You may use the Immunization Record Form on page three (3) of this document to record your immunization history. Please enter
as much of your immunization information as possible. This form will require a signature
or clinic stamp from your physician or health department. Required for international
students or non-US Citizens is the Tuberculosis Screening Questionnaire that should be submitted with your immunization record.
You may submit other acceptable records as proof of your immunizations. Those records
may be obtained from of the following:
- North Carolina High School Records – These may contain some, but not all of your immunization
- High school transcripts from other states are not considered acceptable documentation
per NC Branch of Immunization Requirements.
- Previous College or University – Your immunization records do not transfer automatically. You must request a copy.
- Personal Shot Records – Must be verified by a doctor’s signature or by a clinic or
health department stamp.
- Military Records or WHO (World Health Organization) Documents – These records may
not contain all of the required immunizations.
- State Immunization Registry Documents
Your records must include:
Name, Date of Birth, Student ID Number (92#), Name and address of the physician or
clinic that administered the immunizations, Month,Day & Year of immunization.
North Carolina Required Immunizations
- Hepatitis B
- Three (3) shot series must be completed
- Students born before July 1, 1994 are not subject to this requirement
- MMR Measles, Mumps, Rubella
- Two (2) measles, Two (2) mumps and One (1) rubella are required Students born before 1957 are not subject to this requirement.
- These immunizations may include a combination of the following:
- MMR Measles, Mumps, Rubella
- Most students will have likely received these immunizations as one (1) combined immunization
- Dose one (1) of MMR must have been administered after student’s first birthday
- Measles may also be labeled Rubeolla
- Some students may have received these immunizations as separate shot
- Rubella Students over age 50 old are not subject to the rubella requirement
Titers are accepted with documentation by serological testing to have a protective
- Three (3) doses are required
- Students who have attained their 18th birthday are not subject to this requirement.
- Three (3) doses of tetanus/diphtheria toxoid
- One (1) must be current, administered within the past 10 years.
- One (1) must be Tdap
- Tetanus immunizations may include a combination of the following:
- DTP Diphtheria, Tetanus, Pertussis
- DTaP Diphtheria, Tetanus, acellular Pertussis
- Td Tetanus, Diphtheria
- Tdap Tetanus, Diphtheria, Pertussis
- One dose (two doses preferred) or proof of laboratory confirmation of varicella disease
immunity. Varicella vaccine or proof of immunity is not required if an individual
was born before April 1, 2001.
North Carolina Recommended Immunizations
- Human Papillomavirus HPV
- Three (3) shot series must completed
- Specify Gardasil, Gardasil-9, or Cervarix.
- Specify Menactra, Menveo, Menomune, MPSV4, or MCV4
- Recommended booster after age 16
- North Carolina House Bill 825 requires public and private institutions with on-campus
residents to provide information about meningococcal disease:
On October 20, 1999, the CDC’s Advisory Committee on Immunization Practices (ACIP)
voted to recommend that college students, particularly freshmen living in residence
halls, be educated about meningitis and the benefits of vaccination. The panel based
its recommendation on recent studies showing that college students, particularly freshmen
living in residence halls, have a six-fold increased risk for meningitis. The recommendation
further states that information about the disease and vaccination is appropriate for
other undergraduate students who also wish to reduce their risk for the disease.
Furthermore, in June 2003 the General Assembly of North Carolina passed House Bill
825, which requires public and private colleges with residence halls to provide their
students with information about meningococcal disease.
Meningitis is rare. However, when it strikes, its flu-like symptoms make diagnosis
difficult. Symptoms may include high fever, headache, and a stiff neck. If not treated
early, meningitis can lead to swelling of the fluid surrounding the brain and spinal
column as well as severe permanent disabilities, such as hearing loss, brain damage,
seizures, limb amputation and even death.
Cases of meningitis among teens and young adults 15 to 24 years of age have more than
doubled since 1991. The disease strikes about 3,000 Americans each year and claims
about 300 lives. Between 100 and 125 meningitis cases occur on college campuses and
as many as 15 students will die from the disease.
A vaccine is available that protects four types of the bacteria that cause meningitis
in the United States – types A, C, Y and W-135. These types account for nearly two-thirds
of meningitis cases among college students. Please contact your primary care physician
or your local health department if you are interested in receiving this vaccine. You can also find information about the disease at the Centers for Disease Control
and Prevention http://www.cdc.gov/meningitis/index.html.
Required of international students or non-US Citizens. Students from high risk countries
(as determined by CDC) may require a Tuberculin Skin Test (TST) or PPD. Students with
a positive skin test may be required to submit results from a recent chest x-ray.