Vaccination Waiver Form For Your Vet Records


Dear Doctor <White Coat> and staff at <Hunky Dory Vet Clinic>,

Since my dog <Bowser (or cat Fluffy)> has been diagnosed with <flea allergies, hypothyroidism, irritable bowel, etc.> I see the need to exempt him from further vaccinations going forward. As every vaccine is labeled, “Only For Use in Healthy Dogs, Cats, and Ferrets,” and healthy doesn’t include <allergies, hypothyroidism, lipomas, chronic ear infections, etc.: (fill out as many diagnoses as have been made, either by the vet or by you)>, it’s apparent that Bowser <Fluffy> needs to be exempt from more vaccinations.

Further, as veterinary immunologists Ronald D. Schultz, Ph.D. and Tom R. Phillips, D.V.M, Ph.D. wrote in Current Veterinary Therapy XI, in 1992,

“A practice that was started many years ago and that lacks scientific validity or verification is annual revaccination. Almost without exception there is no immunologic requirement for annual revaccination. Immunity to viruses persists for years or for the life of the animal… Furthermore, revaccination with most viral vaccines fails to stimulate an anamnestic (secondary) response…. The practice of annual vaccination in our opinion should be considered of questionable efficacy…”

Even though the current recommendations of triennial vaccinations are now popular, they exist bereft of basic research to indicate immunity wanes at the three year mark. I believe these researchers when they state the likelihood of years or life-long immunity, as they have no vested interest in selling vaccinations.

Please mark Bowser’s <Fluffy’s> record boldly: “NO FURTHER VACCINATIONS” until further notice from me. I fully understand rabies has legal requirements associated with it, but I also understand I have immunized Bowser <Fluffy> against this disease (#) times in the past, and trust his immunity is long lasting to this virus like all the others.

If you’d like, I’m happy to sign a personal waiver of responsibility document for my files.


<You, you responsible pet owner, you>

(This post sourced wholly or in part from Vital Animal)