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This document provides information about meningococcal disease and vaccination requirements for students at residential schools and colleges, along with a waiver for those choosing not to be vaccinated.

How to fill out meningococcal disease information and

How to fill out Meningococcal Disease Information and Vaccination Waiver

1. Obtain the Meningococcal Disease Information and Vaccination Waiver form from a reliable source such as your school or health department.
2. Read the informational material about meningococcal disease and vaccination carefully to understand the risks and benefits.
3. Fill out the personal information section at the top of the form, including your name, date of birth, and contact information.
4. Provide information about your current health status and any previous vaccinations you may have received.
5. Carefully review the waiver statement, ensuring that you understand what you are waiving and the implications of that decision.
6. Sign and date the waiver form, indicating that you are aware of the information provided.
7. Submit the completed waiver form to the designated authority (e.g., school administration or health office).

Who needs Meningococcal Disease Information and Vaccination Waiver?

1. Students entering college or university who are required to provide proof of meningococcal vaccination.
2. Individuals who are allergic to components of the vaccine or have certain medical conditions that prevent vaccination.
3. Parents or guardians of minors who choose to opt-out of the vaccination for their children.

People Also Ask about

How can I be exempt from meningitis vaccine?

Exemption is permitted with proof of immunity, non-medical exemption or birth before 1957. First-time enrollees at California State University and University of California must show proof of hepatitis B vaccine. All institutions with on-campus housing must provide information about meningococcal ACWY and B.

Can you opt out of the meningitis vaccine?

Meningococcal ACWY is required for all full-time students 21 years of age or younger. Students may decline vaccination via signed waiver. Students of public or private postsecondary educational institutions must receive immunization against MMR, diphtheria and tetanus unless evidence of immunity is provided.

What does it mean to waive receipt of meningococcal vaccine?

Individuals 18 years of age and older may sign a written waiver choosing not to be vaccinated against meningococcal disease after reviewing the information on the risks of meningococcal disease, the availability of the vaccine, and effectiveness of the vaccine.

What happens if I don't get the meningococcal vaccine?

Meningococcal disease is a very serious infection that can cause severe scarring, loss of limbs, brain damage and death. Vaccination is a safe and effective way to protect yourself from meningococcal disease.

How to get meningitis vaccine exemption?

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 can't receive the vaccine; 2) the student (or the student's parent or legal guardian, if the student is a minor)

Is it mandatory to get 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.

Who is eligible for meningococcal prophylaxis?

For children and adolescents aged 10 years and older who are at increased risk for serogroup B meningococcal disease, a three-dose series at 0, 1–2, and 6-month intervals is recommended.

For pdfFiller’s FAQs

What is Meningococcal Disease Information and Vaccination Waiver?

The Meningococcal Disease Information and Vaccination Waiver is a document that allows individuals to acknowledge the risks associated with meningococcal disease and to waive the vaccination requirements under certain conditions.

Who is required to file Meningococcal Disease Information and Vaccination Waiver?

Individuals who are entering certain educational institutions, such as colleges or universities, may be required to file the Meningococcal Disease Information and Vaccination Waiver if they choose not to receive the vaccination.

How to fill out Meningococcal Disease Information and Vaccination Waiver?

To fill out the Meningococcal Disease Information and Vaccination Waiver, individuals should complete the form provided by their educational institution, providing necessary personal information, acknowledging the information about the disease, and indicating their decision regarding vaccination.

What is the purpose of Meningococcal Disease Information and Vaccination Waiver?

The purpose of the Meningococcal Disease Information and Vaccination Waiver is to ensure that individuals are informed about the risks of meningococcal disease and to legally document their choice to opt out of vaccination, thus protecting educational institutions from liability.

What information must be reported on Meningococcal Disease Information and Vaccination Waiver?

The Meningococcal Disease Information and Vaccination Waiver must typically include personal information such as the individual's name, date of birth, and contact details, as well as an acknowledgment of the information provided about the disease and the vaccination option.