University of California San Diego Varicella Zoster Vaccine Acceptance/Declination Form 2014-2025 free printable template

Varicella Zoster Vaccine Acceptance/Declination Form Occupational exposure to Varicella Zoster Virus VZV puts individuals at risk for varicella zoster infection chickenpox and recurrent infection with herpes zoster shingles. Varicella infection causes symptoms of fever rash and malaise. Latent VZV may reactivate and cause recurrent disease Herpes Zoster/Shingles with painful skin lesions. Varicella Zoster Vaccine Acceptance/Declination Form Occupational exposure to Varicella Zoster Virus VZV...

How to fill out University of California San Diego Varicella Zoster Vaccine

How to fill out University of California San Diego Varicella Zoster Vaccine

1. Obtain the Varicella Zoster Vaccine from a qualified healthcare provider.
2. Complete the required vaccination form provided by UC San Diego.
3. Provide proof of vaccination or the medical history indicating previous chickenpox infection.
4. Submit the completed form and any required documents through the UC San Diego student health portal.
5. Ensure that the submission is completed before the deadline set by the university.

Who needs University of California San Diego Varicella Zoster Vaccine?

1. All incoming students at UC San Diego who have not been previously vaccinated against chickenpox.
2. Individuals who have no documented history of chickenpox.
3. Students born after 1980 who are enrolling in UC San Diego and have not received the vaccine.

People Also Ask about

When should I withhold my varicella vaccine?

Precautions for Varicella Vaccination People with acute severe illness, including untreated, active tuberculosis, should postpone vaccination until they recover. The decision to delay vaccination depends on the severity of symptoms and the etiology of disease.

Do you want a positive or negative varicella titer?

If your test result comes out negative or equivocal, you need to get vaccinated. If it's positive, it means you have had the chickenpox infection previously (or the immunization) and have developed an immunity to the disease. It's best to consult with medical experts when uncovering the results of your varicella titer.

How do you get proof of varicella immunity?

Evidence of immunity includes any of the following: Documentation of two doses of varicella vaccine; Blood tests showing immunity due to a history of disease; or. Documentation of a diagnosis or verified history of varicella (chickenpox) or zoster (shingles) from a health care provider.

Do I need varicella titer if I had vaccine?

In what circumstances should I obtain a varicella titer after vaccination? Postvaccination serologic testing is not recommended in any group, including healthcare personnel. A child received only one dose of varicella vaccine and subsequently tests positive for varicella IgG antibody.

How long is a varicella titer good for?

Several studies have shown that people vaccinated against varicella had antibodies for at least 10 to 20 years after vaccination.

Can you get titer after vaccine?

Once vaccinated, titers should not be drawn until 6-8 weeks after the vaccination. Why? If drawn too soon afterwards, the titers will indicate non-immunity as the vaccine will still be in your system. Don't make the mistake of getting a titer drawn prematurely in order to meet the deadline.

When do you need a varicella titer?

Anyone who needs to get the varicella vaccine or is looking to verify their immunity status should take a varicella titer test. Generally, it's recommended for: All adults living with children. Childcare workers.

For pdfFiller’s FAQs

Who is required to file varicella declination form?

Parents or guardians of children enrolling in school or daycare in the United States are required to file a Varicella Declination Form if their child has not previously received the Varicella (chickenpox) vaccine.

What is varicella declination form?

There is no specific term or concept called "varicella declination form." It could possibly be a typographical error or a misunderstanding. However, there is a vaccination called the Varicella vaccine (also known as the chickenpox vaccine). This vaccine is used to protect against the varicella-zoster virus that causes chickenpox. When people receive the vaccine, they may need to fill out a form called a "vaccine declination form" if they choose not to get vaccinated. This form documents their decision to decline or refuse vaccination, typically due to personal or religious reasons.

How to fill out varicella declination form?

