Pre-Licensure Immunization Frequently Asked Questions
Frequently-Asked Questions (FAQs) regarding Immunizations
Q: What type of documentation is acceptable for my immunizations?
A: We accept records from your healthcare provider, childhood immunization records, and records from your employer, when employed with a hospital system. All current immunization documentation must include:
- Your name and provider name
- Vaccination type (MMR, etc.)
- Lot # and expiration date
- Date of vaccination
- Injection site
- For TB, must have interpretation (negative or positive) along with the actual mm of induration (ranges not accepted)
- Name or initials of individual who administered the injection
- When submitting a titer, include the lab report and interpretation. Please note, MMR must be listed separately (Mumps, Measles, Rubella) with lab value for each.
Q: I have a record from my elementary or high school and/or another college or school of nursing. May I submit that?
A: No, we do not accept public education records. Additionally, we do not accept records from other colleges.
Q: I have a childhood immunization and/or county health record but it doesn’t have lot numbers or expiration dates. May I submit that?
A: Yes, we do accept childhood immunization records and county health records without lot #, etc. as long they’re signed or stamped by your provider or the county clerk.
Q: I had my Hep B series as a teenager or young child and have the record. Is this sufficient for the school?
A: Yes; however, you will still be required to have a Hep B Surface Antibody titer to ensure immunity.
Q: I have a Hep B titer (or Varicella/MMR/Hep A titer) that shows immunity, but I don’t have documentation of my immunization series. Is the titer sufficient or do I have to do the series over again?
A: For now, the titer proving immunity is sufficient. Please note, some clinical sites (such as the pediatric hospitals and units, for example) may require documentation of the series as well as the titer. In that instance, you would need to locate the series.
Q: Do I have to have the Hep B titer if I’ve already completed the series?
A: Yes, the surface antibody titer is required for Hep B even if you have documentation of the series.
Q: Can I do the Twinrix (Hep A/Hep B combo) series?
A: Yes, you may do Twinrix if you need to start both Hep A and Hep B. Please note, if you start the Twinrix series, you must finish the Twinrix series. Do not switch to the single Hep A or Hep B midstream.
Q: My tetanus/diphtheria (Td) immunization was within the past 10 years. Do I still need to get a Tdap?
A: You must have a Tdap within the last 10 years (taken 2006 or later) regardless of when your Td was completed.
Q: I received my Tdap over 10 years ago. Do I have to get another one or will a new Td suffice?
A: You must get another Tdap.
Q: My titer for Measles, Mumps, Rubella, Hep B, Hep A or Varicella is equivocal or negative. What do I do?
A: If your Hepatitis B titer is equivocal or negative you will need to repeat the immunization series in full and then run a titer six weeks later (Hep B only). If you have already completed the series twice and still receive an equivocal or negative result, you may be a non-responder and will need to sign a document waiving further Hep B vaccinations. You will also need to provide documentation of both immunization attempts. For an equivocal or negative Rubella titer, you need one additional MMR booster. You do not need to run an additional antibody titer. For an equivocal or negative Mumps, Measles, or Varicella titer, you must complete the full series (MMR for Mumps or Measles; Varicella for Varicella) again. You do not need to run an additional antibody titer.
Q: I had Chicken Pox as a child. Do I still need to get the Varicella vaccinations?
A: You do not have to get the vaccinations, but you must get a titer to show that you have the immunity.
Q: I had only one Varicella shot and then I got a positive titer. Do I have to complete the second shot since my titer is positive?
A: Yes, if you submit only one Varicella shot and a positive titer, you still have to complete the series, per the pediatrics unit on that rotation.
Q: What is a 2-step TB test?
A: A 2-step TB test just means that you take the TB test twice; once as a baseline and then again one to three weeks later. After that, you renew annually with just one TB test. You can find additional information regarding the TB two-step on the CDC website: https://www.cdc.gov/tb/publications/ltbi/diagnosis.htm. Scroll down to “Booster Phenomenon” and review recommendations for healthcare providers.
Q: My 2-stepTB skin test was negative and done within the past year, but will not cover the last 2 weeks of clinical. Can I update my TB test when it comes due?
A: No, your TB test must be valid for the entire upcoming academic term. That will be the case for all four terms. If your TB is due for renewal anytime during an academic term, you must renew before the term starts by the due date assigned. For example, if your TB is technically due for renewal in October, but the term goes through December, you must renew your TB in July or August (program coordinator will assign a due date each term based on facility requirements).
Q: I have received TB tests annually with my employer for several years. Do I still have to do the two-step?
A: It depends. Provided you started out with a two-step upon employment and have renewed annually on time, you may be fine, as long as the most recent TB skin test or blood test covers the duration of the JR1 term. If any of these conditions do not apply, you may still be required to get the two-step.
Q: I got a blood test for TB-do I still have to do the two-step?
A: If you have a negative blood test taken within the last year and it will be valid through the entire JR1 term, that will be sufficient and you do not need to get the TB skin test.
Q: I don’t want to get the TB test or the blood test. Can I just do a chest x-ray?
A: We will only accept a chest x-ray with proof of a past-positive TB skin or blood test or with proof of the BCG immunization.
Q: My TB skin test was positive. What do I do now?
A: You will need to submit proof of the positive skin test with millimeters of induration along with a copy of your negative chest x-ray report.
Q: I have a history of positive TB skin tests because I had the BCG immunization. What do I do?
A: You may either do a Quantiferon or T-spot OR you may submit documentation of a positive TB skin test along with a negative chest x-ray taken within the last year.