San Diego California Hepatitis B Vaccine Acceptance Declination Form

State:
Multi-State
County:
San Diego
Control #:
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 decides not to receive the hepatitis B vaccine, they must complete the San Diego California Hepatitis B Vaccine Acceptance Declination Form. This form allows employees to officially decline the vaccination while acknowledging their choice. Submission of this form helps employers maintain accurate records and ensures compliance with health regulations. It is essential for the employee to read the implications of their decision before signing.

Hepatitis B Vaccine Mandates for Child Care and K-12 StateHep B childhood vaccination mandate?Hep B elementary school mandate (year took effect)Californiayes1997Coloradoyes1997Connecticutyes1996Delawareyes199947 more rows ?

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.

Who should NOT receive hepatitis B vaccine? People who had a serious allergic reaction to one dose of hepatitis B vaccine should not have another dose of hepatitis B vaccine. People with a history of a serious allergy to yeast should not receive this vaccine.

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.

Who should be vaccinated against hepatitis B. All babies should be vaccinated to protect them against hepatitis B infection. This is because the infection can persist for many years in children and can eventually lead to complications, such as scarring of the liver or liver cancer.

People who do not respond to this vaccination course, and in whom chronic hepatitis B virus infection has been excluded, should be offered further doses. People can receive a single booster dose (4th dose) of vaccine to confirm non-responder status. See Serological testing after hepatitis B vaccination.

The following statement of declination of the hepatitis B vaccine must be signed by an employee who: 2022 Chooses not to accept 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.

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San Diego California Hepatitis B Vaccine Acceptance Declination Form