Massachusetts State requires that students have certain immunizations completed prior to arriving on campus. In the event of a campus disease exposure or outbreak, non-immunized students may be required to leave campus during the period of contagion.
Vaccine Requirements
- One dose of tetanus, diphtheria and pertussis (Tdap) on or after 10 years of age. A booster is recommended every 10 years.
- Two MMR (measles, mumps and rubella) shots or blood tests indicating immunity to these conditions. The first shot must be given AFTER 12 months of age.
- A medical provider certified history of chicken pox or two doses of varicella (chicken pox) vaccine given at least 4 weeks apart or a blood test indicating immunity to varicella.
- Three doses of hepatitis B vaccine (or 2 doses of Heplisav) or a blood test indicating immunity to hepatitis B.
- One dose of a quadrivalent meningococcal conjugate vaccine (Menveo or MenQuadfi) on or after your 16th birthday. Do not complete if you will be over 21 years of age at the start of your first semester. Meningococcal-B vaccine does not fulfill requirement.
- A tuberculosis blood test or skin test depending on your country of origin and tuberculosis history.
Vaccine Recommendations
Students are strongly recommended to receive and stay up to date with:
- An influenza (flu) vaccine for the current influenza season (August-May) by December 1st.
- CDC COVID-19 vaccine recommendations.
*Additional vaccine requirements for clinical students can be found here.
Tuberculosis (TB)
Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attacks the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal.
TB Compliance at BU
Two tests may be used to detect exposure to tuberculosis: a Blood Test (IGRA T-spot or Quantiferon Gold test) or a TB Skin Test (TST or PPD or Mantoux Test).
At Boston University:
- Students in clinical programs or engaging in any patient care are required to complete a TB Risk Assessment and Symptom Screen. In addition, students will need to submit proof of a negative blood test upon matriculation. Annually, students will need to complete a TB Risk Assessment and Symptom Screen on Patient Connect.
- All international students who were born or lived for more than one month in a country of high incidence are required to submit a negative TB Blood Test. A negative TB Skin Test is also acceptable.
If you have a positive reaction to either test, you will be required to have a chest x-ray performed to rule out pulmonary TB disease. All students within this category will need to follow up with a TB Risk Assessment and Symptom Screen annually.
Countries of High Incidence
You are required to complete a TB skin test if you were born in or have traveled or lived for more than one month in any country other than the United States, Canada, Australia, New Zealand, and those in Northern Europe or Western Europe.
Source: Centers for Disease Control and Prevention
Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist:
Latent TB Infection
TB bacteria can live in the body without making you sick. This is called latent TB infection. People with latent TB infection do not feel sick and do not have any symptoms. People with latent TB infection are not infectious and cannot spread TB bacteria to others. However, if TB bacteria become active in the body and multiply, the person will go from having latent TB infection to being sick with TB disease.
Active TB Disease
TB bacteria become active if the immune system can’t stop them from growing. When TB bacteria are active (multiplying in your body), this is called TB disease. People with TB disease are sick. They may also be able to spread the bacteria to people they spend time with every day.
Symptoms
Symptoms of Active TB Disease
- A bad cough that lasts three weeks or longer
- Pain in the chest
- Coughing up blood or sputum
- Weakness or fatigue
- Weight loss
- No appetite
- Chills
- Fever
- Sweating at night
Complications of TB
Once a person is infected with TB bacteria (LTBI), the chance of developing TB disease is higher if the person:
- Has HIV infection;
- Has been recently infected with TB bacteria (in the last 2 years);
- Has other health problems, like diabetes, that make it hard for the body to fight bacteria;
- Abuses alcohol or uses illegal drugs; or
- Was not treated correctly for TB infection in the past.
Spreading, Treatment & Prevention
How TB Spreads
TB is spread through the air from one person to another. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected.
TB is NOT spread by:
- Shaking someone’s hand
- Sharing food or drink
- Touching bed linens or toilet seats
- Sharing toothbrushes
- Kissing
How to Treat TB
Treatment for Latent TB Infection
If you have latent TB infection but not TB disease, your health care provider may want you be treated to keep you from developing TB disease. Treatment of latent TB infection is essential to controlling and eliminating TB in the United States. The decision about taking treatment for latent TB infection will be based on your chances of developing TB disease.
