 701.252.8130 City-County Health District works with the North Dakota Department of Health and Human Services (NDHHS), public safety agencies, and other community groups to plan and prepare for disasters or emergency situations. This is in conjunction with local all hazards emergency planning, preparedness, and response. City-County Health District is part of an eight-county region established by NDHHS for emergency preparedness and response planning. Counties included in our region are: Barnes , Dickey , Foster , LaMoure , Logan , McIntosh , Stutsman , and Wells. An emergency preparedness/response coordinator and a public information officer serve the eight counties within the Southeast Central Region. Their work is funded in part by federal grants and is focused on public health emergencies. This is done through public education and planning which involves partnerships for enhanced regional response plans and capabilities. For more information, contact Central Valley Health District – Emergency Preparedness. Emergency Notifications Barnes County offer services to inform residents of emergency situations or critical community alerts. Alerts are issued for a variety of situations, including natural disasters, terrorism threats, gas leaks, water contamination, chemical spills, missing child alerts, severe weather such as tornadoes and flash flooding, and for general community notifications. Signup for Barnes County alerts . Previous Item Next Item

WIC Maternal Child Health 701.845.8518 WIC (Women, Infants and Children) Not sure if you are eligible? The WIC PreScreening Tool can help you determine if you may be eligible. About The WIC Program aims to safeguard the health of low-income women, infants, and children up to age 5 who are at nutrition risk by providing nutritious foods to supplement diets, information on healthy eating, and referrals to health care. Clients receive an individualized food package and nutrition education. Families must meet income guidelines and be screened for a nutritional risk. Appointments are necessary, please call (701) 845-8518 . Eligibility You must be a: pregnant woman ; breastfeeding woman (up to one year after giving birth) new mother (up to six months after giving birth) parent, guardian or caretaker who has an infant or child younger than 5 years of age AND You must have a nutritional health risk . The WIC Staff will be able to find a risk by checking your height, weight and iron level and having you answer some health and diet questions. AND Your annual household income must be within WIC Income Eligibility Guidelines which are based on gross income unless you are self-employed. Note: You may have a job and still meet these guidelines. OR If you receive Medical Assistance (Medicaid), TANF, SNAP, or Healthy Steps , you are income eligible for WIC even if your income is above these guidelines. [Note: If you are pregnant, you can add one more person to the size of your household.] Did you know WIC offers the following? 1. Healthy Food + Nutrition Tips WIC helps you feed your family healthy meals by providing: Monthly food benefits on an eWIC card to use at your local grocery store Recipes and ideas on how to use the WIC foods Tips for picky eating 2. A Community of Support WIC offers a network of experts for information and guidance: Nutritionists provide personalized nutrition counseling Breastfeeding specialists to help you breastfeed successfully Individual assessment of growth and health 3. Referrals WIC offers information about other helpful services including: Health care professionals such as doctors, dentists, and lactation consultants Immunization services Local social service programs including Medical Assistance, SNAP, and housing assistance. Resources WIC Food List WIC Program Previous Item Next Item