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Vaccine Refusal Form 2025

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The document is a Vaccine Refusal Form in which the parents formally declare their decision not to vaccinate their child due to philosophical objections. They outline several reasons for their stance, including concerns about potential harm from vaccines, lack of guarantees regarding vaccine efficacy, and insufficient scientific understanding of vaccine effects. The parents acknowledge their responsibility for their child's health and accept the consequences of exclusion from educational facilities during outbreaks of vaccine-preventable diseases.

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Can I decline vaccines?

Thirty states and Washington D.C. allow exemptions for people who have religious objections to immunizations. Thirteen states allow exemptions for either religious or personal reasons. Two states, Louisiana and Minnesota, do not specify whether the non-medical exemption must be for religious or personal reasons.

What is a religious reason to not get vaccinated?

Objection to vaccination was also related to: faith in divine protection and healing for Protestants, Catholics, Jewish and Muslims (10); the use of aborted fetal cells for vaccines production among Amish and Catholic communities (including during the COVID-19 outbreak when Senior Catholic leaders from the US and

What are valid reasons to decline the flu vaccine?

6 reasons patients avoid flu vaccination Im healthy, so I dont need a flu vaccine. The flu vaccine isnt safe and can give me the flu. It is better to get sick with the flu. Ill wait until flu hits my area. I hate getting injections. I was vaccinated last year.

What is the form to decline immunizations?

For healthcare providers who want to assure that these parents fully understand the consequences, Immunize.org has produced a form titled Record of Vaccine Declination. This form facilitates and documents the discussion that a healthcare professional can have with parents about the risks of not having their child

Can parents choose not to vaccinate?

Nothing is more troubling to a practitioner than when a parent makes a decision that could jeopardize their childs health, such as vaccination refusal. Ultimately, the parent has a right to refuse any medical intervention or treatment for their child, including a vaccine.

Which states have religious exemptions for vaccinations?

All states allow exemptions for medical reasons, and almost all states (except California, Mississippi and West Virginia) grant religious or philosophical exemptions for people who have sincerely held beliefs that prohibit immunizations.

How do you document parental refusal to have their children vaccinated?

For parents who refuse one or more recommended immunizations, document your conversation, the provision of the VIS(s), and have the parent sign the vaccine refusal form and keep the form in the patients medical record.

Vaccine Refusal Form 2025

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