Broward Florida Hepatitis B Vaccine Acceptance Declination Form

State:
Multi-State
County:
Broward
Control #:
US-0509BG
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PDF
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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

The Broward Florida Hepatitis B Vaccine Acceptance Declination Form is a crucial document designed to provide individuals in Broward County, Florida, with the option to either accept or decline the Hepatitis B vaccine. This form serves as an official record of an individual's decision regarding the vaccine and helps healthcare providers ensure proper understanding and communication in terms of vaccination requirements. The form consists of various sections that capture essential information, including the individual's personal details such as name, address, date of birth, and contact information. Additionally, the form requires individuals to indicate their healthcare provider's name, the date of the vaccine offer, and the reason for their decision to either accept or decline the vaccine. By utilizing this form, healthcare professionals can maintain accurate records regarding the acceptance or declination of the Hepatitis B vaccine, allowing them to track immunization rates and make informed decisions regarding community health initiatives. It ensures that individuals have a voice in their own healthcare decisions, aligning with the principles of patient autonomy and informed consent. Depending on specific circumstances, there may be variations of the Broward Florida Hepatitis B Vaccine Acceptance Declination Form. For instance, these variations may exist based on the location where the form is being utilized, the healthcare provider or organization issuing it, or specific modifications to meet legal or administrative requirements. However, the core elements of the form generally remain consistent across different versions. It is important to note that while the Broward Florida Hepatitis B Vaccine Acceptance Declination Form provides individuals with the option to decline the vaccine, healthcare professionals strongly recommend obtaining the Hepatitis B vaccine as it is a crucial preventive measure against the potentially life-threatening Hepatitis B virus.

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FAQ

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.

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.

'Healthcare workers for whom hepatitis B vaccination is contra-indicated, who decline vaccination or who are non-responders to vaccine should be restricted from performing EPPs unless shown to be non-infectious (see paragraphs 37-40). Periodic re-testing may need to be considered.

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.

Occupational Safety and Health Administration.

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.

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.

Hepatitis B vaccination is recognized as an effective defense against HBV infection. The standard requires employers to offer the vaccination series to all workers who have occupational exposure.

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.

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Broward Florida Hepatitis B Vaccine Acceptance Declination Form