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Original Research |

Student Vaccination Requirements of U.S. Health Professional Schools: A Survey

Megan C. Lindley, MPH; Suchita A. Lorick, DO; Jovonni R. Spinner, MPH; Andrea R. Krull, MPH; Gina T. Mootrey, DO; Faruque Ahmed, PhD; Rosa Myers, MSN; Geraldine P. Bednash, PhD; Tyler C. Cymet, DO; Rika Maeshiro, MD, MPH; C. Fay Raines, PhD; Stephen C. Shannon, DO; Henry M. Sondheimer, MD; and Raymond A. Strikas, MD
[+] Article and Author Information

From Centers for Disease Control and Prevention, Atlanta, Georgia; National Institutes of Health, Bethesda, Maryland; U.S. Department of Health and Human Services, American Association of Colleges of Nursing, and Association of American Medical Colleges, Washington, DC; U.S. Department of Health and Human Services, Philadelphia, Pennsylvania; American Association of Colleges of Osteopathic Medicine, Chevy Chase, Maryland; and University of Alabama in Huntsville, Huntsville, Alabama.


Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, the National Vaccine Program Office, the American Association of Colleges of Nursing, the Association of American Medical Colleges, or the American Association of Colleges of Osteopathic Medicine. None of the authors has any financial or proprietary interest in this work.

Acknowledgment: The authors thank Alicia Tindall, BS, RN; Luta Garbat-Welch, MPH; Mark Lamias, BS; Lon Gross, BS; Lola Okunola, MBA; Angela Austin; Neelima Kandukuri; Gary Edgar; Bayo Arthur, MPH; Norma Allred, PhD, MSN; Pascale Wortley, MD, MPH; Suzanne Begeny, MS, RN; and Robert Rosseter, MS, MBA.

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-1762.

Reproducible Research Statement:Study protocol: Not available. Statistical code and data set: Available from Ms. Lindley (e-mail, MLindley@cdc.gov); data that can be used to identify surveyed institutions will be omitted.

Requests for Single Reprints: Megan C. Lindley, MPH, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E-52, Atlanta, GA 30333; e-mail, MLindley@cdc.gov.

Current Author Addresses: Ms. Lindley, Dr. Lorick, Dr. Ahmed, and Dr. Strikas: Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E-52, Atlanta, GA 30333.

Ms. Spinner: National Institutes of Health, Building 31A, Suite 4A20, 31 Center Drive, MSC 2480, Bethesda, MD 20892.

Ms. Krull: U.S. Department of Health and Human Services, 200 Independence Avenue SW, Washington, DC 20201.

Dr. Mootrey: Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop C-25, Atlanta, GA 30333.

Ms. Myers: Office on Women's Health Region 3, 150 South Independence Mall West, Suite 436, Philadelphia, PA 19106.

Dr. Bednash: American Association of Colleges of Nursing, Suite 530, One Dupont Circle NW, Washington, DC 20036.

Drs. Cymet and Shannon: American Association of Colleges of Osteopathic Medicine, 5550 Friendship Boulevard, Suite 310, Chevy Chase, MD 20815.

Drs. Maeshiro and Sondheimer: Association of American Medical Colleges, 2450 N Street NW, Washington, DC 20037.

Dr. Raines: College of Nursing, University of Alabama in Huntsville, 301 Sparkman Drive, Huntsville, AL 35899.

Author Contributions: Conception and design: M.C. Lindley, S.A. Lorick, J.R. Spinner, A.R. Krull, G.T. Mootrey, F. Ahmed, H.M. Sondheimer, R.A. Strikas

Analysis and interpretation of the data: M.C. Lindley, S.A. Lorick, A.R. Krull, G.T. Mootrey, F. Ahmed, R. Myers, T.C. Cymet, S.C. Shannon, H.M. Sondheimer, R.A. Strikas

Drafting of the article: M.C. Lindley, S.A. Lorick, A.R. Krull, S.C. Shannon, R.A. Strikas

Critical revision of the article for important intellectual content: S.A. Lorick, J.R. Spinner, G.T. Mootrey, F. Ahmed, R. Myers, T.C. Cymet, R. Maeshiro, H.M. Sondheimer, R.A. Strikas

Final approval of the article: M.C. Lindley, S.A. Lorick, J.R. Spinner, G.T. Mootrey, F. Ahmed, R. Myers, G.P. Bednash, T.C. Cymet, R. Maeshiro, C.F. Raines, S.C. Shannon, H.M. Sondheimer, R.A. Strikas

Administrative, technical, or logistic support: M.C. Lindley, S.A. Lorick, J.R. Spinner, A.R. Krull, G.T. Mootrey, T.C. Cymet, R. Maeshiro, C.F. Raines, S.C. Shannon, R.A. Strikas

Collection and assembly of data: M.C. Lindley, S.A. Lorick, A.R. Krull, R. Myers, G.P. Bednash, T.C. Cymet, R. Maeshiro, S.C. Shannon, R.A. Strikas


Ann Intern Med. 2011;154(6):391-400. doi:10.7326/0003-4819-154-6-201103150-00004
Text Size: A A A

Background: Unvaccinated health care personnel are at increased risk for transmitting vaccine-preventable diseases to their patients. The Advisory Committee on Immunization Practices (ACIP) recommends that health care personnel, including students, receive measles, mumps, rubella, hepatitis B, varicella, influenza, and pertussis vaccines. Prematriculation vaccination requirements of health professional schools represent an early opportunity to ensure that health care personnel receive recommended vaccines.

Objective: To examine prematriculation vaccination requirements and related policies at selected health professional schools in the United States and compare requirements with current ACIP recommendations.

Design: Cross-sectional study using an Internet-based survey.

Setting: Medical and baccalaureate nursing schools in the United States and its territories.

Participants: Deans of accredited medical schools granting MD (n = 130) and DO (n = 26) degrees and of baccalaureate nursing programs (n = 603).

Measurements: Proportion of MD-granting and DO-granting schools and baccalaureate nursing programs that require that entering students receive vaccines recommended by the ACIP for health care personnel.

Results: 563 schools (75%) responded. More than 90% of all school types required measles, mumps, rubella, and hepatitis B vaccines for entering students; varicella vaccination also was commonly required. Tetanus, diphtheria, and acellular pertussis vaccination was required by 66%, 70%, and 75% of nursing, MD-granting, and DO-granting schools, respectively. Nursing and DO-granting schools (31% and 45%, respectively) were less likely than MD-granting schools (78%) to offer students influenza vaccines free of charge.

Limitations: Estimates were conservative, because schools that reported that they did not require proof of immunity for a given vaccine were considered not to require that vaccine. Estimates also were restricted to schools that train physicians and nurses.

Conclusion: The majority of schools now require most ACIP-recommended vaccines for students. Medical and nursing schools should adopt policies on student vaccination and serologic testing that conform to ACIP recommendations and should encourage annual influenza vaccination by offering influenza vaccination to students at no cost.

Primary Funding Source: None.

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