The Hawaii Vaccine Exemption Form is a document designed for individuals who, based on medical, religious, or personal reasons, choose to exempt their child or ward from vaccines required by the Hawaii Department of Education and the Department of Health. This exemption, grounded in the Hawaii Administrative Rules and Hawaii Revised Statutes, acknowledges the right of parents and guardians to opt-out of vaccinations for their children while also highlighting the responsibilities and potential consequences of such a decision. For those interested in or needing to file an exemption, understanding the specific conditions and legal implications is key.
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In the heart of Hawaii's approach to public health and individual choice, the Hawaii Vaccine Exemption form stands as a testament to the complex landscape where personal beliefs, health considerations, and public safety intersect. This document, underpinned by various state laws and regulations, provides a pathway for parents and guardians to exempt their children from vaccinations on medical or religious grounds. The form explicitly acknowledges the potential risks associated with both vaccination and non-vaccination, citing concerns about vaccine injuries and the inherent nature of vaccines not guaranteeing immunity. It balances these risks against the backdrop of public health concerns, particularly in situations where the Department of Health identifies a communicable disease threat, at which point exemptions may become temporarily null to prevent epidemics. The rules guiding this exemption process, supported by references to the Hawaii Revised Statutes and Hawaii Administrative Rules, underscore the gravity of the decision to opt-out of vaccinations. The document doesn't shy away from encouraging parents to make informed decisions, highlighting the importance of understanding both the risks of vaccinations and the implications of forgoing them. It points out resources for further research, emphasizing the need for thorough personal investigation into the topic, and presents the Vaccination Refusal Form as a declaration of informed choice, subject to Hawaii state law. This form encapsulates a critical dialogue between individual rights and communal health obligations, making it a significant piece of documentation for those navigating the vaccination debate in Hawaii.
State of Hawaii Vaccine Exemption
Pursuant to:
Hawaii Administrative Rules §11-157-5
Hawaii Revised Statues §302A-1156, §302A-1157, §325-0034
I understand that all children are susceptible to diseases, even if they are vaccinated for that particular disease. I understand that, according to the CDC vaccination does NOT provide immunity, and therefore my child could contract the disease, even if vaccinated.
Furthermore, I understand that there is significant risk involved with vaccination and that many children have become seriously injured, sometimes resulting in death, as a direct result of the vaccination. VAERS (Vaccine Adverse Event Reporting System) was specifically created by the government to handle the large number of people that have died or received serious injury from vaccination.
I understand that some advocates of vaccination (usually ones with a vested financial interest) report that vaccination can help prevent certain diseases. However, I do not believe the reported benefits outweigh the confirmed danger and risks inherit with vaccination.
If at any time there is, in the opinion of the Department of Health, danger of an outbreak or epidemic from any communicable disease for which vaccination is required, this exemption from vaccination shall not be recognized. As a result, my child will NOT be vaccinated, but will be excluded from school until the threat of an epidemic is over.
VACCINE REFUSAL FORM
I,____________________________, as the parent, guardian or person in loco parentis of
(insert your name)
the child _________________________, do hereby certify that the administration of any
(insert your child’s name)
vaccine or other “so called” immunizing agents is contrary to our bona fide religious
tenets and practices and our personal beliefs. In Summary, I directly forbid any and all
parties, public or private, to administer any form of vaccination to my child.
This is pursuant to my right to refuse vaccination based on Hawaii State Law (see
§302A-1156, §302A-1157, §325-0034 and HAR §11-157-5). Pursuant to Hawaii statutes I am providing a copy of this statement to our child’s school administrator or operator of the child’s group program.
Pupil’s Name:_________________________________
Date of Birth:______________
School:______________________________________
Grade:____________________
Parent/Guardian Name (print) :_____________________________________________________
Parent/Guardian Signature:________________________________________________________
Date:_________________________
http://www.capitol.hawaii.gov/hrscurrent/Vol05_Ch0261-0319/HRS0302A/HRS_0302A-1156.htm [§302A-1156] Exemptions A child may be exempted from the required immunizations:
(1)If a licensed physician certifies that the physical condition of the child is such that immunizations would endanger the child's life or health; or
(2)If any parent, custodian, guardian, or any other person in loco parentis to a child objects to immunization in writing on the grounds that the immunization conflicts with that person's bona fide religious tenets and practices. Upon showing the appropriate school official satisfactory evidence of the exemption, no certificate or other evidence of immunization shall be required for entry into school. [L 1996, c 89, pt of §2]
http://www.capitol.hawaii.gov/hrscurrent/Vol05_Ch0261-0319/HRS0302A/HRS_0302A-1157.htm [§302A-1157] Exemptions from immunization; not recognized; epidemic conditions.
