Contra Costa California Hepatitis B Vaccine Acceptance Declination Form

State:
Multi-State
County:
Contra Costa
Control #:
US-0509BG
Format:
PDF
Instant download

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

How to fill out Hepatitis B Vaccine Acceptance Declination Form?

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FAQ

Hepatitis B vaccine is available for all age groups. 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.

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.

Since everyone is at some risk, all adults should seriously consider getting the hepatitis B vaccine for a lifetime protection against a preventable chronic liver disease.

That's why health experts recommend that all babies get the vaccine right from birth. The HepB injection usually creates long-term immunity. Most infants who get the HepB series are protected from hepatitis B infection beyond childhood, into their adult years.

OSHA's Bloodborne Pathogens Standard requires that employers offer the hepatitis B vaccination series to any employee who is reasonably anticipated to have exposure to blood or other potentially infectious materials. The offer must be made within 10 days of employment and at no cost to the employee.

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.

Hepatitis B vaccine can prevent hepatitis B. Hepatitis B is a liver disease that can cause mild illness lasting a few weeks, or it can lead to a serious, lifelong illness.

29 CFR § 1910.1030 requires employers to make available the hepatitis B vaccine and vaccine series to all employees who have occupational exposure. The employer must ensure that the hepatitis B vaccine and vaccination series and follow-up is made available at no cost to the employee.

The easiest method to document properly why the hepatitis B vaccination was not given is simply to have the employee sign the declination form regardless of the reason. The declination form provides a clear and written record of why the vaccination was not performed.

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Contra Costa California Hepatitis B Vaccine Acceptance Declination Form