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Immunization Issues

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Hello everyone!

I am an overseas student and I will start my PhD in the US in Fall 2018. My admit package was saying that, in accordance with the health laws of the state in which my school is located, I should be vaccinated against a number of diseases. I didn't care about this much, as I had taken all these vaccinations on the list (MMR, Tdap, Hepatitis B, etc.) in my home country. But when I went to the website of my university's health services to download the forms I have to fill, I saw that they want a much more comprehensive documentation of my vaccinations than I had initially expected. 

The biggest problem is that they want me to specify when exactly (MM/DD/YYYY) I received a vaccine. 

Now, the problem is, I have received all these obligatory vaccines in my schools throughout K-12, and this is how it happened: On a pre-specified day, healthcare professionals from a nearby public hospital visited our school and basically vaccinated every student. This is how I received ALL my immunization shots. As an individual student, I was not given a certificate of vaccination - so I cannot technically prove that I have been vaccinated, nor can I show the exact date on which I have been vaccinated. I also don't know how well official records of school vaccinations are kept in my country but I suspect I couldn't get any info on this from any official sources. 

So how should I go about filling these forms, actually? I should be writing the dates of my vaccinations, and my doctor has to sign this document. Would it be OK if I only specified the year in which I took the vaccine (as this is fixed for many vaccines in my country - for example MMR is given in 1st and 5th grades, if I am not mistaken - I'll check this again, though) and left out the day and month info? And would I get into trouble if I made up the month and day info just to submit a complete form?

Thanks in advance for your help!

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I would contact your doctor and ask them how you should fill out the form. Don't assume there are no records whatsoever without first verifying this. And definitely do NOT falsify the records by making up the day and month.

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As rising_star said, do not make up anything on the forms.  Speak with your physician.  The equivalent of the local school board or local public health unit may have proof of your vaccinations.  There are also other ways to show immunity that may be acceptable - your doctor will know what approach to take.

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I had the same situation and I made up the dates and years and got my doctor to sign it.

Up to you if you want to do the same thing. Hardly ethical, but I'm not going to be bothered to take a bunch of vaccines I had already taken.

Edited by Comparativist

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Speak with your doctor to make sure you have the right vaccines and to get the proper vaccines if necessary.

Then, basically make up the dates / guess approximate dates corresponding to your kindergarten year and approx month. The school is asking for this information to prove that they did their due diligence in ensuring students are vaccinated so that if an outbreak happens, they don't get sued by parents of a sick student. Note that this is also mostly for undergrads who live in dorms or other close shared quarters on campus. They don't really care for grad students. 

Also, my grad school asked for these things and if you don't have them, they just encourage you to get them done when you are there. As far as I know, no one was ever forced to get a vaccine. You can sign waivers for some of them too. I found this exercise useful because I would have forgotten that I needed a MMR booster (it needs to be some number of years after my last one and I would have reached that point while in the US so my Canadian health unit may not have been able to reach me to remind me).

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10 minutes ago, TakeruK said:

Also, my grad school asked for these things and if you don't have them, they just encourage you to get them done when you are there. As far as I know, no one was ever forced to get a vaccine. You can sign waivers for some of them too. I found this exercise useful because I would have forgotten that I needed a MMR booster (it needs to be some number of years after my last one and I would have reached that point while in the US so my Canadian health unit may not have been able to reach me to remind me).

My grad school would not let graduate students enroll in classes if they had not received their immunization form so I would check to see what the policies are for your school and not assume that they will be lax on it - especially since this is a state law and not an internal policy.