If at any time there is, in the opinion of the department of health, danger of an epidemic from any of the communicable diseases for which immunization is required under sections 302A-1154 to 302A-1163, no exemption from immunization against the disease shall be recognized. Quarantine shall be a legal alternative to immunization. [L 1996, c 89, pt of §2]
http://www.capitol.hawaii.gov/hrscurrent/Vol06_Ch0321-0344/HRS0325/HRS_0325-0034.htm [§325-34] Exemptions.
Section 325-32 shall be construed not to require the vaccination or immunization of any person for three months after a duly licensed physician or an authorized representative of the department of health has signed two copies of a certificate stating the name and address of the person and that because of a stated cause the health of the person would be endangered by the vaccination or immunization, and has forwarded the original copy of the certificate to the person or, if the person is a minor or under guardianship, to the person's parent or guardian, and has forwarded the duplicate copy of the certificate to the department for its files.
No person shall be subjected to vaccination, revaccination or immunization, who shall in writing object thereto on the grounds that the requirements are not in accordance with the religious tenets of an established church of which the person is a member or adherent, or, if the person is a minor or under guardianship, whose parent or guardian shall in writing object thereto on such grounds, but no objection shall be recognized when, in the opinion of the director of health, there is danger of an epidemic from any communicable disease.
http://gen.doh.hawaii.gov/sites/har/AdmRules1/11-157.pdf [§11-157-5] Exemptions.
(a)Medical exemptions from the requirements for specific immunizing agents shall be granted upon certification by a physician on the physician’s professional stationery that an immunization is medically contraindicated for a specific period of time. The original certificate shall be provided to the exempt person or parent or guardian. A copy of the certificate shall be maintained in the student’s school health record. Reports of such certificates shall be submitted to the department by each school.
(b)A religious exemption shall be granted to a student whose parent, custodian, guardian, or other person in loco parentis certifies that the person’s religious beliefs prohibit the practice of immunization. Requests for religious exemptions based on objections to specific immunizing agents will not be granted. Students who have reached the age of majority shall apply on their own behalf. The certification shall be retained in the student’s health record. Reports of such exemptions shall be submitted to the department by each school.
(c)If at any time, the director determines that there is the danger or presence of an outbreak or epidemic from any of the communicable diseases for which immunization is required under this chapter, the exemption from immunization against such disease shall not be recognized and inadequately immunized students shall be excluded from school until the director has determined that the presence or danger of the outbreak or epidemic no longer exists.
Making Informed Decisions
Your decision to vaccinate or not should be an informed decision. Vaccines can cause severe injuries such as seizures, death, anaphylaxis, brain damage and other reactions. The type and severity of reactions may vary from vaccine to vaccine and child to child. The effects of a vaccine injury may be temporary or permanent. If you notice any changes in your child’s condition after receiving a vaccine, you should contact your doctor immediately or go to a hospital. Vaccines have never been proven to be safe or effective and your child may contract the disease even if he is vaccinated. What has been proven is that you can get the disease from the vaccine or from coming into contact with a recently vaccinated person. The polio vaccine is just one example. It is a known fact that most healthcare providers do not fully inform patients of the side effects a vaccine can have on the body, brain and immune system. Because of the highly toxic ingredients all vaccines contain, you should thoroughly research vaccines for yourself before making such an important decision. DO NOT allow someone else, even your healthcare provider, scare or force you into making this decision without being fully informed. Many healthcare providers have not researched vaccine history or toxicology and are not fully informed. Always provide a detailed history of your child’s health to your doctor. Make sure they know of allergies, neurological problems, nutritional deficiencies, any immune system disorder and skin diseases such as eczema. Most physicians and nurses do not warn parents that if their child’s health is compromised in any way, such as having a common cold or previous reaction to a vaccine, they should not receive vaccines.
