Documentation

All immunization requirements must be met prior to registration.  Immunizations may be obtained from your current university student health services, private physician's office, city/county health department or other clinics.

Acceptable documentation of immunizations includes one of the following:

1. The immunization form filled out and signed by your health care provider.

2. Documentation of vaccines administered that include the signature or stamp of the physician or his/her designee, or public health personnel.

3. An official immunization record generated from a state or local health authority, such as a registry.

4. A record received from school officials.

5. Immunization History Form

Please note:

1. Vaccines administered after September 1, 1991, shall include the month, day, and year each vaccine was administered.

      2. Enclose a copy of the laboratory report on all immune titers.

(For medical students, many residency programs require immune titers for measles, mumps, rubella, varicella, and hepatitis B. If you have insurance which will cover the cost of immune titers, you are encouraged to obtain the titers now.)

One of the following is required for each immunization:

Tetanus:  One dose of tetanus/diphtheria/acellular pertussis (Tdap).  Td/DPT/DtaP does not satisfy this requirement.  Tetanus toxoid (Td) will only be accepted if it was received within 2 years prior to enrollment.

Measles (Rubeola or Red Measles): If you were born on or after January 1, 1957:

(1) Documentation of two doses of measles vaccine administered since January 1, 1968 OR

(2) Documentation of two doses of MMR vaccine administered since January 1, 1968   OR

(3) Documentation of one dose of measles vaccine and one dose of MMR vaccine administered since January 1, 1968   OR

(4) A positive titer (blood test) confirming immunity or evidence of prior infection (include copy of laboratory report)

Mumps: If you were born on or after January 1, 1957:

(1) Documentation of one dose of mumps vaccine   OR

(2) Documentation of one dose of MMR vaccine   OR

(3) A positive titer (blood test) confirming immunity or evidence of prior infection

(include copy of laboratory report)

Rubella (German Measles): If you were born on or after January 1, 1957:

(1) Documentation of one dose of rubella vaccine   OR

(2) Documentation of one dose of MMR vaccine   OR

(3) A positive titer (blood test) confirming immunity or evidence of prior infection (include copy of laboratory report)

Hepatitis B:

(1) Documentation of three doses of Hepatitis B vaccine   OR

(2) A positive titer (blood test) confirming immunity or evidence of prior infection (include copy of laboratory report)

Varicella (Chicken Pox):

(1) Documentation of two doses of varicella vaccine   OR

(2) A positive titer (blood test) confirming immunity or evidence of prior infection (include copy of laboratory report)   OR

(3) History of disease validated by yourself, your parent/guardian, or health care provider. You may enclose a letter written by you, your parent/guardian, or healthcare provider stating the approximate date or year that you had the disease.

Tuberculin skin test (PPD):  Documentation of 1 negative PPD tuberculin skin test within 6 months prior to starting your UT Southwestern program.

Positive Tuberculin Skin Test (PPD):  If you tested positive, or have a history of a positive PPD, include the month,day, and year of the positive test on the form, and documentation of a chest x-ray within 6 months of starting your UTSW program.  Chest x-ray results must include a copy of the radiology report.

Please call if you have any questions regarding the required immunizations.

Mail or fax all immunization information to:

University of Texas Southwestern Medical Center
Student Health Services
5323 Harry Hines Blvd.
Dallas, Texas 75390-8861

Telephone (214) 645-8690 Fax (214) 645-8676