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Meningococcal Vaccine Declination Form doc 2026

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The document is a Meningococcal Vaccine Declination Form from Columbus State University, where the signer acknowledges understanding the risks of meningococcal disease, particularly for college students living on campus. By signing, they decline the vaccine and release the university from liability, while also noting that they can choose to receive the vaccine later at a specified cost.

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Click ‘Get Form’ to open the Meningococcal Vaccine Declination Form in the editor.
Begin by entering your name in the designated field at the top of the form. This identifies you as the individual making the declination.
Read through the provided information about meningococcal disease and vaccination carefully. Understanding this context is crucial for making an informed decision.
In the signature field, sign your name to confirm your declination of the vaccine. Ensure that your signature is clear and legible.
Next, enter today’s date in the corresponding field to document when you are submitting this form.
If required, have a witness sign and date the form in their respective fields to validate your declination.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can I opt out of the meningitis vaccine?

California removed its personal and religious exemption option in 2015. Parent/guradian must complete an online educational module to receive a non-medical exemption. Connecticut removed its religious exemption option in 2021.

How to get a meningitis exemption?

Students may begin classes without a certificate of immunization against meningococcal disease if: 1) the student has a letter from a physician stating that there is a medical reason why he/she cant receive the vaccine; 2) the student (or the students parent or legal guardian, if the student is a minor) presents a

Is MCV the same as meningococcal?

There are two kinds of meningococcal vaccine in the U.S.: Meningococcal conjugate vaccine (MCV4) is the preferred vaccine for people 55 years of age and younger. Meningococcal polysaccharide vaccine (MPSV4) has been available since the 1970s. It is the only meningococcal vaccine licensed for people older than 55.

How can I be exempt from meningitis vaccine?

Exemptions: Students may begin classes without a certificate of immunization against meningococcal disease if: 1) the student has a letter from a physician stating that there is a medical reason why he/she cant receive the vaccine; 2) the student (or the students parent or legal guardian, if the student is a minor)

What is the difference between MenACWY and Menb?

Meningococcal vaccine (MenACWY) is effective at protecting against four strains of the meningococcal bacteria. The MenACWY vaccine does not contain the meningococcal B strain that may cause some cases in adolescents and young adults. There is a separate vaccine that protects against the meningococcal B strain.

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