2.4 Immunizations and Documentation Requirements: Graduate

Any student enrolled in any two or four-year institution of higher education (schools, universities) listed in the Texas Higher Education Coordinating Board's list is required to have the following immunizations. This applies to all students enrolled in health-related courses that will involve direct patient contact in medical or dental facilities, regardless of the number of courses taken, the number of hours taken, and the student's classification. Students considered to be provisionally enrolled cannot enroll without receipt of at least one dose of MMR vaccine if direct patient contact will occur during the provisional enrollment. These requirements must be completed prior to students beginning their first nursing semester.

All students must complete all requirements in the Castle Branch system before attending clinical. Failure to produce documentation of met requirements will result in a missed clinical day. 

2.4.1 Immunizations

Students enrolled in nursing courses are required to certify immunity to or to certify immunization of the following vaccines:

Influenza: Documentation of a flu shot administered during the current flu season (August-May) OR declination signed by a healthcare provider. Documentation DOES NOT need to indicate that the vaccine you received is from the batch of the current flu season. The renewal date will be set to 11/01 of the following flu season.

Series in process is acceptable but MUST be completed by the end of the 1st semester. If series is in process, submit where you are, and a new alert will be created for you to complete the series and titer.

Measles, Mumps, & Rubella (MMR): Students born on or after January 1, 1957, must have two vaccines OR positive antibody titers for all three components (lab report or physician verification required). If your titer is negative or equivocal, a new alert will be created for you to submit proof of physician recommendation for follow-up action (physician signature required) AND completed follow-up action.

Tetanus, Diphtheria, & Pertussis (Tdap): Documentation of a Tdap booster administered within the past ten years. The renewal date will be set 10 years from the administered date.

Polio: Although the polio vaccine is not required for any student, nursing students are encouraged to ascertain that they are immune to poliomyelitis.

Varicella (Chicken Pox): Evidence of immunity is either documentation of two doses of varicella vaccine given at least 28 days apart OR positive antibody titer (lab report or physician verification required) OR History of Disease (medically documented). If your titer is negative or equivocal, a new alert will be created for you to submit proof of physician recommendation for follow-up action (physician signature required) AND completed follow-up action.

2.4.2 Tuberculosis Screening

• A Two-step PPD Mantoux tuberculin skin test (TST) (Students: If the first TST is negative, retest with a second TST in 1-3 weeks) 

OR

• A Negative IGRA Blood test (QuantiFERON or T-spot)

Students/HCWs with a baseline POSITIVE or newly POSITIVE test result for M. tuberculosis
infection or documentation of previous treatment for latent tuberculosis infection (LTBI) or TB
disease: 

1.  Documentation showing the start of treatment 
2.  Documentation showing the completion of treatment from a health care provider. 

**Students may attend clinical experiences if they are undergoing treatment for infection and are clear of TB disease. Please speak with your School Administrator in these cases. 

• For Past Negative tests: A one-step PPD Mantoux tuberculin skin test (TST) 

OR

• For Past Positive Tests: Provide documentation that you have received an Annual TB symptom screen. (This screen should be accomplished by educating the student/HCW about symptoms of TB disease and instructing the HCW/student to report any such symptoms immediately to the health care provider or the local health department. Treatment for LTBI should be considered in accordance with CDC guidelines). 

**International Students: Please download, complete and submit the Mandatory Tuberculosis Screening Documentation Form and Lab Report of Test Results, Signed by your Health Care Provider. Access the form.

1. Students with medical contraindications must submit written verification from a healthcare provider that the immunization required would be injurious to the health and well-being of the student or any member of the student's family or household. Unless a lifelong condition is specified, the verification is valid for only one year from the date signed by the physician.
2. Students whose religious beliefs forbid the use of vaccines must present an affidavit signed by the applicant stating that the immunization conflicts with the tenants and practice of a recognized church or religious denomination of which the applicant is an adherent or member.
3. Pregnant female students who submit written documentation of a positive pregnancy test are not required to take any of the above-listed vaccines, except Tdap. If the student has not had a Tdap within the last ten years, it is best to delay the administration of Tdap until the second trimester. There are no contraindications to Tdap during pregnancy after the first trimester.

2.4.3 Liability Insurance

Professional liability insurance fees will be added to the bill at registration.

2.4.4 Licensure

Licensure Verification for current registered nurses (RNs): For all licensed nurses, current licensure in the state will be verified before admission is considered. Any licensed nurse with a current license restriction or who receives a subsequent restriction after admission to the SON must contact the appropriate program director. Progression in the program will be contingent upon the nature of the restriction.

2.4.5 BLS/CPR

Submit your current Basic Life Support (BLS) or Cardiopulmonary Resuscitation (CPR) certification. Must be either an American Heart Association (AHA) or American Red Cross BLS/CPR course designed for healthcare providers. Heart Saver, Lifeguard, or other nonhealthcare provider level BLS courses are NOT accepted. Courses from other companies that
use AHA guidelines but do not result in either an AHA or American Red Cross card are NOT
accepted.

A copy of both the front and back of your card (including your signature) or e-card containing the
name of the course and your name is required. The renewal date will be set based on the expiration of certification.

A temporary certificate or letter from a provider will be accepted and temporarily approved for 30
days, by which time the permanent documentation must be uploaded. The renewal date will be set based on the expiration of certification.

2.4.6 Health Insurance and Health Insurance Waiver

Health Insurance: Submit a copy of your current health insurance card OR proof of coverage.
Verification of coverage provider is required if the name on the document does not match.
The renewal date will be set to 1 year from the date of upload.

Students may opt to waive the health insurance requirement. By waiving personal healthcare
coverage, the student agrees to accept all financial responsibility for any injury associated with
clinicals, as required for the Graduate program. The document to waive health insurance is
available on our policy website as item 2.4.6.