�鶹��ýSystems - Health Clearance Information

HEALTH CLEARANCE REQUIREMENTS

TB (TUBERCULOSIS)

A completed TB Risk Assessment Form (such as the State of �鶹��ý Department TB Risk Assessment Form)
- This form must be completed within 12 months of starting at �鶹��ýor must have been completed on or after the age of 16.
IF the Risk Assessment Form presents risks, one of the following is required:
- A negative Tuberculin skin test (PPD-Mantoux). The skin test must be read 48-72 hours after administration and documented in millimeters (mm). Test results without the induration in millimeters will be rejected.
- A negative QuantiFERON Gold In-Tube or T-Spot Blood Test.
- A negative chest x-ray (taken within the last 12 months or done age 16 or older) with laboratory report/results attached.

NOTES:

TB clearance should be completed before receiving any live vaccines or before getting any vaccines.
Quantiferon Gold Test/Blood Test Results done outside of the U.S. are accepted
All TB risk assessments/skin tests/chest x-rays MUST be completed and signed by a U.S.-Licensed Healthcare Professional (M.D., D.O., N.P., P.A., or clinic stamp). (Chapter 164.2 of Title 11. �鶹��ý Administrative Rules (HAR) for Tuberculosis)
As long as the student was 16 or older when they last received their negative CXR chest x-ray, no further TB screenings are needed.

TB EXEMPTIONS:

A TB CLEARANCE MAY BE OBTAINED FROM ANY OF THE FOLLOWING:

MMR (MEASLES, MUMPS, RUBELLA)

2 doses of MMR (Measles, Mumps, and Rubella) are required
- 1st dose must have been given on or after 12 months of age.
- 2nd dose must have been given at least 4 weeks after the first dose.

MMR EXEMPTIONS:

Student was born before 1957 (must provide proof of birth date).
Laboratory evidence of immunity (positive antibodies) to Measles and/or Rubella. Please note that the State of �鶹��ý Department of Health does not accept serologic test results for Mumps immunity.

VARICELLA (CHICKENPOX)

2 doses of varicella vaccine are required.
- 1st dose must be given after the age of 12 months.
- 2nd dose must have been given 4 weeks after 1st dose (for students who received 1st dose at age 13 years or older)

CHICKENPOX EXEMPTIONS:

Students born in the United States prior to 1980 (Must provide proof of date of birth)
A signed, documented diagnosis or verification of a history of varicella disease or herpes zoster by a practitioner may be substituted for a record of varicella vaccination. Practitioners may complete this form to confirm the documented diagnosis.

TDAP (TETANUS-DIPHTHERIA-ACCEULAR PERTUSSIS)

1 dose required - most recent Tdap.
NOTE: Valid Tdap dose must be administered on or after 10 years of age. Do not confuse with DTaP (administered to children 0-6 years of age). Tdap was licensed for use in the U.S. in 2005. Doses recorded as “Tdap” with an administration date in the U.S. prior to 2005 should not be counted.

MCV (MENINGOCOCCAL CONJUGATE)

1 dose required - most recent dose must have been given on or after the age of 16 years.
NOTE: Only required for new students planning to live on-campus who are 21 years of age or younger.

Valid exemptions for MMR, Varicella, MCV and TDAP immunizations include medical and/or religious reasons. NO OTHER EXEMPTIONS ARE ALLOWED BY THE STATE
Persons claiming a religious exemption to immunization requirements must sign the following form Religious Exemption Form for Immunizations (PDF) *. There are NO religious exemptions to Tuberculosis clearance requirements.
Persons claiming a medical exemption to immunization requirements must have their physician sign the Medical Exemption Form (PDF) *.
There is NO medical and/or religious exemption for TB. TB clearance is required to participate in any on-campus activity (eg. in-person classes, etc.)
Those enrolled in Fully Online Programs are exempt from submitting Health Clearances. *Please note, if you wish to participate in on-campus employment and or activities, you must submit Health Clearances to be cleared to do so.