Immunizations - Level 3 : For students entering Summer Semester 2016 or later

Clinical Immunization Form

**Only use the Clinical Immuniation Form if you have an official Immunization Record

Physical Exam Form

Health History Form

Due Dates and General Information

Physical Examination

All students registered in a Clinical Program is required to have a physical examination. This examination must be signed by a health care provider. This physical must be recorded on the UAB Student Health Physical Form

Immunization Requirements

Given the nature of their work, students engaged in health professional training programs could have a higher risk of contracting Rubeola, Rubella, Mumps, Tetanus, Diphtheria, Varicella, Tuberculosis, Pertussis, and Hepatitis B. All UAB students in the Joint Health Sciences programs and in the Schools of Medicine, Dentistry, Optometry, Public Health, Nursing, and Health Professions are required to be immunized as follows:

  • I. MMR (Measles, Mumps, Rubella)

    All students born in the U.S. after 1/1/1957 must show evidence of immunity to Measles, Mumps and Rubella as below:

    Measles
    1. Documentation of vaccination with 2 doses of live measles virus-containing vaccine, or
    2. Laboratory evidence of immunity, or
    3. Laboratory confirmation of disease, or
    4. Born before 1957
    Rubella
    1. Documentation of vaccination with 1 dose of live rubella virus-containing vaccine, or
    2. Laboratory evidence of immunity, or
    3. Laboratory confirmation of disease, or
    4. Born before 1957
    Mumps
    1. Documentation of vaccination with 2 doses of live mumps virus-containing vaccine, or
    2. Laboratory evidence of immunity, or
    3. Laboratory confirmation of disease, or
    4. Born before 1957

    Source: Centers for Disease Control and Prevention. Prevention of Measles, Rubella, Congenital Rubella Syndrome and Mumps, 2013: Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP), June 14, 2013 / 62(RR04); 1-34. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6204a1.htm

  • II. Tdap – (Tetanus, Diphtheria, Acellular Pertussis)

    1. All students 11-64 must have had one dose of adult Tdap. If the Tdap is more than 10 years old, a Td booster is required.
      • In the absence of proof of immunization, Tdap can be administered regardless of interval since the last tetanus-diptheria toxoid-containing vaccine.
    2. Adults should receive decennial Td boosters, beginning 10 years after receiving the Tdap.
  • III. Hepatitis B Series

    1. All students must have a series of three Hepatitis B vaccinations (0, 1, and 6 months), and a post-vaccine surface antibody titer (to demonstrate immunity) 1-2 months after 3rd vaccine dose. *Those beyond the 1-2 month post vaccination period must also have a post-vaccine surface antibody titer drawn.
      • If Hep B surface antibody titer is non-reactive, Hepatitis B surface antigen is required to rule out acute or chronic Hepatitis B infection.
        1. If Hep B surface antigen is positive, appropriate counseling and recommendation to seek medical evaluation will be made.
        2. If Hep B surface antigen is negative, repeat series is required.
      • Repeat Hep B surface antibody is required 1-2 months after completion of repeat vaccine series.
        1. If repeat Hep B surface antibody is reactive, no additional vaccines are required.
        2. If repeat Hep B surface antibody is non-reactive, student will be considered a non-responder and will be counseled regarding additional precautions.
  • IV. Varicella (Chickenpox/Shingles)

    All students must satisfy this requirement , either by documented history of Varicella or Herpes Zoster (Shingles), a positive Varicella antibody titer, or two doses of Varicella vaccines.

    1. History of Varicella (chickenpox or shingles) must be documented by healthcare provider and must include date of disease.
    2. With no documentation of disease, a Varicella IgG antibody blood titer is required.
      • If VZVIgG positive, no additional vaccines required.
      • If VZVIgG negative or equivocal, 2 additional vaccinations are required.
    3. Two doses of Varicella vaccine, given at least 28 days apart.
  • V. Meningococcal

    1. All students 21 and younger must provide proof of an immunization against meningitis (Menactra, Menveo, or Mennomune) given any time after the 16th birthday, even if a vaccine dose was given at a younger age.
    2. All students 22 and older are exempt from this requirement.
  • VI. Tuberculosis Screening

    *ALL TB TESTING (skin, blood, Chest X-Ray) MUST BE PERFORMED IN THE U.S.

    1. If no history of positive Tb skin test, two separate skin tests or one IGRA blood test (Quantiferon/T-Spot) performed in the U.S. are required.
      • Initial skin test within 12 months prior to matriculation is acceptable.
      • Second skin test must be within 3 months prior to matriculation.
      • Tb skin tests must be placed at least 1 week apart.
      • IGRA blood test must be within 3 months prior to matriculation.
    2. If positive skin test or IGRA result, Chest X-Ray within 3 months prior to matriculation and UAB TB Questionnaire are required.
      • If Chest X-Ray result is negative for Tuberculosis, no additional testing required.*
      • If Chest X-Ray result is positive for tuberculosis, proof of initiation of appropriate therapy is required, and the student will not be allowed on campus until cleared by the Jefferson County Department of Health and UAB Student Health & Wellness.
    3. If medication therapy has been completed, documentation of completion of therapy, Chest X-Ray performed in the United States within the past 2 years, and UAB TB Questionnaire are required.

    *Annual Tb screening is required for those with a history of positive skin test, blood test, or Chest X-Ray. Please visit our TB TESTING POLICY for additional details.

  • If individuals do not have proof or have not been immunized, they must be immunized against these diseases prior to attending, enrolling, or participation in UAB academic, research, observing, or clinical program activities.
  • Enrolling students must show proof of these immunizations with either an official certificate of immunization, a photocopy of an immunization certificate, or written documentation from their physician. Students must provide proof of their immunizations and TB testing. The preferred and most efficient method to accomplish this is to download the Clinical Immunization Record form. This should be completed by the documenting physician’s office and uploaded to the patient portal or faxed to 205-996-SHOT (7468) by the student. The actual “Blue Form," chart records, and TB records need not be sent if this form is properly completed. The student may send these records in lieu of the Immunization Record Form.

General

The UAB Student Health Services will provide such immunizations and titer testing on a fee-for-service basis for any student who needs to meet the UAB immunization or titer requirements. Students may choose to fulfil these requirements at your local health department or a private physician.

Exceptions

Exceptions to this policy may be made in limited circumstances for students who can document medical and/or other contraindications to the vaccine. Requests for exceptions must be submitted to UAB Student Health Services for consideration and approval.

Students enrolled in online classes only, with no on-campus classes, are exempted from these requirements.