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Declination of COVID-19 Vaccination

The information on this page relates ONLY to current Mulgrave Private and South Eastern Private employees.

Declination of COVID-19 Vaccination

My employer, Healthe Care, recommends I receive the COVID-19 vaccination to protect myself, patients, staff and others in the healthcare facility.

I acknowledge that I am aware of the following facts:

I understand that COVID-19 is a serious, contagious virus that can easily spread from person to person. Some infected persons may have severe disease and die. No one knows how COVID-19 may affect them.

I understand that COVID-19 vaccination is recommended for me, and for all other healthcare workers, to help prevent spreading the disease to patients, families and staff, and to protect me from getting COVID19 or from serious illness if I do get infected.

I understand that if I contract COVID-19, I am potentially contagious for two days before any symptoms appear. During this time, and for 10-14 days after infection, I can potentially transmit COVID-19 to patients, families and staff in this facility and to my family.

I understand that if I become infected with COVID-19, even if my symptoms are mild or non-existent, I can spread the virus to others. Symptoms that are mild or non-existent in me can still cause serious illness and death in others.

I understand that if I get COVID-19, I will be required to isolate away from others and will not be able to work for a minimum of 10 days after symptoms appear or 14 days from the date I test positive if I have no symptoms, and I will not be able to return to work until I receive two negative COVID 19 tests.

I understand that I cannot get COVID-19 from the vaccine and that getting the vaccine is a safer way to build up immunity.

I understand that side effects usually go away on their own within a week and are a sign that the immune system is working.

The consequences of my refusal to be vaccinated could be life threatening for me and the health of everyone with whom I have contact, including my co-workers and all patients in this healthcare facility.

Despite the above facts, if you would still choose to decline the COVID-19 vaccine, please download and complete the Declination Form below and return it to [email protected]