Student Statement Regarding Hepatitis B.

I understand that as a nursing or health sciences student I will potentially be exposed to blood borne pathogens or other potentially infectious materials (OPIM), and that I may be at risk of acquiring the Hepatitis B Virus (HBV) infection or other potentially dangerous diseases as an occupational hazard.

I further understand that while I am in process of receiving the series of vaccine injections for Hepatitis B, I may not be fully protected against the disease and may continue to be at risk for the Hepatitis B Virus and that receiving the series does not guarantee me immunity to the disease. I also recognize that completing the Hepatitis B series also does not guarantee my immunity from the disease, and that only by obtaining a titer can this be determined.

I also understand that it is my right to decline the Hepatitis B vaccination series at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B, a serious disease. If, in the future, I continue to have occupational exposure to blood or other potentially infectious materials, and I want to be vaccinated with hepatitis B vaccine, I can receive the vaccination series at any time at my expense.

American University of Health Sciences strongly urges you to use precautions and established best practices when dealing with potentially infectious materials and to obtain a Hepatitis B titer to determine whether you are protected from the disease.

By choosing nursing or another health science related career, I acknowledge my risk of exposure to blood borne pathogens and other potentially infectious materials and accept full responsibility for my decisions related to Hepatitis B.

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I have completed the Hepatitis B series or am completing the series and accept that this does not guarantee me immunity from the disease.

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