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Something else I would add is that usually when people don't have documentations of their vaccinations, either your current physician or the physicians at your program would be able to run a panel that tests for antibodies in your system associated with the relevant vaccinations/illnesses. This antibody panel would act as documentation of what vaccinations you have received, and show what vaccinations you lack. Your situation is actually more common than some may think, so yeah definitely 1. talk to your current physician about your situation, if you have one. And if not you could consider going to same-day clinics or urgent care (you will have to pay out of pocket for the visit, however). 2. if you have no resources on your end, let your program know of your situation and they may be able to guide you with what to do from there (i.e. antibody panel, referrals). 
I thought I had missing documents for vaccinations and was told by my undergraduate health center that the antibody panel is typically what they do for people who don't have proper vaccination records. But then I found my documents through lots of backtracking of hospitals I've been to since like age 5 so. haha yeah. The information pertaining to what to do when you don't have records still stands though. Of course I'm not a health care professional and I was already enrolled in an institution when that happened so take this info with a grain of salt. This is just what was told to me in my personal experience.

Oh and what @TakeruK said. Some of the vaccines they can just give you another one and that'll fulfill the immunization requirement. It's not harmful and in fact acts as a booster (in some instances). So depending on the situation you might not even need to do a panel-- just get another shot. I did this for Hep A when I thought I didn't get it as a kid. Turns out I actually did, and the doctor said that it's totally fine and just acts as a booster shot. 

Edited by DippinDot
wanted to piggyback on someone else's post

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First off, once you get what records you can, I'd call your university.  You're not the only international student they have, so they probably have a set suggestion for "How to deal with it if you can't get the documentation."  There may also be documentation in odd places.  I was looking at my high school transcript the other day, and it has documentation of vaccines on it.  Go figure.  Your various primary schools may be able to send you records too.

Secondly, I'm surprised nobody has suggested this: Couldn't you also just re-get the vaccines that you don't have documentation for?  I'd be hard pressed to get physical documentation of vaccines at age 5, but I doubt there would be deleterious health effects if I got them again.  Presumably, your doctor could advice which ones would be "safe" to double up on.

Welcome to the US!  I hope you enjoy it.  You're in a good place to get help adapting; I have found that everyone here really genuinely wants to help people get acclimated, both to their programs and to their new homes.

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1 hour ago, ZeChocMoose said:

My grad school would not let graduate students enroll in classes if they had not received their immunization form so I would check to see what the policies are for your school and not assume that they will be lax on it - especially since this is a state law and not an internal policy.

Fair enough. I should have been more clear but I did mean for the original poster to discuss the lack of documentation with their school and see what the school says, rather than just ignoring the requirements! In the case of my school, the paperwork sent to us left no room to even indicate that they will consider anything but a complete record but if you just call them up and say that you don't have the records, they provide you with tons of options. 

I didn't know this before starting at my school and I ended up having to pay $150 for a physical exam (in Canada, they are free but they cost money if you need a doctor's report to send to a school or employer). But after starting, I realised that many people who asked the school about the actual requirements, they say that they just want the physical done within a few months of starting and if you wait until you get here, our student insurance plan covers it. Same with the vaccines for this school.

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Yeah I think the re-getting vaccines was what @TakeruK and I were thinking. It depends on the vaccine, but in most instances getting another one is safe and just acts as a booster. (again we're not professionals so asking your physician or the school would be the best bet).

Edited by DippinDot

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When I started my PhD program in the fall, I had trouble finding official documentation of my vaccines too, just a piece of paper from my MA institution saying that they had record of receiving that documentation from me years ago. So I emailed the healthcare office at my current school  and explained to them my situation. They told me to send over the document that I had, and the woman I communicated with was very kind about it. She accepted most of the immunizations and just had me get an MMR booster (which was free). I would say email whoever is in charge of receiving your immunization forms, let them know what you are and aren't able to find, and see what they say.

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On 08.03.2018 at 9:02 PM, rising_star said:

I would contact your doctor and ask them how you should fill out the form. Don't assume there are no records whatsoever without first verifying this. And definitely do NOT falsify the records by making up the day and month.

Thank you. As a matter of fact, yesterday I went to the hospital where I had had my early childhood vaccines (not the ones administered to me when I was at school), but the employees told me that the hospital was obligated to safeguard the records for only 10 years - so there is a good chance that my records have been destroyed. We have also called the archive section of the hospital, but nothing came up. The people were also puzzled, in my opinion, and almost everyone I talked to expressed surprise, as - I presume - nobody had requested their vaccination records from 20+ years ago. So in my case, at least, it seems I will not be able to track my records down.

