Oregon Department of Corrections OfferDeclination of Hepatitis B Vaccination - oregon 2026

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How to use or fill out Oregon Department of Corrections Offer Declination of Hepatitis B Vaccination

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your full name in the 'Print Name' field. This identifies you as the employee completing the form.
  3. Next, input your Employee OR Number in the designated field. This is crucial for tracking and record-keeping purposes.
  4. Sign the form in the 'Signature' section to confirm your choice regarding vaccination.
  5. Select either option 1 or 2 to indicate whether you accept or decline the vaccination offer. If declining, circle one of the reasons (A, B, or C) provided.
  6. Finally, date the form and specify your Functional Unit before submitting it to DOC - Human Resources - Records at the address provided.

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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.
The Advisory Committee on Immunization Practices (ACIP) recommends hepatitis B (HepB) vaccination among all infants at birth, unvaccinated children younger than 19 years of age, adults aged 1959 years, and adults aged 60 years and older with risk factors for hepatitis B or without identified risk factors but seeking
The hepatitis B vaccination must be made available within 10 working days of initial assignment, after appropriate training has been completed.
The Centers for Disease Control and Prevention (CDC) recommends everyone from birth up to age 60 years get hepatitis B vaccination. Children routinely get hepatitis B vaccine, but many adults have not been vaccinated.
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.
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