Department of Nursing and Allied Health

Hepatitis B vaccine is used to protect individuals from Hepatitis B virus (HBV) infection acquired on the job. It is usually the result of a needle stick or an accident involving sharps, and other hospital procedures associated with exposure to the virus including phlebotomy, intravenous line placement, bronchoscopy, intubation and airway suctioning. Hepatitis B vaccine is a method of preventing HBV infection.

All Spoon River College students working in hospital areas that involve direct patient contact with blood products or patient care items are urged to receive the Hepatitis B vaccine on a voluntary basis. The vaccine is given in a series of three injections over a six-month period. Vaccine is available at county health departments and private physician’s offices.

General Policy

  • The vaccine is recommended, but voluntary.
  • Students who do not wish to receive this vaccine must sign a waiver stating that he/she has been informed about the risk of Hepatitis B virus infection, but refuses to be vaccinated against it.
  • Students who have had a prior proven Hepatitis B infection or pregnant women may be asked to have a screening test for antibody to the Hepatitis B antigen to determine the need for vaccination.
  • Students who are unsure about a previous personal history of Hepatitis B infection may be asked to have a screening test for antibody to the Hepatitis B antigen to determine the need for vaccination.
  • Hepatitis B vaccine is for protection only from Hepatitis B infection. Other hepatitis virus infection may still occur. Consequently, all needle sticks and other possible infection exposure problems must be reported.
  • Hepatitis B vaccine does not protect individuals from Human Immunodeficiency Virus (HIV) infections. Following the CDC (Centers for Disease Control and Prevention) guidelines for standard precautions (barrier protection, safety guidelines and needle precaution) will minimize the risk of HIV infection, as well as HBV. Note: the transmission of Hepatitis B Virus (HBV) is much more probable than transmission of Human Immunodeficiency Virus (HIV).


In order to document your vaccinations (or your choice to not receive them), please complete the following form:

  1. Fill the required and appropriate areas below.
  2. Once the form is submitted, you will be taken to a printable page with your form results.
  3. Use the “Print This Page to Finish” button at the bottom of the page to…
    1. Print a hard copy to sign the waiver if not receiving vaccinations.  Or…
    2. If only saving for your records, use a “print to PDF” option if available.
  4. (If you make an error in printing or need to print more than once, return to the print page and reload the page to display the print button again.)
Hepatitis B Vax Record

Clinical sites utilized by Spoon River College require health occupation students show proof of either receiving the series of three Hepatitis B vaccine immunizations or sign a waiver indicating that the student has chosen to not receive the vaccination series at this time.  If the series of three Hepatitis B vaccine immunizations are not complete, the waiver must be signed.  This is the same for any student in a healthcare lab setting at the college.

  1. I have elected to receive the Hepatitis B vaccination series:


2. Waiver signed and attached: