> ## Documentation Index
> Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt
> Use this file to discover all available pages before exploring further.

# The Immunization Decline Object

> A patient's documented refusal of a vaccine, recorded in the patient's chart.

## In the EHR

Practice users record immunization declines in the Vaccination section of a patient's chart, alongside the doses the patient has received. A decline names the vaccine group the patient declined, the date of the decline, the reason, including a decline because the patient already has immunity. See [Vaccination Documentation Guide](/articles/Vaccination-Form-Guide).

## Working with immunization declines via the API

**Creating a decline records it in the chart; reporting it to an immunization registry is separate.** A successful `POST` places the decline in the patient's chart. Submission to a connected immunization registry happens when a practice user records the decline in the chart with registry sharing turned on, so declines created through the API are not submitted to a registry. If your workflow needs the decline reported, plan for a practice user to submit it from the chart.