Benefits of Non-Vaccination
When you choose to not vaccinate your child, you have the responsibility to educate yourself on how to maintain the well-being of not only their body but also their mind and spirit as well. Childhood diseases can result in minor symptoms to severe complication or death depending on the child’s immune system and treatment protocols followed. The stronger the immune system, the less severe are the symptoms of the disease. A child that goes through the full expression of the disease (i.e. fever and skin eruptions, without suppressing any of these symptoms) usually acquires immunity from that disease for life. Good nutrition and cleanliness play a major role. The risk of contracting various diseases can vary over time or locality. Symptoms or complications of these diseases may be treatable by alternative methods or may resolve without treatment. Educate yourself on childhood diseases from informed alternative sources. Fear of these diseases comes from not being properly informed.
For More Information
To make a truly informed decision there are numerous sources of information on the risks of vaccines and the risks and benefits of childhood diseases. Sources of information to determine if the risks associated with vaccines outweigh any perceived benefits include: vaccine package inserts, the Physicians Desk Reference, the U.S. Center for Disease Control and Prevention, public and medical libraries or state and local health agencies. (NOTE: These sources do not give complete and total information on vaccine ingredients and their toxicity, nor do they provide accurate statistics.)
Vaccination Liberation – www.vaclib.org or (888) 249-1421
National Vaccine Information Center – www.909shot.com or (800) 909-SHOT / (703) 938-0324
(NOTE: The two websites above, Vaccination Liberation and the National Vaccine Information Center, have proven to be excellent sources for extensive vaccine information.)
Reporting Reactions
If you do decide to vaccinate, report vaccine reactions to:
Vaccine Adverse Event Reporting System (800) 822-7969
Always get the vaccine name, vaccine manufacturer and lot number. Keep records of day to day reactions from the time of vaccination for at least 6 months to 2 years, no matter how slight the reactions. Long-term effects of vaccines have not been well documented by the allopathic community and are just now being researched. If your child has been injured by a vaccine, he may be eligible for compensation under the National Vaccine Injury Compensation Program.
Revised 11/2008 Source:
A New Life Family Chiropractic
803 Kamehameha Hwy., Suite 301
Pearl City, HI 96782
This form may be reproduced
Opting out of vaccination for your child is a significant decision requiring thorough consideration and understanding of both the implications and the legal steps involved. When deciding to apply for a vaccine exemption in Hawaii, familiarize yourself with the detailed process to ensure compliance with state laws and regulations. The form mentioned serves as an official declaration of vaccine refusal based on either medical or religious grounds, outlines the possible risks associated with vaccination, and emphasizes the importance of making an informed decision.
To fill out the Hawaii Vaccine Exemption form correctly, please follow these steps:
Remember, this form is a declaration that should not be taken lightly. It is highly recommended to research and consult healthcare professionals to make an informed decision that best serves the health and well-being of your child. Keeping open communication with your child's school and staying informed about public health notifications in your area are critical steps following the submission of this form.
What is the purpose of the Hawaii Vaccine Exemption form?
The Hawaii Vaccine Exemption form allows parents or guardians to exempt their child from vaccination requirements for school entry based on religious beliefs or if a licensed physician certifies that vaccination would endanger the child's life or health. This exemption applies under certain sections of the Hawaii Administrative Rules and Hawaii Revised Statutes, emphasizing informed decision-making regarding vaccination risks and effects.
Who can file for a vaccine exemption in Hawaii?
Parents, guardians, or any person in loco parentis to a child can file for a vaccine exemption in Hawaii. There are two grounds for exemption: medical, if a vaccine poses a risk to the child's health as certified by a physician, and religious, if vaccination conflicts with the genuine religious beliefs of the family.
How can I apply for a religious or medical vaccine exemption for my child?
To apply for a medical exemption, a physician must certify on professional stationery that an immunization is medically contraindicated for the child. For a religious exemption, the parent or guardian must certify that their religious beliefs prohibit the practice of immunization. This documentation should be submitted to the child's school administrator or the operator of the child's group program.
What happens if there is an outbreak of a disease?
In the event of an outbreak or epidemic of a communicable disease, the Hawaii Department of Health may not recognize exemptions. Children who are not vaccinated may be excluded from school until the health department determines that the threat is over. Quarantine may be offered as a legal alternative to immunization during such events.
Are there resources available to help make an informed decision about vaccination?
