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IDAHO CERTIFICATE OF IMMUNIZATION EXEMPTION

pneumonia, encephalitis, seizures, and death. _____ Initial _____ Date mumps. Serious symptoms and effects of this disease include: Mumps (MMR): I understand by not receiving this vaccine, my child is at increased risk of developing meningitis, inflammation of the testicles or ovaries, sterility, pancreatitis, deafness, and death. _____

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  Encephalitis, Seizure

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