Medical students are frequently exposed to infectious diseases during their clinical experience.  They are, therefore, at risk of contracting several illnesses that are easily preventable by immunization.  The students are also potential carriers of these illnesses and may infect other patients who may be immunocompromised.  To protect both the students and patients, all students in the USACOM must present proof of immunity to the following diseases and are strongly urged to receive an annual influenza vaccine during the two clinical years.

MEASLES (RUBEOLA): All students born after 1956 are required to provide documentation that they have received two doses of live measles vaccine prior to their matriculation.  The first dose of the vaccine should have been administered after 15 months of age.  If documentation cannot be provided then the student is required to receive immunization for measles from his/her personal physician or the Board of Health.  Pregnancy is a contraindication to this vaccine.  If necessary, pregnant students should be vaccinated in the post-partum period.

MUMPS AND RUBELLA:  All students born after 1956 will be required to provide documentation that they have received one dose of live Mumps/Rubella vaccine after 15 months of age or produce the results of serologic studies showing a protective titer of Mumps and Rubella antibodies.  Without this documentation the student is required to receive immunization for Rubella/Mumps prior to matriculation from a personal physician or the Board of Health.  Pregnancy is a contraindication to this vaccine.  If necessary, pregnant students should be immunized in the post-partum period.

TETANUS - DIPHTHERIA: All students are required to document that they have received the primary series and a booster dose of adult Tetanus-Diphtheria (Td) vaccine within ten years of the beginning of the academic year.  Without this documentation the student is required to receive the Td vaccine from his/her personal physician or the Board of Health.

POLIO:  All students are required to document that they have received the primary series of Polio vaccine.  If documentation cannot be produced the students will be required to receive the primary series of inactivated polio vaccine from their personal physician or the Board of Health.

VARICELLA:  All students must certify that they have had varicella or they must have a varicella titer determined.  If the titer is undetectable, they must receive two doses of varicella vaccine 4-8 weeks apart.  The student may elect to receive the vaccine without having a titer done.

HEPATITIS B: All students are encouraged to be immunized against infection from hepatitis B virus.  Freshmen will be given the opportunity for the 3-shot series (initial inoculation, one month later, and 6 months later).  Recombivax HB [Hepatitis B Vaccine (Recombinant), MSD] is a non-infectious subunit viral vaccine derived from Hepatitis B surface antigen (HBsAg) produced in yeast cells.  A portion of the hepatitis B virus gene, coding for HbsAg, is cloned into yeast, and the vaccine for hepatitis B is produced from cultures of this recombinant yeast strain according to methods developed in the Merck Sharp & Dohme Research Laboratories.  Students who elect not to receive this vaccine will be required to sign a document stating that they have been advised of the risks and benefits of vaccination and that the vaccine has been offered to them and they declined.  The consent form follows this section.

INFLUENZA:  All students are strongly urged to receive an annual influenza vaccine during the two clinical years.

TUBERCULOSIS:  In light of the significant incidence of multiple drug-resistant tuberculosis and the need for effective infection control measures, pre-matriculation and annual testing for tuberculosis is required for all students in the College.

All students must have had a tuberculosis skin test within the previous year.  Students with a positive skin test must be able to document that they have been adequately evaluated for tuberculosis.

Any student who is positive due to a childhood or other exposure must provide either a statement from his/her physician that no follow-up is indicated, or provide the results of a recent chest X-ray.

EXCEPTIONS:  In the event that a student has a problem that he/she believes would be a contraindication to a specific vaccination, the pertinent information should be provided to the Assistant Dean for Student Affairs.  He will consult with the faculty of the Division of Infectious Disease and will render a final decision regarding the need for the vaccination based on their recommendation.

May 15, 2000