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Documentation of (If needed for graduate school admission, medical school For Additional Information rotation, student teaching or other requirement) Make a formal request to the Medical Records U.Va. Student Health Center department: www.virginia.edu/studenthealth • Complete the “Consent for the Medical Release of Information” form, available at Student Health and at www.virginia.edu/studenthealth/records.html Centers for Disease Control (CDC) • Please allow at least 10 working days for the www.cdc.gov/nip/recs/adult-schedule.htm Medical Records Department to fill your request. American College Health Association Available at www.acha.org/info_resources/guidelines.cfm Student Health www.acha.org/info_resources/RIPIstatement.pdf

Costs will vary based on manufacturer guidelines: Healthy Hoos (Online Student Health) Requirements for Flu https://www.healthyhoos.virginia.edu (HPV) incoming U.Va. students Hepatitis A Japanese Encephalitis MMR (Measles, Mumps, Rubella) Meningitis (Menactra/Menveo) 2014-2015 PPD (TB skin test - not available on Thursdays Rabies (pre exposure) (Td & Tdap) Typhoid Twinrix (Td & Tdap) Varicella Yellow Fever: ONLY available at Student Health during Travel Clinics Department of Student Health Division of Student Affairs

400 Brandon Avenue Vaccines Administered in Charlottesville,VA 22903 General Medicine Clinic: (434) 982-3915 Monday-Friday email: [email protected] 9am-12pm and 1pm-4pm www.virginia.edu/studenthealth

Self-Schedule@ https://www.healthyhoos.virginia.edu Produced by: Sandra J. Murray, RN, MSN

Revised 05/2014 Medical & Nursing Students Only: Required and Recommended The University ofVirginia, based on national guidelines, Required Vaccines Immunizations Virginia law, and national college health standards, requires proof of immunization for required vaccines Frequency/Information RequiredVaccines on the Pre-Entrance Health Form (abbreviated “PEHF”). Vaccine Dose(s) Frequency/Information The PEHF is located on the Student Health website. Rubella Rubella Titer (blood test)

MMR 2 1 month apart, or 2 doses Varicella Varicella Titer (blood test) (Measles, Mumps, Rubella) each of MMR, or Positive AdditionalVaccine Information (if no history of Chickenpox or (if born 1957 or later) Immune Titer • Although students may request an exemption waiver dates given at least 4 weeks apart), or Polio series Documentation of vaccine to decline Meningitis and Hepatitis B vaccines we strongly Documentation of Chickenpox by a care series AND date of urge you to be vaccinated for your safety (medical and provider. Dates of each is required. last booster, or Positive nursing students excluded from Hep B waiver). Immune Titer Tuberculosis Mantoux PPD skin test (2 step) at least 1 week but not more than 3 months apart • Meningitis is characterized by rapid onset of symptoms Tuberculosis (TB) Risk assessment on PEHF OR a single immunoassay test. (completed and is a potentially fatal or disabling disease. It is a (March 1, 2012 or later) by health care provider to March 1, 2012 or later) See supplemental determine if further testing requirement that incoming undergraduate students information sheet needed receive the meningitis vaccine. Menactra/Menveo are the Tdap Must be administered prior to enrollment. preferred vaccines for Meningitis, as they are expected to May be given regardless of interval since Meningitis 1 1) Menactra/Menveo provide better, longer-lasting protection. (Undergraduates) (preferred) or last Td. Last Tdap should have been given 2) Menomune) (since Sept. within 10 years of 9/1/2014 1, 2010) • ,Tdap, is the preferred vaccine because it protects against all three diseases: tetanus, and Chest X-ray Negative chest X-ray ONLY if History Hepatitis B 3 0-1-6 month interval pertussis. Tdap replaces a single dose of Td for booster of + PPD or immunoassay (Date immunization, and should be considered when a tetanus REQUIRED) Tetanus 1 Documentation of Tdap booster is recommended by a health care provider. A one- (Td orTdap) (preferred) or Td within 10 Hepatitis B 3 doses (0, 1, 6) or have a positive antibody years of 9/1/2014. time booster dose of Tdap can be given alone at any time to protect against pertussis. Subsequent booster dose(s) titer. If the last shot in series is after 1/1/2012, a positive titer is REQUIRED. Recommended Vaccines recommended by health care provider should be given Vaccine Dose(s) Frequency/Information with Td. Influenza Influenza vaccination is MANDATED each fall during the flu vaccination Hepatitis A 2 6 months apart • HPV, Human PapillomaVirus, is the virus that can cause program at Student Health. Students will genital warts in men & women and cervical cancer in Twinrix 3 0-1-6 month interval (can be asked to wear a mask during flu season women. Gardasil provides the best protection against HPV (Hepatitis A & B replace both Hepatitis A if they do not comply. combination) and B vaccine) for males and females aged 9-26.

Varicella 2 1 month apart • The Flu vaccine should be received annually, every fall, in Student Health’s HelpfulTips (Chickenpox) (if no history of Chickenpox) order to avoid disruption in class and exam-schedules, as • Vaccines administered at Student Health: Monday-Friday by well as to protect family members. Pertussis 1 Tdap,May be given regardless appointment at: https://www.healthyhoos.virginia.edu (Whooping Cough) of interval since lastTd. **TB SKINTESTS ARE NOT AVAILABLE ON • Considered pertussis • International Students Immunization Clinic is THURSDAYS** booster offered during the first week of school each fall. • See additional vaccine • As a convenience you may make your own appointment information Traveling Abroad for the Immunization Clinic through Healthy Hoos! HPV 3 Gardasil in 0-2-6 month • Plan early for your travel . (Human PapillomaVirus) intervals Multiple dose vaccines are given over several weeks, and • Students are responsible for understanding their medical take time to build in the body. insurance coverage. Influenza (Flu) 1 Annually, during fall • Make a Travel Immunization Appointment. Call Student • Fall “Flu” Clinic: Hosted by Student Health at the Health (434) 982-3915.Appointment should be at least • Spring class registration will be blocked for students Newcomb Hall Ballroom in early Fall each year. Student one month prior to departure. until proof of immunization is provided Health does not submit claims for insurance companies • ALL signature pages on the PEHF must be signed by other than Aetna Student Health. your health care provider • Follow the instructions described on the Student Health Website for “Travel Appointments”.