On 09.03.2018 at 2:45 AM, Comparativist said:

I had the same situation and I made up the dates and years and got my doctor to sign it.

Up to you if you want to do the same thing. Hardly ethical, but I'm not going to be bothered to take a bunch of vaccines I had already taken.

I see that this is a viable option, but as you said - it is hardly ethical. I mean, technically it wouldn't be a lie, because if I've been vaccinated against varicella (which I have), the idea is that it is supposed to provide lifelong protection (which is not the case for all vaccines) and hence, the exact date on which I received this particular vaccine shouldn't matter. But still, I'd rather not do this. I feel uneasy about giving false info, even though it would practically not change anything as far as some vaccines are concerned.

On 09.03.2018 at 9:03 AM, ZeChocMoose said:

My grad school would not let graduate students enroll in classes if they had not received their immunization form so I would check to see what the policies are for your school and not assume that they will be lax on it - especially since this is a state law and not an internal policy.

This is also the case at my school. You cannot enroll in classes, and nor can you stay in a dorm, unless you provide documentation of immunization.

On 09.03.2018 at 9:19 AM, DippinDot said:

Something else I would add is that usually when people don't have documentations of their vaccinations, either your current physician or the physicians at your program would be able to run a panel that tests for antibodies in your system associated with the relevant vaccinations/illnesses. This antibody panel would act as documentation of what vaccinations you have received, and show what vaccinations you lack. Your situation is actually more common than some may think, so yeah definitely 1. talk to your current physician about your situation, if you have one. And if not you could consider going to same-day clinics or urgent care (you will have to pay out of pocket for the visit, however). 2. if you have no resources on your end, let your program know of your situation and they may be able to guide you with what to do from there (i.e. antibody panel, referrals). 
I thought I had missing documents for vaccinations and was told by my undergraduate health center that the antibody panel is typically what they do for people who don't have proper vaccination records. But then I found my documents through lots of backtracking of hospitals I've been to since like age 5 so. haha yeah. The information pertaining to what to do when you don't have records still stands though. Of course I'm not a health care professional and I was already enrolled in an institution when that happened so take this info with a grain of salt. This is just what was told to me in my personal experience.

Oh and what @TakeruK said. Some of the vaccines they can just give you another one and that'll fulfill the immunization requirement. It's not harmful and in fact acts as a booster (in some instances). So depending on the situation you might not even need to do a panel-- just get another shot. I did this for Hep A when I thought I didn't get it as a kid. Turns out I actually did, and the doctor said that it's totally fine and just acts as a booster shot. 

 

On 09.03.2018 at 9:26 AM, E-P said:

First off, once you get what records you can, I'd call your university.  You're not the only international student they have, so they probably have a set suggestion for "How to deal with it if you can't get the documentation."  There may also be documentation in odd places.  I was looking at my high school transcript the other day, and it has documentation of vaccines on it.  Go figure.  Your various primary schools may be able to send you records too.

Secondly, I'm surprised nobody has suggested this: Couldn't you also just re-get the vaccines that you don't have documentation for?  I'd be hard pressed to get physical documentation of vaccines at age 5, but I doubt there would be deleterious health effects if I got them again.  Presumably, your doctor could advice which ones would be "safe" to double up on.

Welcome to the US!  I hope you enjoy it.  You're in a good place to get help adapting; I have found that everyone here really genuinely wants to help people get acclimated, both to their programs and to their new homes.

Thank you for these suggestions. After some consideration, I have also decided to take all those vaccines, as this appears to be the only option that will work. 

I'll just write down why I made this decision, as it might help someone else in the future who browses the forum to find an answer to a similar question.

There are 5 vaccines that are required by my school, and these are MMR, Tdap, varicella, Hepatitis B, and meningococcal.

