IMMUNIZATIONS: Page 1 ALLIED HEALTH AND NURSING PROGRAM HEALTH REQUIREMENTS Measles 2 MMR Vaccinations 2 Measles Vaccinations Positive antibody titer for Measles (lab report required or employer health report required) Mumps 2 MMR Vaccinations 2 Mumps Vaccinations Positive antibody titer for Mumps (lab report required or employer health report required) Rubella 2 MMR Vaccinations 2 Rubella Vaccinations Positive antibody titer for Rubella (lab report required or employer health report required) Varicella (Chicken Pox) 2 Vaccinations Positive antibody titer (lab report required) Hepatitis B -A positive Hep B antibody titer is required. If you are just starting the vaccination series you must follow the CDC recommended schedule and then follow the series with a titer. If the titer is negative or equivocal, you must repeat the vaccine series two weeks after the original titer. A repeat titer is required after the series. Repeat titer will be accepted even if negative. (Please see the post vaccination requirements on p. 3) TB Skin Test 2 step TB Skin test (1-3 weeks apart) 2 tests within one year period (most recent within last 12 months) Past 2 Step PLUS all subsequent annuals 2 consecutive annual tests Negative QuantiFERON Gold or T-Spot test within the past 12 months If TB results are positive, provide a Chest X-Ray (lab report or employer health report required). If INH therapy was received, you must submit documentation of this as well. -Tuberculosis (Single PPD) A single PPD is required annually. Tetanus, Diphtheria, and Pertussis (Tdap)
-There must be documentation of a Tdap booster within the past 10 years. Influenza -Submit documentation of a flu shot administered during the current flu season, starting August 1. -The annual deadline is October 1. Additional Required Documentation CPR Certification (If required by Program) -Must be the American Heart Association or Red Cross Healthcare Provider course for all Nursing Programs. Please see your program manager for specific CPR requirements. When submitting documentation of certification, the copy must be front and back of the card. The card must be signed. Letters of certificate verifying the completion of course are acceptable. Rabies Vaccine Vet (Tech ONLY) - -Pre-exposure Rabies vaccine highly recommended. As veterinary students you will experience an increased risk of exposure to rabies. Rabies immunization is a series of 3 doses of vaccine. ADDITIONAL INFMATION What are Antibody Titers? An antibody titer is a laboratory test that measures the level of antibodies in a blood sample. A titer is a blood test that determines whether you have immunity to certain diseases by measuring your antibody level to those diseases. If you have had the disease in the past of have been vaccinated to it, your blood should show evidence of immunity through a positive titer, or antibody, level. A positive titer result may be used in lieu of an immunization record. The following antibody titer tests are available: MMR (Measles/Rubeola, Mumps, Rubella) Hepatitis B Varicella/Chickenpox Tetanus Diphtheria QuantiFERON-TB Gold Blood Test (alternative to skin test/x-ray) Polio Pertussis What should be done if a person s postvaccination anti-hbs test is negative (less than 10 miu/ml) 1 2 months after the last dose of vaccine? Repeat the 3-dose series and test for anti-hbs 1 2 months after the third dose of vaccine. If the test is still negative after a second vaccine series, the person should be tested for HBsAg and total anti-hbc to determine their HBV infection status. People who test negative for HBsAg and total anti- HBc should be considered vaccine nonresponders and susceptible to HBV infection. They should be counseled about precautions to prevent HBV infection and the need to obtain hepatitis B immune globulin (HBIG) prophylaxis for any known or likely exposure to HBsAg-positive blood. Those found to be HBsAg negative but total anti-hbc positive were infected in the past and require no vaccination or treatment. If the HBsAg and total anti-hbc tests are positive, the person should receive appropriate counseling for preventing transmission to others as well as referral for ongoing care to a specialist experienced in the medical management of chronic HBV infection. They should not be excluded from work. http://www.immunize.org/catg.d/p2109.pdf (Please see the Hepatitis B requirements on p. 1) Page 2
What preservatives are used in vaccines? Thimerosal, a mercury-containing organic compound which is approximately 50% mercury by weight, has been one of the most widely used preservatives in vaccines. Thimerosal has been widely used as a preservative in a number of biological and drug products, including many vaccines, to help prevent potentially life threatening contamination with harmful microbes. However, Thimerosal has been removed from or reduced to trace amounts in all vaccines routinely recommended for children 6 years of age and younger, with the exception of inactivated influenza vaccine, a preservative-free version of the inactivated influenza vaccine (contains trace amounts of thimerosal) is available in limited supply. Some vaccines such as Td, which is indicated for older children ( 7 years of age) and adults, are also now available in formulations that are free of thimerosal or contain only trace amounts. Vaccines with trace amounts of thimerosal contain 1 microgram or less of mercury per dose. http://www.fda.gov/biologicsbloodvaccines/safetyavailability/vaccinesafety/ucm096228 A student s refusal to obtain the required vaccinations due to the presence of Thimerosal is not a recognized excuse or exception. All students must prove the required immunizations by either proof of a positive titer or an immunization record (see declination or waiver information below). Can I use a declination or waiver for the required immunizations? The College does not provide a waiver or declination of any immunization, with the exception of the rabies vaccination. However, some of our clinical affiliates may allow for the use of a waiver or declination under certain circumstances. These circumstances include, but are not limited to, medical reasoning and religious reasoning. You MUST check with your program manager to verify whether or not the facility that you will be attending will allow for your circumstances. Medical reasoning, including a recommendation from your physician, does not automatically guarantee that you will be given a waiver or declination ability. Further, if you have obtained a waiver/declination from one facility and then are rotating into a different facility, the waiver/declination will not be valid in the new facility. A student s inability to obtain one or more of the required vaccinations, for any reason, may prevent them from entering into their mandatory clinical rotations and thus from entering or completing their chosen program. A student s refusal to obtain the required immunizations due to personal, religious or medical reasoning cannot be accepted due to our contractual agreements with the clinical affiliates used for mandatory clinical rotations. Please see your program manager for more details. Page 3
CUYAHOGA COMMUNITY COLLEGE HEALTH CAREERS AND NURSING PROGRAMS PHYSICAL EXAM AND IMMUNIZATION DOCUMENTATION FM Program Name STUDENT NAME Tri-C S# DOB Page 4 Requirement Tdap Documentation of a Tdap booster within the past 10 years. MMR - Mumps documented dates of 2 doses of MMR vaccine ( at least 28 days apart) lab evidence of immunity confirmation of disease birth before 1957 MMR - Measles (Rubeola) documented dates of 2 doses of MMR vaccine ( at least 28 days apart) lab evidence of immunity confirmation of disease birth before 1957 MMR - Rubella- documentation of 1 dose of MMR vaccine laboratory evidence of immunity confirmation of rubella infection birth before 1957 Hepatitis B Written documentation of 3 doses of vaccine and/or proof of positive titer. See page 1 for specific testing information. Date of immunization (mo/ dy/ yr) or Result of Titer Drawn (pos. or neg.) Date of vaccine: Healthcare Provider Signature
Tuberculosis (Double PPD, or Double Mantoux) Written documentation of a negative 2 step Mantoux test is required. An IGRA blood test for TB (e.g. QuantiFERON) may be obtained in place of the double Mantoux test. See page 1 for specific testing information. #3 STEP 1 Date Given Date Read Result STEP 2 Date Given Date Read Result Varicella -Chicken Pox, Herpes Zoster ( Shingles) documentation of 2 doses of vaccine laboratory evidence of immunity laboratory confirmation of disease diagnosis of history of Varicella disease by healthcare provider IGRA blood test ie: QuantiFERON-TB Result Date diagnosis of history of Herpes Zoster by healthcare provider Flu Vaccine Documentation of annual influenza vaccination or signed declination form. DENTAL ONLY Dental Exam Date of Exam: DENTAL ONLY Radiographs DENTAL,OPTICAL, MLT, PHLEBOTOMY Vision Exam - (MLT & Phlebotomy also require Color-blindness test) Vet Tech ONLY Page 5 Date of Exam:
Documentation of 3 doses of Pre-exposure Rabies Vaccine highly recommended #3 Version 10 (09-2013) Page 6
PHYSICAL EXAM VERIFICATION This is to certify that had a physical exam on and is in apparent good health, has no condition that would endanger the health and wellbeing of other students or patients, and is physically/mentally able to participate in the Health Career/Nursing Program at Cuyahoga Community College. Provider s Signature: Provider s Printed Name: Address: Office Phone Number: Comments: Page 7