Treatment for Active TB Disease
TB disease can be treated by taking several drugs, usually for six to nine months. It is very important to finish the medicine, and take the drugs exactly as prescribed.
How to Prevent TB
Travelers should avoid close contact or prolonged time with known TB patients in crowded, enclosed environments (for example, clinics, hospitals, prisons, or homeless shelters).
Travelers who will be working in clinics, hospitals, or other health care settings where TB patients are likely to be encountered should consult infection control or occupational health experts. They should ask about administrative and environmental procedures for preventing exposure to TB. Once those procedures are implemented, additional measures could include using personal respiratory protective devices.
If you think you have been exposed to someone with TB disease, contact your health care provider or local health department to see if you should be tested for TB. Be sure to tell the doctor or nurse when you spent time with someone who has TB disease.
Source: Centers for Disease Control and Prevention
Meningitis (Meningococcal)
Meningococcal disease is a serious, potentially fatal infection that most often causes severe swelling of the tissue around the brain and spinal cord (meningitis) or a serious blood infection (meningococcemia).
How Meningococcal Disease is Caused
Meningococcal disease is caused by Neisseria meningitidis, a leading cause of bacterial meningitis in older children and young adults in the United States. There are five types of bacteria or serogroups for meningococcal disease that circulate worldwide: A, B, C, Y, and W-135.
How Meningococcal Disease is Spread
Meningococcal disease is spread person-to-person through the air by respiratory droplets (e.g., coughing, sneezing). The bacteria also can be transmitted through direct contact with an infected person, such as oral contact with shared items like cigarettes or drinking glasses, and through kissing.
Massachusetts Requirements
Massachusetts requires all newly enrolled full-time students attending a secondary school (e.g., boarding schools) or postsecondary institution (e.g., colleges) who will be living in a dormitory or other congregate housing licensed or approved by the secondary school or institution to either:
- Receive quadrivalent meningococcal polysaccharide or conjugate vaccine to protect against serotypes A, C, W and Y.
- Fall within one of the exemptions in the law, which are discussed in the source link below.
All newly enrolled full time students 21 years of age and younger must receive a dose of one of the following quadrivalent meningococcal conjugate vaccines (Menveo or MenQuadfi) on or after their 16th birthday or a complete a waiver. Meningococcal-B vaccine is not required.
Source: Commonwealth of Massachusetts Information about Meningococcal Disease and Vaccination
CDC Recommendations
Certain persons aged 10 years or older who are at increased risk for meningococcal disease should receive Meningitis vaccine. These persons include:
- Individuals with certain diseases and medications or surgical procedures that may weaken the immune system.
- College students, particularly those living in residence halls (Due to lifestyle factors, such as crowded living situations, bar patronage, active or passive smoking, irregular sleep patterns, and sharing of personal items, some college students may be more likely to acquire meningococcal disease than the general college population).
- Persons with persistent complement component deficiencies.
- Persons with anatomic or functional asplenia.
- Microbiologists routinely exposed to isolates of Neisseria meningitidis.
- Persons identified as at increased risk because of a serogroup B meningococcal disease outbreak.
Certain conditions also increase a person’s susceptibility to the disease. Persons with immature or damaged immune systems are at increased risk. Respiratory tract infections also increase a person’s risk of getting the disease. There also may be certain genetic factors that increase the risk of infection.
Source: Centers for Disease Control and Prevention
Declination of Meningitis (ACWY) Vaccine
Quadrivalent meningococcal conjugate vaccine (Menactra and Menveo) protects against 4 serotypes (A, C, W and Y) of meningococcal disease. These vaccines are routinely recommended at age 11-12 years with a booster at age 16. Students receiving their first dose on or after their 16th birthday do not need a booster.
Students who do not wish to receive a booster vaccine on or after the age of 16 must provide a signed copy of the waiver form to BU Student Health Services. To upload this document into our online portal, please follow the instructions below:
For students 17 years of age and younger, the waiver must be signed by a parent or legal guardian.
- Log into Patient Connect
- In the menu on the left, select Messages
- Select New Message
- Select Meningitis Waiver
- Select Attach Document and upload the signed Waiver
- Click Send
Source: Commonwealth of Massachusetts Information about Meningococcal Disease and Vaccination