WAIVER FOR RABBIT HEMORRHAGIC DISEASE (RHD) VACCINATION
I have elected to have my rabbit(s), ______________________ (patient name(s))
vaccinated with ________ vaccine, as an attempt to protect against Rabbit Hemorrhagic Disease Virus Serotype 2 (RHDV2). I understand the following:
- This vaccine is not licensed in the US and is being used under a special research and evaluation import permit from the USDA (US Department of Agriculture).
- This vaccine does not guarantee full protection against the disease, rabbit hemorrhagic disease.
- For best efficacy, it is recommended that rabbits over 1 month of age receive the vaccine and then are given a booster vaccine every year. Please note that booster vaccines will only be available if additional vaccine importation is permitted by the state veterinarian’s office and USDA.
- The vaccine will take a minimum of 7 days to provide some protection.
- Side effects have been documented in rabbits given the vaccine, including but not limited to: lethargy, fever, digestive upset, nodule or swelling at vaccination site, anaphylactic reaction, and death. If my rabbit develops any side effects from the ______ vaccine or the vaccination procedure, I do not hold the ______________ or the veterinarians responsible, and as the owner of this rabbit, will assume full responsibility for any treatment costs associated with said side effects.
- I acknowledge that there may be other, unknown risks and that the long-term effects and risks of this vaccine are not known at this time.
- The effects of this vaccine on fertility have not been determined and the risk of abortion in pregnant does is undetermined at this time.
- There is currently no medical data on the interaction of this vaccine with other medical products.
- Because rabbits are considered by some for meat production, USDA requires a 21-day withdrawal period for meat consumption, to avoid potential risks to US food supplies.
- We ask that you stay (in your car) for 15 minutes after vaccination in case there is an adverse reaction.
I have read and fully understand the terms and conditions set forth above. I, as the undersigned owner (or agent) of the pet identified below, authorize the staff of _____________ to vaccinate my rabbit with the vaccine.
Owner name (printed)
Date
Owner signature
Witness signature