College of Nursing Immunization Requirements:
The required vaccinations for all College of Nursing programs are listed below. Please submit this
form directly to Student Health Services once the entire form is completed by your primary care
provider. Once Student Health Services processes your records, you can monitor your
compliance status through the College of Nursing Beacon.
Submission Instructions:
• Once this form is completely filled out by your health care provider, this form and all required
supporting documentation must be uploaded through My BuckMD. Vaccination records
should not be submitted to the Office of Student Affairs, Equity and Inclusion through
CONcompliance@osu.edu.
• All medical documentation for compliance should be submitted at once utilizing this form, with
the exception of those students who are being revaccinated for Hepatitis B.
• This form will be kept in your medical record at Student Health Services. Student Health
Services will exchange health information with your academic program only for the purposes of
determining compliance with program requirements under the Family Educational Rights and
Privacy Act (FERPA).
• If you have any questions regarding specific immunization requirements, please contact the
Preventive Medicine Coordinator at 614-247-2387 or preventivemedicine@osu.edu.
• Please allow Student Health Services 1-2 weeks for the processing of records. During times of
high submission volume, this processing time may be even longer. Be sure to submit your
documentation early enough ahead of any deadlines to remain compliant.
• Non-health related compliance requirements submitted to Student Health Services will not be
processed, and will be shredded for security.
Please see the following pages for additional information regarding the various immunization and
testing requirement for the College of Nursing.
Immunization and Testing Compliance Requirements
1. Hepatitis B: a complete vaccination series (either 2-dose or 3-dose) AND a positive surface antibody titer required.
• If you have documented proof of a complete hepatitis B vaccination series, a titer must be collected to
determine your antibody levels and immunity.
o Positive results mean you are immune, and no additional vaccines or testing are required.
o Negative results will require re-vaccination to raise your antibody levels, with a repeated titer required
afterwards to check your immunity from the new vaccine(s).
Re-vaccination option 1: receive a booster dose of Engerix-B, then re-titer one month after
vaccine administration.
Re-vaccination option 2: repeat entire HEPLISAV-B (2-dose) or Engerix-B (3-dose) vaccine
series, then re-titer one month after the last dose.
• If there is no documented proof of a complete hepatitis B vaccination series, a new series must be completed
before a titer is collected. Positive hepatitis B surface antibody titers without proof of a complete vaccination
series will not be accepted.
2. Influenza: a current and updated influenza vaccine required annually.
• The new flu vaccines are usually available starting in late August/early September each year.
3. MMR: a complete 2-dose vaccine series required.
• 2 doses of the MMR vaccine given after 1 year of age is acceptable for the requirement.
• Measles, mumps, and rubella titers are only recommended if there is no proof of the vaccination history, but
the student is certain they received the vaccines in the past.
o Positive results mean you are immune, and no additional vaccines or testing are required.
o Negative titer results will require re-vaccination, with no repeated titers required.
4. Tdap: one Tdap vaccine within the last 10 years required.
• If Tdap vaccine is over 10 years old and expired, a TD or Tdap booster dose is required.
5. Toxicology (drug) screen: a negative 10-panel urine drug screen required upon entry to the program
• Results must show number of total drugs tested, overall or individual results, with the date included.
6. Tuberculosis: initial negative 2-step PPD or QFT-G blood test; annual 1-step PPD or QFT-G update required.
• For the first year of the program, students are required to have an initial negative 2-step Tuberculosis skin test
(PPD), which is two separate PPDs completed within 1-3 weeks of each other.
• One negative TB blood test (QFT-G, T-Spot, or IGRA) will satisfy the 2-step PPD requirement.
• As each TB test expires annually, completion of the Partnership to Prevention training is required.
7. Varicella: a complete 2-dose vaccine series required
• 2 doses of the Varicella vaccine given after 1 year of age is acceptable for the requirement.
• If a student never received the vaccines because of having Chickenpox in the past, a Varicella antibody titer is
required to prove immunity from having the disease.
.
.