To fill out a varicella (chickenpox) declination form, you need to follow these steps: 1. Obtain the form: Contact the relevant institution, such as a school or healthcare facility, to request a copy of the varicella declination form. They may provide it in person or have it available for download on their website. 2. Read the form: Carefully review the entire form to understand the information required and any instructions or guidelines provided. 3. Personal Information: Write your full legal name, date of birth, address, and contact information in the sections designated for personal information. Ensure that the information matches your official identification documents. 4. Reason for Declination: In the appropriate section, indicate why you are declining the varicella vaccine. This could include reasons such as prior infection, medical contraindication, religious beliefs, or personal preference. 5. Signature and Date: Sign and date the form to certify that the information provided is accurate and true to the best of your knowledge. 6. Witness Signature: If required, find a witness who can observe your signing of the form and attest to its legitimacy by signing and dating it themselves. 7. Submit the Form: Once completed, return the form to the institution that provided it. They may ask for it in person, through mail, or through an online submission process. Follow their instructions to ensure proper submission. Remember to retain a copy of the filled-out form for your records.

What is the purpose of varicella declination form?

The purpose of the varicella declination form is to document that an individual has declined or refused to receive the varicella vaccine, which is a vaccine that protects against chickenpox. This form ensures that the individual has made an informed decision regarding their vaccination status, and it may be required by schools, workplaces, healthcare facilities, or other organizations to maintain records and ensure compliance with vaccination policies.

What information must be reported on varicella declination form?

The specific information required on a varicella declination form may vary by organization or jurisdiction, but generally, it could include the following details: 1. Name of the individual declining the varicella (chickenpox) vaccination. 2. Date of birth of the individual. 3. Contact information of the individual (address, phone number, email address). 4. Reason for declining the varicella vaccination (such as medical contraindication, religious belief, personal choice). 5. Any additional comments or explanations the individual wishes to provide. 6. Signature of the individual and the date of signing. 7. In some cases, the form may also require the signature or acknowledgment of a healthcare provider, parent/guardian (if the individual is a minor), or employer representative (if the individual is an employee) confirming the declination. Please note that the specific requirements may vary, so it is advisable to consult the specific form or guidelines provided by the organization or jurisdiction in question.

How do I complete University of California San Diego Varicella Zoster Vaccine online?

Filling out and eSigning University of California San Diego Varicella Zoster Vaccine is now simple. The solution allows you to change and reorganize PDF text, add fillable fields, and eSign the document. Start a free trial of pdfFiller, the best document editing solution.

How do I edit University of California San Diego Varicella Zoster Vaccine on an iOS device?

Create, edit, and share University of California San Diego Varicella Zoster Vaccine from your iOS smartphone with the pdfFiller mobile app. Installing it from the Apple Store takes only a few seconds. You may take advantage of a free trial and select a subscription that meets your needs.

How do I fill out University of California San Diego Varicella Zoster Vaccine on an Android device?

Use the pdfFiller Android app to finish your University of California San Diego Varicella Zoster Vaccine and other documents on your Android phone. The app has all the features you need to manage your documents, like editing content, eSigning, annotating, sharing files, and more. At any time, as long as there is an internet connection.

What is University of California San Diego Varicella Zoster Vaccine?

The University of California San Diego Varicella Zoster Vaccine is a vaccine administered to protect individuals against the varicella-zoster virus, which causes chickenpox and shingles.

Who is required to file University of California San Diego Varicella Zoster Vaccine?

Individuals who are enrolling at the University of California San Diego, including new students, typically need to file proof of varicella vaccination or immunity.

How to fill out University of California San Diego Varicella Zoster Vaccine?

To fill out the University of California San Diego Varicella Zoster Vaccine form, you need to provide personal information, vaccination dates, and healthcare provider details, along with any necessary documentation of immunity.

What is the purpose of University of California San Diego Varicella Zoster Vaccine?

The purpose of the University of California San Diego Varicella Zoster Vaccine is to ensure that students are immunized against chickenpox, helping to prevent outbreaks within the campus community.

What information must be reported on University of California San Diego Varicella Zoster Vaccine?

The information that must be reported includes the individual's name, date of birth, vaccination dates, type of vaccine received, and the healthcare provider's signature.