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  • Hepatitis B Vaccination Declination Or Request - Drs Illinois

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University of Illinois at Urbana-Champaign Hepatitis B Vaccination Declination or Request Employee Name: Date: University Identification Number (UIN): Employee Occupation/Title: Employer Representative.

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Employers must ensure that workers who decline vaccination sign a declination form. The purpose of this is to encourage greater participation in the vaccination program by stating that a worker declin- ing the vaccination remains at risk of acquiring hepatitis B.

Reducing HBV infections and deaths by 2030 Vaccines can help prevent the disease and have reduced the number of reported hepatitis B cases by 90% since being introduced in 1982. A hepatitis B vaccine is now recommended for adults ages 19 to 59 years without risk factor screening and disclosure.

The hepatitis B vaccine is given as a series of three shots. The first dose is given within 24 hours of birth. The second dose is given one to two months after the first dose, and the third dose is given between 6 months and 18 months of age.

Routine administration schedule for hepatitis B vaccine in adults. The dosing schedule is 0, 1 to 2 months, and 4 to 6 months. There is some flexibility in the schedule, but be sure to keep in mind the minimum intervals between doses: At least four weeks between doses #1 and #2.

The hepatitis B vaccine is recommended for all infants, all children or adolescents younger than 19 years of age who have not been vaccinated, all adults age 19 through 59 years, and adults age 60 years or older with risk factors for hepatitis B infection.

Prevention. WHO recommends that all infants receive the hepatitis B vaccine as soon as possible after birth, preferably within 24 hours, followed by 2 or 3 doses of hepatitis B vaccine at least 4 weeks apart to complete the vaccination series. Protection lasts at least 20 years and is probably lifelong.

The employee responsibilities vary regarding the hepatitis B vaccination. The employee has the right to decline the vaccination, but also has the right to change their mind and still receive the vaccination at a later date. This is dependent on their occupational role still encompassing occupational risk of exposure.

DECLINATION: I understand that due to my occupational exposure to blood or other poten tially infectious materials that I may be at risk of acquiring Hepatitis B Virus (HBV) infection. I have been given the opportunity to be vaccinated with Hepatitis B vaccine.

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232