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This document provides information about meningococcal disease and the requirement for vaccination for students at residential schools and colleges in Massachusetts, including details on exemptions,

How to fill out mdph meningococcal information and

How to fill out MDPH Meningococcal Information and Waiver Form

1. Obtain the MDPH Meningococcal Information and Waiver Form from the official website or your healthcare provider.
2. Review the instructions provided on the form carefully.
3. Fill out the personal information section, including your name, date of birth, and contact information.
4. Provide information about your vaccination history, indicating if you have received the meningococcal vaccine and the date of the vaccine.
5. If opting for the waiver, check the appropriate box indicating your decision.
6. Read and sign the acknowledgment section to confirm your understanding of the information provided.
7. Submit the completed form to the designated authority, such as your school or healthcare provider.

Who needs MDPH Meningococcal Information and Waiver Form?

1. Students attending college or university who are required to have the meningococcal vaccine.
2. Parents or guardians of minors who are enrolling in college or university.
3. Individuals who are opting out of the meningococcal vaccination for personal reasons and wish to submit a waiver.

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 provided by the Massachusetts Department of Public Health that offers information about meningococcal disease and allows parents or guardians to waive the requirement for their child to receive the meningococcal vaccine.

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

Students in grades 11 and 12 in Massachusetts are required to have the meningococcal vaccine, and their parents or guardians must file the MDPH Meningococcal Information and Waiver Form if they choose not to vaccinate.

How to fill out MDPH Meningococcal Information and Waiver Form?

To fill out the MDPH Meningococcal Information and Waiver Form, parents or guardians should provide their child's information, indicate whether they intend to vaccinate or waive the vaccine, and sign the form to acknowledge understanding of the information provided.

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

The purpose of the MDPH Meningococcal Information and Waiver Form is to educate parents and guardians about the risks of meningococcal disease and vaccination, while also providing a means to formally waive the vaccination requirement if they choose to do so.

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

The form must report the student's name, date of birth, school, and information regarding the meningococcal vaccine, including whether the vaccine has been administered or if the waiver is being requested.