Requirement
Required Documentation
Tuberculosis
Screening
Either a 2-step PPD
OR
TB blood test
required
Note: Annual
renewal only requires
completion of the
Partnership to
Prevention training
unless you are
placed in a high-risk
unit
**2-step tuberculin skin test**
PPD testing must meet the
following criteria:
• Must be read in 48-72 hours by
a certified health care provider
with results documented in mm.
• 2
nd
PPD must be placed 1-3
weeks after the placement date
of the first
PPD#1 date given: ____________
PPD #1 date read: ____________
Result: _________________ mm.
Read by: ____________________
Title: _______________________
PPD #2 date given: ___________
PPD #2 date read: ____________
Result: _________________ mm.
Read by: ____________________
Title: _______________________
**TB blood test (IGRA)**
Recommended for those that have
received the BCG vaccine
Date Completed: ____________ Result: _______________
Type of Test: _______________ Lab report attached
Positive TB tests (either past or current) will require the completion of a one-time chest x-ray and annual
Tuberculosis questionnaire. Please consult the Preventive Medicine department at Student Health Services to
discuss appropriate next steps for the compliance requirement
Tdap
(Tetanus, Diphtheria,
and Pertussis)
Date: _______________________ Brand: ______________________ Provider initials: ______________
Required if you have not received Tdap previously, regardless of when previous TD was administered
*Tdap must be re-administered every 10 years (TD booster accepted after initial Tdap vaccine)
Measles,
Mumps, &
Rubella
(MMR)
2 doses of the MMR
vaccine required
If given individually, 2
doses of Measles, 2
doses of Mumps, and
1 dose of Rubella
required
**2 doses MMR vaccine**
MMR #1 date: ________________
MMR #2 date: ________________
**Individual vaccines**
Measles #1 date: _____________
Measles #2 date: _____________
Mumps #1 date: ______________
Mumps #2 date: ______________
Rubella #1 date: ______________
Provider initials: ______________
**MMR titers only required if proof of vaccination is unable to be located**
Positive Measles, Mumps, and Rubella antibody titers: Lab report attached .
2021-2022
Full Name: ________________________________ Date of Birth: ____________ Academic Program: __________________
Requirement
Required Documentation
Varicella
(Chickenpox)
2 doses of the
Varicella vaccine
required
Dose #1 date: ___________________
Dose #2 date: ___________________
Provider initials: ______________
**Varicella titer only required if previously infected with the disease (Chickenpox) or
if proof of vaccination is unable to be located**
Positive Varicella antibody titer: Lab report attached .
Hepatitis B
A full vaccine series
(either 2-dose
or 3-dose)
AND
a positive surface
antibody titer
required
Note: a positive titer
without proof of a full
vaccine series will
not be accepted
**Engerix-B (3-dose) series**
Dose #1 date: ________________
Do
se #2 date: ________________
Dose #3 date: _______
_________
**HEPLISAV-B (2-dose)
series**
Dose #1 date: ________________
Dose #2 date: ________________
Provider initials: ______________
**Hepatitis B surface
antibody titer**
Date Completed: ______________ Result: _______________
.
La
b report attached
If the titer is negative, either a booster dose of Engerix-B or a full series (either 2-dose or 3-dose) must be
completed, with a repeated titer completed afterwards. Contact Student Health Services ASAP if you receive a
negative test to plan the next steps and to gain temporary compliance during re-vaccination.
Influenza
Dose date: ___________________ Provider initials: ______________
NOTE: Seasonal flu vaccines are typically available starting in August/September.
Drug Screen
10-panel urine test
Completion Date: _________________ Results:____________________ Lab report attached
Provider
Information
Signature required
for this document to
be valid
Name: _________________________________________________________________________
Address: _________________________________________________________________________
_________________________________________________________________________
Phone: _________________________________________________________________________
S
ignature: ______________________________________________ Date Completed: __________________
2020-2021
Full Name: ________________________________ Date of Birth: ____________ Academic Program: __________________
