Get the free MDPH Meningococcal Information and Waiver Form

This document provides information about meningococcal disease, vaccination requirements for students in Massachusetts, and a waiver form for those who choose not to receive the vaccination.

How to fill out mdph meningococcal information and

How to fill out MDPH Meningococcal Information and Waiver Form

1. Gather necessary information: Name, address, and date of birth of the child.
2. Obtain vaccination history: Check if the child has received the meningococcal vaccine.
3. Complete the personal information section: Fill in the child's details accurately.
4. Review the information about meningococcal disease: Read the provided information carefully.
5. Sign the waiver: If opting out of the vaccine, both the parent/guardian should sign the waiver.
6. Submit the form: Return the completed form to the appropriate school or health department.

Who needs MDPH Meningococcal Information and Waiver Form?

1. Students entering 7th grade or higher.
2. Students attending college who are living in dormitories.

People Also Ask about

Is meningococcal meningitis vaccine mandatory?

At least 34 states and the District of Columbia require some type of vaccination for students who are attending college or university classes. For example: At least 22 states require meningococcal vaccine, with most requiring meningococcal vaccine for students living on campus.

What is an immunization waiver?

All states allow exemptions from school immunization requirements for children who are unable to receive vaccines for medical reasons. State laws vary regarding non-medical exemptions, for religious or personal reasons. Personal exemptions are also referred to as "philosophical exemptions" by some states.

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.

Why not to get the meningococcal vaccine?

There may be times when someone shouldn't get a meningococcal vaccine, like if they: Had a life-threatening allergic reaction after the vaccine. Have a life-threatening allergy to any part of the vaccine.

Is meningococcal vaccine mandatory?

Key points. CDC recommends meningococcal vaccination for all adolescents. CDC also recommends meningococcal vaccination for children and adults at increased risk for meningococcal disease. Follow the recommended immunization schedule to ensure that your patients get the meningococcal vaccines that they need.

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.

Can I get the meningitis vaccine for free?

Are free or low-cost meningococcal shots available? Yes, if you don't have insurance or your insurance does not cover the cost of the meningococcal vaccines, you may be able to find free or low-cost meningococcal shots. Note that there may still be an administration fee of up to $21.22 per shot.

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.

For pdfFiller’s FAQs

What is MDPH Meningococcal Information and Waiver Form?

The MDPH Meningococcal Information and Waiver Form is a document required by the Massachusetts Department of Public Health that provides information about meningococcal disease and allows individuals or guardians to waive the vaccination requirement under certain circumstances.

Who is required to file MDPH Meningococcal Information and Waiver Form?

The form is required to be filed by students attending post-secondary educational institutions in Massachusetts who are not receiving the meningococcal vaccine.

How to fill out MDPH Meningococcal Information and Waiver Form?

To fill out the form, individuals must provide personal information such as their name, address, and educational institution. They must also indicate their vaccination status and sign the form. It may also require a parent's or guardian's signature if the individual is under 18.

What is the purpose of MDPH Meningococcal Information and Waiver Form?

The purpose of the form is to ensure that students and their guardians are informed about the risks of meningococcal disease and to allow students to formally waive the vaccination requirement if they choose not to get vaccinated.

What information must be reported on MDPH Meningococcal Information and Waiver Form?

The form requires information such as the student's personal details, vaccination status related to meningococcal disease, and the signatures of the student and their guardian if applicable.