Quad Villages to Host Vaccination Clinic
For Children Ages 12 through 17
July 7, 2021

Dear School Community,

The Quad Village School Districts of Ardsley, Dobbs Ferry, Hastings and Irvington, in partnership
with the Westchester County Department of Health (WCDOH), are pleased to announce a free
COVD-19 vaccination clinic for children 12 through 17 years of age. This clinic will be held on
Tuesday, July 13, 2021, (hours of 2:00 pm - 6:30 pm), in the Irvington Middle School/High School
Campus Library, which is located at 40 North Broadway in Irvington.

This opportunity is open to residents of the Quad Villages and is limited to 120 children aged 12
through 17. Appointments are required and will be scheduled on a first come, first served basis
through the WCDOH link below. In the event that the demand for vaccines exceeds 120 children,
more appointments may be added by the WCDOH.

Please note that masks are required and we ask that everyone respect social distancing
guidelines.

For students 12 years to under 16 years of age: In order for the student to receive the vaccine
they must be accompanied by a parent or an adult. If the attending adult is not the parent or
legal guardian, then the parent must be reachable by phone in order for the child to be
vaccinated. If the parent cannot be reached, the vaccine will not be given.

For students 16 and 17 years of age: Students must have a signed parental consent form in order
to receive the vaccine and parents are encouraged to be present during the vaccine
administration. If your child does not have a consent form signed by a parent/legal guardian and
we cannot reach you by phone, your child will not be vaccinated.

There are a limited number of appointments. In addition to filling out the screening and
consent form, you must use the link below to secure your appointment:

WCDOH School First Dose Pfizer Vaccination Clinic – Irvington
Tuesday, July 13, 2021: 2:00 pm-6:30 pm


A consent form is required for students to obtain the COVID vaccine. Students cannot receive the
COVID vaccination without having completed this consent form. Please make sure your child has
the consent form with them when they arrive.

The screening and consent forms below are available in English and Spanish:

The follow-up date for the second vaccination is scheduled for Monday, August 4, 2021 also in
the Irvington Middle School/High School Campus Library.

The following are resources pertaining to the vaccine:

Fact Sheets:

Reporting Side Effects:

After the vaccine is given, the student will be required to remain for at least 15 minutes to be
watched for any potential allergic reactions. Persons with a history of allergies will be required to
stay for a minimum of 30 minutes.

After the vaccine is given, we will ask parents to wait outside for the 15-30 minute observation
period.

Medical staff will be onsite the day of the clinic to answer questions, but if you have any questions
about the vaccine prior to your child’s appointment, please call the Westchester County
Department of Health at 914-995-5800 during regular business hours.

Sincerely,

Melissa Szymanski                                                                                                                                                                                                                                                                                 Interim Superintendent of Schools (7/1/2021 - 7/31/2021)