attached: HRS
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 |
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