Wyoming 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

The standard requires employers to offer the vaccination series to all workers who have occupational exposure.Employers must ensure that workers who decline vaccination sign a declination form.More items...

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.

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.

An employee has a right to refuse the vaccination. If you do, however, you should realize that without the hepatitis B immunization three-injection series or evidence of immunity from previous viral infection, you remain at risk for acquiring hepatitis B virus (HBV) infection.

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.

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.

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Wyoming Hepatitis B Vaccine Acceptance Declination Form