Yes, various resources can help in making an informed decision. These include vaccine package inserts, the Physicians Desk Reference, the U.S. Center for Disease Control and Prevention, and state or local health agencies. Organizations like Vaccination Liberation and the National Vaccine Information Center also offer extensive information on vaccines.
How can vaccine reactions be reported?
Any adverse reactions following vaccination should be reported to the Vaccine Adverse Event Reporting System (VAERS). It's important to document the vaccine name, manufacturer, and lot number, as well as to keep records of any reactions for at least 6 to 24 months. If a child is injured by a vaccine, they may be eligible for compensation under the National Vaccine Injury Compensation Program.
Filling out the Hawaii Vaccine Exemption form requires careful attention to detail to ensure compliance with state laws and regulations. People often make mistakes during this process, which can complicate or delay their exemption requests. Below are nine common errors to avoid:
When properly completed and submitted, the Hawaii Vaccine Exemption form allows for legal exemption from vaccination requirements under specified conditions. However, it is essential to approach this process with care and thorough understanding of the legal and health implications to ensure the well-being and compliance of all involved parties.
When navigating the process of requesting vaccine exemptions in Hawaii, it is common to include additional documents alongside the Hawaii Vaccine Exemption form to ensure a thorough and robust submission. These documents often provide further evidence, compliance, or clarity required by schools, healthcare providers, or legal authorities. Understanding these documents and their purpose can streamline the exemption process and clarify the rights and responsibilities of all parties involved.
Together, these documents form a comprehensive packet that addresses both the legal and personal considerations involved in requesting a vaccine exemption in Hawaii. Providing complete and clear documentation can assist officials and institutions in processing exemption requests efficiently, ensuring that the child's health and education needs are met in compliance with state laws and regulations.
The Hawaii Vaccine Exemption form is similar to other legal documents that enable individuals to express their medical or religious preferences in accordance with state laws. These documents often serve to communicate a personal decision that deviates from the norm, especially in situations where such decisions impact public health policies. Among these, the most notable are the Medical Exemption Form and the Religious Exemption Form, each catering to different grounds for exemption.
Similar to the Hawaii Vaccine Exemption form, the Medical Exemption Form is used when a licensed healthcare provider determines that a vaccine poses a risk to the health of the individual due to pre-existing medical conditions. This form requires detailed documentation from a physician, outlining the medical rationale behind the exemption. It is a critical piece of documentation that must be presented to school authorities or other relevant parties to ensure the individual is exempt from mandatory vaccinations without facing penalties or denial of services. The emphasis on a healthcare provider’s certification parallels the Hawaii form's requirement for a health risk assessment in determining eligibility for exemption.
Equally important, the Religious Exemption Form serves as a declaration that vaccination contradicts the personal religious beliefs of the individual or family. While the specifics can vary by jurisdiction, this form generally does not require the endorsement of a religious leader but rather a signed statement from the individual or guardian. This is akin to the section of the Hawaii Vaccine Exemption form which permits exemptions based on religious tenets and practices. The form acknowledges the rights of individuals to refuse vaccinations on the grounds that it conflicts with their religious values, thereby safeguarding their freedom of religious expression as recognized by state laws.
Filling out the Hawaii Vaccine Exemption Form is a responsible act that should be approached with care and understanding. Here are six essential dos and don'ts to keep in mind during the process:
Understanding the vaccine exemption process in Hawaii requires clarity about its framework and common misconceptions. Below are seven misconceptions about the Hawaii Vaccine Exemption form:
It's crucial for parents and guardians considering the vaccine exemption route to thoroughly understand not only the content of the exemption form but also the broader context in which vaccines are administered and regulated. Making an informed choice means considering a wide range of information, including scientific evidence and public health guidelines, alongside personal beliefs and values.
When considering the use of the Hawaii Vaccine Exemption form, it's essential to grasp the implications fully and ensure all steps are correctly followed. Here's what you need to know:
Whether choosing to vaccinate or not, the importance of being well-informed cannot be overstated. The decision should be based on thorough research and a well-rounded understanding of all available information. In this endeavor, consider consulting multiple sources, including medical professionals, to ensure a decision that is best for your child's health and well-being.
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Hawaii Department of Revenue - The Hawaii M-38 form serves as an exemption certificate specifically for diesel oil and liquefied petroleum gas utilized away from public highways.
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