Immunization Form

COM Immunization Form  – If you have any questions regarding immunizations, please contact Vicki Busseno or 352-273-7973.  It is important that you identify yourself as a medical student.  Medical students have stricter requirements than some other UF students.  The immunization requirements for matriculation to the College of Medicine are as follows:

Prior to the start of medical school, you must provide documentation of:

  • MMR – Required for everyone born after December 31, 1956. Two doses are required for entry into the University of Florida. One must have been received at 12 months of age or later and in 1971 or later. The second dose must have been received at least 30 days after the first dose and in 1990 or later.
    OR: Provide lab evidence of immunity by doing a blood test to check for antibodies for Measles, Mumps and Rubella. If you do the blood test, you need to provide the results on a laboratory form that should be faxed or mailed with the completed Immunization Health History Form. ** All lab evidence of immunity testing must be accompanied by a lab report**
  • Hepatitis B Vaccine (HBV) – You are required to receive the Hepatitis B Vaccine (HBV) series. Hepatitis B is a serious viral infection of the liver that can lead to chronic liver disease, cirrhosis, liver cancer, liver failure and even death. This disease is completely preventable. Hepatitis B vaccine is available to all age groups to prevent Hepatitis B viral infection. Missed doses may still be sought to complete the series if only one or two have been acquired. If you completed the vaccination series within the past two months, you must also provide serologic proof of immunity, i.e., a positive serum titer for Hepatitis B surface antibody – quantitative. ** All lab evidence of immunity testing must be accompanied by a lab report**
  • Tdap (Tetanus/Diphtheria/Pertussis) – Available since June 2005.
    Note: Either Adacel or Boostrix Tdap vaccine is required for the College of Medicine Students.
  • Varicella/chickenpox – Provide proof of two doses of Varivax vaccine. OR: lab evidence of immunity to varicella/chickenpox. ** All Titers must include a lab report** (Note: History of disease is not acceptable)
  • Flu Shot – Flu Shots are required of ALL University of Florida College of Medicine Students. UF COM Students are required to get a flu shot every year. Although students are not required to have a flu shot before the August start date, all students must have a flu shot when the new Flu shot is made available in early fall of each corresponding school year. Failure to comply with this requirement may result in delayed graduation due to the inability to participate in certain clinical activities.
  • MCV4 (Menactra/Menveo) (bacterial meningitis vaccine) – The Advisory Committee on Immunization Practices (ACIP) currently recommends this vaccine for freshmen planning to live in campus dormitories/residence halls. Students wishing to decline this vaccine must read the “Waiver Statement” below, then check and sign where indicated on the form. Signing the waiver indicates you understand the possible risk in not receiving this vaccine.
    Waiver Statement: Meningococcal Meningitis – College students, especially freshmen living in residence halls, are at a slightly increased risk for contracting meningococcal disease. The bacterial form of this disease can lead to serious complications such as swelling of the brain, coma and even death within a short period of time. Two vaccines are currently available that decrease, but do not completely eliminate a person’s risk of acquiring meningococcal meningitis. This element of uncertainty remains because there are many different serotypes and the current vaccines do not offer any protections from serotype B. For more specific information about meningococcal meningitis and college students’ risks, visit the “Immunizations” section of the UF Student Health Care Center’s website at www.shcc.ufl.edu.
  • Tuberculosis Screening – either by Two-Step Tuberculosis Skin Test – TST by Mantoux, current within 12 months of the COM admission date or Interferon-based Assay (IGRA) Lab Test (QFT or T spot).
    TB Skin Test by TST must be read between 48-72 hours of administration.
    The second TB Skin Test by TST must be applied at least 7 days after the first TST is placed. The result must be recorded in “mm’s” in the space provided.
    If you do the blood test, the Interferon-based assay (IGRA) lab test, either the QFT or T-spot, then attach a copy of the lab report.
    If you have a positive TB Skin Test by TST or positive Interferon-based assay (IGRA) lab test, you must provide documentation of both the positive test and a negative chest X-ray within three months of the start of school.
    If both the TST and MMR or Varivax are given, they must be given on the same day for the TST to be accurate or given 30 days apart.