<>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 11 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> The QR code may be scanned into an app on your smartphone and used to verify your COVID-19 vaccination history at places that have a SMART Health Card compatible verifier app, such as airports, business, and large venues. Polio Find out if you qualify for a Special Enrollment Period. Answer:There is a medical exemption for nursing home employees for flu vaccination. When both are completed, you can go to "My Tickets" on ACMS and upload the completed form to your RA ticket. Your patient has requested a medical exemption from this . All employees wishing to obtain either a religious or medical exemption from the COVID-19 vaccination need to complete and sign the first page. To fill out a health coverage exemption application, you'll need to download it onto your computer first. A goal of the Arkansas Department of Health is to control and prevent the spread of these diseases by providing vaccines to local health units in each county and over 500 non-health department facilities in Arkansas. Eight requests are for religious reasons and. Those seeking a medical exemption will need to fill out this form and have it signed by a medical provider certifying that they should not receive the COVID-19 vaccine. PLEASE NOTE: The form requires a signature and seal of a Notary Public. 2017 Arkansas Department of Health. Updated COVID-19 boosters can both help restore protection that has decreased since the previous vaccination and provide broader protection against newer variants. If aSMART Health Card compatible verifier app is not available, you may present the paper copy of your SMART Health Card. Please Click here to download the list of International Travel Physicians who provide immunizations for travelers. . I have read the Vaccine Information Statement and understand by not receiving the Hepatitis A vaccine, the student listed here is at risk of yellow skin or eyes, flu-like illness, abdominal pain, loss of appetite, nausea, joint pain, and/or life-long liver problems (such . Arkansas will implement COVID-19 SMART Health Cards beginning September 14. They can give you allergy testing to see what, exactly, you're allergic to and then recommend the right COVID-19 vaccine for you based on the findings, said Dr. Schaffner. Click to download the Medical Exemption Application Form for nursing home workers. Cloudflare Ray ID: 7c0a196d9a2cef7f Centers for Disease Control and Prevention. To apply, please view the brief Introduction video below. Here you will find vaccination recommendations for children, teens, and adults. Click to download the exemption application form. Provider Annual Profile and Order Form Q: How do I get a religious or philosophical exemption for my child regardingtheir required immunizations? Provider Annual Profile and Order Form HIB They are available in local health departments and many physicians offices. Answer:The Arkansas Department of Health does not provide immunizations for travelers. As part of the application, the law requires that the parent/guardian or college student complete an educational activity when requesting an exemption. 1 and Hepatitis B (for those exposed to blood and body fluids, vaccinations for all of its employees. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources. If you dont have the right software installed, youll be sent to a page telling you to download it. If you do happen to qualify for a medical exemption, it will likely be in the form of a doctor's note, said Dr. Schaffner. For more information, go here. Answer: Yes, please call your local health department to schedule an appointment for vaccinations. When approved, exemptions will be effective for the start of the Fall session in 2022 and go through the . Colorado Senate Bill 163 requires a person seeking a nonmedical exemption (either religious or personal belief) to submit a certificate of completion of an online educational module or a certificate of nonmedical exemption. Each time you receive an additional dose of COVID-19 vaccine, you will need to obtain a new COVID-19 SMART Health Card to ensure all vaccinations are included on your card and in your QR code. If you received COVID-19 vaccinations in another state, you may provide your vaccination information to your health care provider for a local health unit and the information will be added to your Arkansas WebIZ record. Vaccine-preventable diseases can be very serious, may require hospitalization, or even be deadly - especially in infants and young children. