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This form is required for individuals over the age of 30 at Trinity University who choose not to obtain the Meningitis vaccination, as mandated by Texas Senate Bill 1107 for students under the age
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How to fill out meningitis immunization exemption form

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How to fill out Meningitis Immunization Exemption Form for Individuals Over 30 Years of Age

01
Obtain the Meningitis Immunization Exemption Form from your healthcare provider or state health department.
02
Read the instructions carefully to understand the eligibility requirements.
03
Fill out personal information such as your name, date of birth, and contact details.
04
Provide relevant medical history or reasons for requesting the exemption.
05
Have your healthcare provider complete any necessary sections regarding your health status.
06
Review the form to ensure all information is accurate and complete.
07
Sign and date the form to confirm your request for an exemption.
08
Submit the completed form to the appropriate authority as indicated in the instructions.

Who needs Meningitis Immunization Exemption Form for Individuals Over 30 Years of Age?

01
Individuals over 30 years of age who are seeking an exemption from the meningitis immunization requirement, often for college enrollment or specific employment.
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It is recommended for all kids and teens age 11 and older. Some types of MenACWY are given to younger children (as early as 8 weeks of age) if they have a higher risk of getting meningococcal disease. The meningococcal B vaccine (MenB) protects against a fifth type of meningococcal bacterium (called type B).
Contents. Meningitis is an infection of the protective membranes that surround the brain and spinal cord (meninges). It can affect anyone, but is most common in babies, young children, teenagers and young adults.
Key Vaccine27-49 years Shingles HPV Aged 27–45 years Pneumococcal Hepatitis A 10 more rows • Nov 22, 2024
The CDC recommends you get the vaccine if you are an adult and: Are living in a dorm as a student. Work with meningococcal bacteria in a lab. Are in the military.
In order to submit a medical exemption, you will need to obtain a form from your medical provider and bring it into any campus Admissions & Enrollment Office. To be accepted: The affidavit must be signed and dated by a physician who is registered and licensed to practice medicine in the United States.
A healthcare provider often recommends people who are moderately or severely ill wait before getting a meningitis vaccine. The meningitis vaccine is linked to several side effects, including an increased risk of Guillain-Barré syndrome (GBS).
MenACWY vaccine The vaccine is offered to teenagers aged 14 years old. It is also offered to people up to the age of 25 who have never had a vaccine containing MenC.
CDC recommends meningococcal vaccination for all preteens and teens, as well as other children and adults at increased risk. Meningococcal vaccines are the best way to protect against meningococcal disease, but side effects can occur. Talk to a vaccine provider if you have questions about meningococcal vaccines.

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The Meningitis Immunization Exemption Form for Individuals Over 30 Years of Age is a document that allows adults over the age of 30 to formally opt out of receiving the meningitis vaccination due to specific exemptions such as medical, religious, or philosophical reasons.
Individuals over the age of 30 who are required by law or institutional policy to provide proof of meningitis vaccination but choose to opt out for valid exemptions must file this form.
To fill out the form, individuals need to provide personal identification information, select the type of exemption being claimed, and include any supporting documentation or signatures as required by the form's instructions.
The purpose of the form is to officially document an individual's decision to decline the meningitis vaccination, allowing them to comply with state or institutional requirements while exercising their right to refuse vaccination under specified conditions.
The form typically requires personal information such as the individual's name, date of birth, contact information, the specific exemption type, and a reason for the exemption, along with a signature to validate the request.
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