Aloha Families — The Centers for Disease Control and the Food and Drug Administration have granted emergency use authorization for the Pfizer Covid Vaccine to be used for 5-11 year-olds beginning immediately.  Molokai General Hospital, has scheduled the Pfizer Covid Vaccine to be administered on Wednesday, November 24th, 8:30-10:00am at Kualapuu School campus. 

COMPLETE THIS FORM ONLY IF YOU ARE INTERESTED IN HAVING YOUR CHILD RECEIVE THE VACCINE ON THE KUALAPUU SCHOOL CAMPUS.   Please complete the google form for each child you are signing up.  We will be sending hard copies of the consent forms home with your child (see attached for your review).

Consent forms will be due on Tuesday, November 23, at 9am.

11-03-2021 Pre-Vaccination Form.pdf 

Pediatric COVID 19 Consent Form MGH 11.15.21.pdf 

Pfizer 5 though 11 Fact Sheet for Recipients-COVID-19 Vaccine Final.pdf 

Please call Nohea Deponte, Kualapuu Health Aide, at 567-6900 or email [email protected] if you have questions




Kualapuu Public Charter Elementary School