Measles, mumps, tuberculosis, and whooping cough seem like quaint old illnesses confined to 19th century novels. But outbreaks of contagious diseases like measles and mumps have caused problems recently, especially in schools and on college campuses where large numbers of people are together in close quarters.
Part of the problem is that diseases like whooping cough, which were on their way out in the United States, are making a comeback because many contagious diseases are still epidemic in other parts of the world and can be brought across borders by travelers. Some serious infections, like bacterial meningitis, may even have life-threatening consequences for students.
These diseases wouldn't spread as quickly — or be as serious — if people were immunized against them. But that's the other part of the problem: Many people aren't getting all the shots they need. The risk of coming down with a serious disease is far less when you and your peers are immunized. That's why so many colleges require that students get certain immunizations (also known as vaccinations) before they attend school. Most schools give students a grace period of a week or two in which to get vaccines. After the grace period, though, some colleges will suspend students who haven't fulfilled their immunization requirements — that's how seriously they take the issue.
How Does Vaccination Work?
Vaccines contain either parts of microbes (bacteria or viruses) or whole microbes that have been killed or weakened so that they don't cause disease. When a person is vaccinated, these harmless versions of the microbes enter the body, where they stimulate the immune system to react as if a real infection had developed. The immune system makes antibodies to these microbes that "remember" a virus or bacterium should it be encountered again. That way, the body can fight off the real microbe quickly if it enters the body in the future.
After getting a vaccination, it generally takes 10 days to 2 weeks for the body to build up immunity to a disease.
We usually think of vaccines as the shots we were given as kids. But not all vaccines are shots — very occasionally, some are given orally (by mouth) or in other forms like nasal sprays.
What Vaccinations Do I Need for College?
The American College Health Association's (ACHA's) Vaccine-Preventable Diseases Task Force provides a list of recommended vaccines on its website. However, because college immunization requirements are based on state law, not all the vaccines they recommend will be required in different parts of the country. The best idea is to check with your school to make sure you have all the vaccines necessary to matriculate. Students entering medical programs have slightly more stringent requirements than other students.
The vaccinations most commonly required on campuses are:
- tetanus, diphtheria, pertussis booster (Tdap)
- measles, mumps, rubella (MMR)
- polio, in the form of inactivated polio virus (IPV) or oral poliovirus (OPV)
- hepatitis B
- varicella (chickenpox) if you have not had the disease
- human papillomavirus vaccine (HPV) for women
- meningococcal vaccine
- hepatitis A
The following immunizations are particularly encouraged for students who have chronic illnesses, such as diabetes:
- pneumococcus
- influenza — this needs to be given annually to offer protection because the makeup of the vaccine changes with each flu season
Some of these vaccines are given as a single dose; others, like hepatitis B, involve a series of shots separated by a specified number of weeks or months. Still other vaccines require a periodic booster shot to ensure that a person's level of immunity remains high. You can check with your doctor to make sure you have had the requisite number of doses of each vaccine.
Your school may also require tuberculosis (TB) screening. This is a simple skin test that involves a slight prick to the skin and then waiting to see if there's a reaction. You'll need to see a health care provider between 48 and 72 hours after the test is given so he or she can look at the skin prick and interpret the results.
TB screening is not a vaccine, but it does allow doctors and student health staff to identify people who may have TB. The disease can then be treated and prevented from spreading to others. Your doctor can give you more information on the tuberculosis skin test and the meaning of its results.
How Do I Find Out If I've Had the Right Vaccinations?
Contact your pediatrician or family doctor to find out which of these vaccines you've had. Someone from your doctor's office can send your health records to your school or fill out the forms the school provides.
If it's unclear whether you had the infection or received a particular vaccine, your doctor may be able to measure antibodies in your blood to the infectious agent that causes that disease. This measurement is called a titer, and it can be taken with a simple blood test. A certain level of antibodies indicates that you have immunity to a disease, in which case you may not need to be vaccinated.
If it turns out you missed out on one or more of the required immunizations, you can receive them from your doctor or your school's student health center. Health centers typically offer vaccinations at a low cost, and some insurance companies will pick up the tab, too. Your school may even have an annual immunization day, when you can get many of the shots you need. Check the student activity calendar or call your health center for more information.
Are Vaccinations Safe?
Like any medicine, vaccines may cause side effects — but getting a vaccine is far safer than getting the disease it prevents. The most common reactions include soreness, redness, and swelling in the area of the shot or a low-grade fever. Usually acetaminophen or ibuprofen will take care of these side effects.
Adverse reactions to vaccines are rare. Reactions will depend on the type of vaccine given, so ask your doctor about the possible reactions. Also, if you've had reactions to vaccines in the past, let your doctor know.
Who Should Not Be Vaccinated?
Some students might need to hold off on getting their vaccines. If you are pregnant, have a compromised immune system (from AIDS or certain cancers, for example), or are undergoing chemotherapy or receiving other types of medication that can weaken the immune system, consult with your doctor before receiving any shots. Temporary medical exemptions are usually available to enable you to enroll and register for classes if medical reasons prevent you from getting all of the requisite vaccinations.
People with certain allergies may need to exercise caution with specific vaccines. The influenza vaccine, for example, is developed using chicken eggs. So if you're allergic to eggs, be sure to discuss that with your doctor. People who have severe allergies to gelatin or the antibiotic neomycin should also be careful with the MMR and varicella vaccines. And if you are extremely allergic to baker's yeast, which is used to make bread, you should talk to your doctor before getting the hepatitis B vaccine.
In some cases, schools will allow students to opt out of immunizations on religious or other grounds. However, schools usually require documentation to confirm this — and students who do opt out may be asked to sign a waiver.
What About Travel?
Studying abroad? Depending on where you're going, you may need additional vaccinations. The Centers for Disease Control and Prevention's website has a list of specific vaccines recommended for various destinations. Or ask your health care provider or the staff at student health services for information.
Don't put off getting your vaccinations until the last minute. Some immunizations require a series of shots, and it may take time to get the full cycle. To ensure immunity, most immunizations should be given at least 1 month before you travel.
Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: November 2006
