Hawaii Hepatitis B Vaccine Acceptance Declination Form

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Multi-State
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US-0509BG
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Description

The Occupational Safety and Health Act was passed to insure that employees have a safe place at which to work. The Occupational Safety and Health Administration, known as OSHA, was formed to enforce this Act. Completion of this form is a requirement of O

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FAQ

If an employee initially declines the hepatitis B vaccination using the Hawaii Hepatitis B Vaccine Acceptance Declination Form, they can later choose to receive the vaccine. They will need to complete any necessary paperwork to update their vaccination status. It's important to communicate with their employer to ensure proper documentation and compliance with health policies.

It is also possible that a person who does not respond to the vaccine may already be infected with hepatitis B. Therefore, testing for the presence of the hepatitis B virus (hepatitis B surface antigen or HBsAg) is recommended before diagnosing a person as a "vaccine non-responder."

I Decline the Hepatitis B Vaccination I have been given the opportunity to be vaccinated with hepatitis B vaccine, at no charge to myself. However, I decline hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B, a serious disease.

If an employee initially declines the vaccination, and then decides to have it, the employer must pay for the initial vaccination series and post-vaccination testing, and second vaccination series and testing, if necessary. Employers are not required to provide the vaccination to employees who have already received it.

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.

People who are non-responders after receiving the booster should be tested for hepatitis B virus infection. If negative, they are recommended to receive 2 more doses of hepatitis B vaccine 1 month apart. Count the 4th booster dose as the 1st of the 3 repeat doses.

If an employee initially declines the vaccination, and then decides to have it, the employer must pay for the initial vaccination series and post-vaccination testing, and second vaccination series and testing, if necessary.

For instance, sometimes the hepatitis B vaccination is delayed if a baby is premature, has a low birth weight, or is medically challenged. Still, parents always have the option to refuse a vaccination if they want to. But the risks associated with a hepatitis B infection far outweigh the risks of the vaccine.

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Hawaii Hepatitis B Vaccine Acceptance Declination Form