Vaccines and Vaccine Policy

This article serves as a companion to ACHA’s Immunization Recommendations for College Students guidelines, which offer recommendations to implement a comprehensive institutional immunization program to decrease the potential for communicable disease outbreaks among students and foster a healthy campus. As noted in the guidelines, outbreaks can cause major disruptions to a student’s academic life as well as place financial and emotional burdens on students and their families. Education of students, faculty, and staff about the importance of immunization; the reasons for applicable university policies; and the potential for disease spread, morbidity, and possible mortality with failure to comply is paramount for a successful comprehensive immunization program.

State-Mandated Vaccines for Higher Education

Vaccine requirements for students enrolled in institutions of higher education vary from state to state and may also depend on if students are housed on campus. In some states, students residing in campus housing are required to be vaccinated against meningococcal disease or sign a waiver; in other states, there is no such requirement. Your state health department is another resource for the most up-to-date vaccine requirements in your state.

Universities may have policies mandating specific vaccinations for pre-matriculation. These policies may or may not allow first semester students to enroll without meeting vaccination requirements. If they are allowed to enroll, a system for monitoring these students should be implemented to ensure that the requirements are met per the institution’s deadlines. This requires coordination, collaboration, and communication among admissions, health services, the registrar, or others who are responsible for immunization compliance. For example, if the policy prohibits a non-compliant student from registering for classes, the registrar’s office must be informed, prepared, and empowered to block that student’s registration.

The CDC’s Recommended Immunization Schedule is one useful reference when deciding whether to recommend or mandate vaccines for matriculating students. Information for recommended vaccinations for adults (19 years or older) can be found here. Information for recommended vaccinations for children and adolescents (18 years or younger) can be found here.

Despite similar evidence-based guidelines, expert opinions, and recommendations, institutions of higher education remain inconsistent in their approach to mandatory immunization requirements, with some campuses requiring their students be immunized against certain diseases and other campuses only recommending such vaccines.

In addition to university- and/or state-mandated vaccines, health science schools/programs may have unique immunization requirements that are extensively outlined in ACHA’s Immunization Recommendations for College Students and the CDC’s Recommended Vaccines for Healthcare Workers.

Sample Immunization Policies and Forms

Your institution’s policy should be reflective of your university’s requirement(s) as well as any state or local requirements. Schools may wish to utilize ACHA’s Sample Immunization Record and ideally include students’ immunization history in their medical record.If you are looking for sample policies or forms from your state, it may be useful to search the library in ACHA’s online member forum, ACHA Connect, or post a request for the documents to be shared in the forum by another user. Review of policies from other universities within your state may be helpful.

Communicable Disease Prevention and Outbreak Management

Not all communicable diseases are vaccine-preventable. For those that are, such as influenza, measles, and mumps, to name a few, appropriate immunization is the primary preventive response. For those communicable diseases that are not vaccine-preventable, education and behavior modification, for example, hand washing, may help to reduce risk.

Once a disease that could present a public health threat has been detected, action(s) to prevent further spread and to manage the disease include:

  • Notify appropriate university administrators.
  • Engage the local public health department.
  • If applicable, implement disease outbreak plans according to the institution’s emergency operations plan (EOP).
  • Identify students whose records indicate susceptibility to the public health threat.
  • Provide up-to-date information through appropriate communication channels.
  • Educate providers and staff on symptoms, treatment, and diagnosis and ensure clinical guidelines are widely available.
  • Follow CDC Infection Control Basics within the health care setting.

More information may be found in the ACHA Guidelines Emergency Planning Guidelines for Campus Health Services: An All-Hazards Approach.

Travel-Related Vaccines

The student experience may include international travel as part of a study-abroad program or for personal reasons. If your health center in unable to offer students the required and recommended immunizations per CDC or subscription-based guidelines, then information about local resources for travel vaccines should be made readily available.

In addition to routine immunizations, preventive medications and vaccines to consider for students traveling abroad include:

  • Cholera
  • Influenza
  • Japanese encephalitis virus
  • Malaria
  • Meningococcal disease
  • Rabies
  • Typhoid
  • Yellow fever (currently not widely available; refer to the CDC for information where patients may be able to obtain)