I ELECT NOT TO HAVE A FLU SHOT IN 2023-2024

I acknowledge that I was aware of the following facts:

• Influenza is a serious respiratory disease; on average, 36,000 Americans die every year from influenza- related causes.
• Influenza virus is contagious for up to 24 hours before symptoms begin, increasing the risk of transmission to others.
• Some people with influenza have no symptoms, increasing the risk of transmission to others.
• Influenza virus changes often, making annual vaccination necessary. In California, influenza usually begins circulating in early January and continues through February or March.
• I understand that the influenza vaccine cannot transmit influenza.
• I understand that the influenza vaccine does not prevent all diseases.
• I declined to receive the influenza vaccine for the 2023-2024 season. I acknowledge that influenza vaccination is recommended by the Centers for Disease Control and Prevention for all early childhood education workers in order to prevent infection from and transmission of influenza and its complications, including death, to students, my coworkers, my family, and my community.