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. "Because there is more than one type of vaccine available in the United States, I don't think that there are actual true medical exemptions to both mRNA vaccines and the adenovirus vectored vaccine," infectious disease expert Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, told Health. COVID-19 Mu Variant Named a 'Variant of Interest'Here's What You Need to Know, What To Do if You Have an Allergy to a COVID-19 Vaccine, Pfizer-BioNTech's COVID-19 Vaccine Ingredient List, Booster Recommendations After J&J's Janssen COVID-19 Vaccine. PLEASE NOTE: The form requires a signature and seal of a Notary Public. When youre done filling out the form, print it and mail it to the Health Insurance Marketplace. The information in this story is accurate as of press time. Where can I find theSMART health card FAQs? You can email the site owner to let them know you were blocked. "For example, if someone had a severe allergic reaction to dose one of the mRNA vaccines, they could complete their series with the Johnson & Johnson vaccine," said Dr. Adalja. TD (Tetanus, Diphtheria) 2022-2023 Childcare-School Immunization Exemption Application, DTap Their objections were largely based. Screening Checklist Arkansas Immunisation Exemption Application. If you received COVID-19 vaccinations in another state, you may provide your vaccination information to your health care provider for a local health unit and the information will be added to your Arkansas WebIZ record. Centers for Disease Control and Prevention. When you receive a COVID-19 vaccination record from the Arkansas Department of Health or your health care provider and the record is from the state immunization information system, WebIZ, the record will contain your COVID-19 vaccination history and a 2D barcode, commonly known as a QR code. Locate the exemption PDF document you downloaded to your computer in Step 2. For example, one such situation recognized by the CDC as a contraindication to getting a Johnson & Johnson booster vaccine is for those who experience thrombosis with thrombocytopenia syndrome (TTS) after their first J&J shot. Your SMART Health Card will only contain COVID-19 vaccinations that have been entered into the Arkansas immunization information system, WebIZ. Only a 2022-2023 Immunization Exemption Application will be accepted for the 2022-2023 school year. endobj The notary page must be printed, signed, notarized and submitted back to ADH before processing can be complete. For people who experience this or another adverse event following a shot, the CDC encourages you to report it to the Vaccine Adverse Event Reporting System (VAERS). A physician statement outlining medical reasons for an exemption of a specific immunization is to be submitted to the Medical Director of the Immunization Section with the exemption form. They can give you allergy testing to see what, exactly, you're allergic to and then recommend the right COVID-19 vaccine for you based on the findings, said Dr. Schaffner. Interim clinical considerations for use of COVID-19 vaccines currently approved or authorized in the United States. 2017 Arkansas Department of Health. 1 0 obj Additional information on SMART Health Cards is available here. For example, when dozens of employees at Conway Regional Health System in Arkansas sought religious exemptions to a COVID-19 vaccine, citing fetal cells, the CEO sent them a list of common . Hepatitis A All Rights Reserved. All rights reserved. If you do not have access to a printer, you will need to complete the paper form of the application. Arkansas Gov. Vaccine clinics and events may also be available in your area through hospitals, health care providers, or your worksite. Click on the document to open it. When approved, exemptions will be effective for the start of the Fall session and go through the Summer sessions. FLU VIS. Here's a list of the Comirnaty/Pfizer-BioNTech vaccine ingredients: While we're at it, here's a list of the ingredients in the Moderna COVID-19 vaccine: And the ingredients for the Johnson & Johnson COVID-19 vaccine: For each vaccine, the contraindication is the same: You shouldn't get it if you have had a severe allergic reaction to one of the ingredients in the vaccine. Click here for a list of clinics. Screening Checklist To obtain an exemption parents/guardian/student must (1) sign a notarized statement requesting a . Home; Community, Family & Child Health; Immunizations; Immunizations. Regional Health System asks employees requesting a religious exemption from the hospital's COVID-19 vaccine mandate to confirm they will not use. Performance & security by Cloudflare. 7500 Security Boulevard, Baltimore, MD 21244. All Arkansans ages 6 monthsor older are now eligible to receive the vaccine. U.S. Food and Drug Administration. Still, if you happen to be allergic to any ingredient in one COVID-19 vaccine, experts recommend investigating to see if you can get another vaccine. Call 1-800-803-7847 for assistance finding a vaccine in your area or to sign up for an ADH clinic. Hepatitis B Q:Where do I get information on vaccines needed for international travel? Q: Is there a medical exemption regarding flu vaccinations for nursing home workers? ATTN: Exemptions Youre ready to start filling it out. Varicella (Chickenpox), 2023-2024 College Immunization Exemption Application All Rights Reserved. A vaccine exemption Affidavit is a document that is sworn by you and signed before a notary public (including a notary or a paralegal) in order to establish your request to be exempt from the COVID-19 vaccine. %PDF-1.7 Some states make it easier to avoid vaccines than others. Only a valid Immunization Exemption Application will be accepted for the school year. Copyright 2017 - 2018 Arkansas Immunization Program. Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. It establishes an immunization goal of 95% of each school's student population and requires . Q. The COVID-19 SMART Health Care QR Code is not connected to the WebIZ. Immunization doesnt just protect the person getting the shot; it protects the entire community. Or E-mail us to request the exemption form. Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. You will then need to include the requested information and return the updated application for processing. NOTE: The person requesting the shot record must be a responsible party on record. and that you still choose to request an exemption. You have two options: Double-check youre following the download instructions for your web browser. Polio NOTE: You MUST have access to a printer before you start the online application process. "Getting vaccinated is important," said Dr. Schaffner. Statistics show that states where exemptions are easy to get have more. The Centers for Disease Control and Prevention (CDC) breaks down the contraindications and precautions for people getting any of the COVID-19 vaccines. There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data. You are asked to sign that you havereviewed the Vaccine Information Statements, that you understand the risks and benefits of the vaccines, and that you still choose to request an exemption. Office of Performance Management Quality Improvement and Evaluation, 2023-2024 Childcare-School Immunization Exemption Application, 2022-2023 Childcare-School Immunization Exemption Application, 2023-2024 College Immunization Exemption Application, 2022-2023 College Immunization Exemption Application, Immunizations Required for AR Daycares & Schools, NH Immunization Reporting Form for NH's 22-23, Recommended Immunizations for Children (Birth through 6 Years), Recommended Immunizations for Preteens and Teens (7-18 Years), Recommended Immunizations for Adults (19 Years and Older) by Age and Medical Condition, Recommended Immunization Schedule for Children and Adolescents aged 18 Years or Younger, Recommended Immunization Schedule for Adults. stream Hepatitis B Though some healthcare facilities require healthcare workers to get vaccinations for vaccine-preventable diseases, no state requires vaccines for adults. 4 0 obj Office of Performance Management Quality Improvement and Evaluation, 2023-2024 Childcare-School Immunization Exemption Application, 2022-2023 Childcare-School Immunization Exemption Application, 2023-2024 College Immunization Exemption Application, 2022-2023 College Immunization Exemption Application, Immunizations Required for AR Daycares & Schools, NH Immunization Reporting Form for NH's 22-23, Recommended Immunizations for Children (Birth through 6 Years), Recommended Immunizations for Preteens and Teens (7-18 Years), Recommended Immunizations for Adults (19 Years and Older) by Age and Medical Condition, Recommended Immunization Schedule for Children and Adolescents aged 18 Years or Younger, Recommended Immunization Schedule for Adults, Early Hearing Detection and Intervention Performance, Hospital Reporting Form-Lay Midwife Patient Transfer. Tdap (Tetanus, Diptheria, Pertussis) HB1977 and SB739 would require employers that mandate vaccinations to provide an exemption process for workers, including requiring them to produce a negative antigen test once a week or proof of. Pneumococcal Conjugate (PCV13) TD (Tetanus, Diphtheria) Complete and mail to: Arkansas Department of Health 4815 West Markham - Mail slot 48 Little Rock, AR 72205. If you do not have access to a printer, you will need to complete the paper form of the application. What Are the Differences Between the Pfizer and Moderna COVID-19 Vaccines? 3 0 obj Rochelle Collins, DO, is a board-certified family medicine physician and assistant clinical professor of family medicine at Quinnipiac University. % What Conditions Can Get You a Medical Exemption From the COVID-19 Vaccine? Hepatitis A Or E-mail us to request the exemption form. endobj Conway Regional Hospital is requiring its staff to get the COVID-19 vaccine. Pfizer-BioNTech COVID-19 vaccines. In the near future, the federal Occupational Safety and Health Administration (OSHA) and the North Carolina Division of Occupational Safety and Health (NC OSH) are likely to require most larger employers to adopt a vaccine mandate (see here).Vaccine mandates are lawful, subject only to .