First of all, Tdap is not a kind of vaccine that gives you lifelong protection, it protects you for 5-10 years, and your immunity to the diseases that this vaccine protects you from cannot be proven via blood tests (titers) - so I'll have to take this vaccine. (And I really should, because it's been over 5 years since the last time I received this vaccine.) 

The same goes for meningococcal - the FAQ section of my school says that immunity to meningitis cannot be shown via blood tests, so unless I have proper documentation to prove that I have taken the vaccine (and I don't), I should take it (which I will).

Technically, my immunity for measles/mumps/rubella, varicella, and Hepatitis B could be proven via blood tests, if antibodies are found in my blood. BUT, I have read online that the results of these blood tests can sometimes be "equivocal." And if this is the case, I will have to get vaccinated again. Now, such blood tests are not inexpensive in my country. I called a lab a couple of days ago to get pricing information, and it turned out that a blood test for checking immunity for measles, mumps (curiously enough, rubella is not included), and varicella would cost me several hundred dollars. "Several hundred dollars" may not sound like too much to you, perhaps, but considering the currency exchange rate in my country, this is like a small fortune for me. And at the end, there is always the risk that my blood tests will yield equivocal results, and I will have to re-take the vaccines anyway - in which case I will have just poured my money down the drain. All in all, it seems that taking these vaccines will be both cheaper, and much less of a hassle. And as you have pointed out, I may have the additional advantage of having them as "boosters" - which doesn't harm.

Also, thank you @E-P, for your kind words. I am looking forward to coming to the US! 

And also many thanks to everyone who has posted in this thread to help me - I appreciate your advice, and it has helped me make up my mind about this issue. 

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Little late to the discussion but I thought I should chime in as well. I am going through the same process.

In my case, I received most of my vaccines from a private practice, and some of them when I was in school (vaccines are mandatory here as well, nurses just come in one day and administer them to the whole school). I was also told that vaccine records would expire after 10 years, and even if they didn't, people don't care about them so they are hard to find. Another international student (currently in US) told me that he also didn't have comprehensive records, and that I should just make up dates for the vaccinations that I am confident that I have taken. He told me the school administers the vaccinations for free when you are there so there is nothing to worry about. 

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Thanks for sharing your update and reasoning, Blossom!

In Canada (or at least in my home province of BC), the law is that all doctors must keep all records for 16 years and these 16 years don't start until you turn 19. So, anyone under 35 should be able to get all of their records still. 10 years seem so short, especially if there is no extension for your childhood years.

MMR, Tdap, Varicella, Hep B, and meningoccocal were also the vaccines requested by my school. I got the MMR and Tdap boosters as I was due for them anyways. I never had the Varicella vaccine (when I was a kid, they didn't do this routinely and I had chicken pox in the past so I should be immune). Hep B I got in school and have records for. For meningoccocal, my school allows you to opt out of that vaccine if you are over 25 and aren't living in student dorms. So I did.

Note: The reason why I argue for making up the dates (or just choosing the date that seems to be about right) is that no one ever needs hard evidence of these vaccines. Even for my own child's vaccines right now, the most official record we have for our child is a notebook where we write down the vaccines and the dates ourselves. The health unit providing the vaccines also keeps their own records, but they only know about the vaccines they have given (e.g. if my child got a vaccine from a school nurse, the health unit might not know about it). Each of us is considered the primary person responsible for this record, so when doctors want to know if we need another vaccine, they ask us to consult our records. 

Therefore, if you know you have a vaccine, then you can fill in the form that you had the vaccine, even if the exact date is not accurate (the year should be enough). What you are really saying when you fill in and sign that form is that you certify that you did have those vaccines and there's no breach of ethics there, in my opinion. If you are not sure about a vaccine though, then definitely get another booster! But don't spend hundreds of dollars just because someone neglected to note down a date for a vaccine decades ago.

 

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So, another place you can look: Previous schools!  Evidently, Purdue requires vaccination stuff as well, so I've been looking into it today.  Fortunately, undergraduate institution has a web portal, and several of my vaccinations that are required are on record there.  I printed out a copy and shoved it into Evernote so I don't have to think about it again.

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