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I need a vaccine refusal template for someone in the USA

Chubby Rain

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I have a UK one as below but need a USA one also for distribution.


Here is a letter template for anyone in the case they are being told by their employers to get the covid vaccine or lose their employment:

Dear (XXX)

I am writing to yourself, as I have been informed by (XXX) that I must receive the Covid19 vaccine, or face disciplinary action.

As I have made very clear to (XXX), I am declining all forms of the Covid19 vaccine under ethical reasons.

There are no statutory provisions that can force individuals to become vaccinated. The Public Health (Control of Disease) Act 1984 specifically states that members of the public should not be compelled to undergo any mandatory medical treatment, including vaccinations. Forcing, coercing or manipulating an employee to receive a vaccine is in breach of article 8 of the European Convention on Human Rights, which protects people from being interfered with physically or psychologically and includes mandatory vaccinations. Forced vaccinations in the workplace, is not only a human rights concern, but also has criminal implications. Forcing anyone to receive a vaccine injection under duress, under UK law, constitutes an unlawful injury. A vaccination requires an individual’s informed and voluntary consent, which you do not have of mine.

I want to make it very clear, that I am NOT placing any persons at risk by declining this vaccine, but I am protecting my health and my wellbeing. Declining this vaccine does NOT mean that I can not perform my job effectively and I will not be resigning.

In accordance of the Employment Rights Act 1996 and Section 6 of the 2010 Equality act, I am protected from being sacked or chosen unfairly for redundancy and I am safeguarded against unlawful discrimination by my employer.

When signing my work contract, I did not agree for any testing, vaccine or interventions.

I enjoy my job and I would like to keep this as civil as possible, but as per my rights, I will be taking legal action via The ACAS Code of Practice on Disciplinary and Grievance Procedures if I receive disciplinary action because of this.

I look forward to hearing from you.

Kind regards

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41 minutes ago, Ethel said:

Interesting post. Your request is a valid one. As requested, here is a vaccine refusal template. You can put this into written form, although it works just as well in the spoken word:



Needle phobia and vegan excuses will seem to work too. We can say NO but we need to nudge people with legal documents.

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