The University of California will require incoming students to be screened for tuberculosis and vaccinated for measles, mumps, rubella, chicken pox, meningococcus, tetanus and whooping cough under a plan set to take effect in 2017.
Currently, the UC system only requires students to be vaccinated against hepatitis B, though several campuses have additional requirements.
The plan — designed to help protect the health of students and campus communities — has been in the works for a year. But the need is more pressing than ever, given the current multistate measles outbreak and the re-emergence of other vaccine-preventable diseases among those not completely immunized.
“I’m really excited that there’s support and momentum for this new immunization plan,” said Dr. Gina Fleming, medical director for the UC Student Health Insurance Plan. “We know that these preventive measures are effective.”
The plan is being phased in over three years. The first phase focuses on building awareness among students about the upcoming requirement, with all fall 2015 incoming UC students receiving notification of the recommended vaccines and the process for making them mandatory. The intent of the plan is to set a baseline for all of UC, but does not prevent individual campuses from setting immunization standards for all students, or implementing the plan more rapidly.
It was developed based on recommendations from the California Department of Public Health, and in consultation with UC’s student health center directors, vice chancellors for student affairs and the UC system senior vice president for health sciences and services.
It will require that by 2017 all incoming students show documentation not only for hepatitis B vaccination but also for TB screening and four more vaccines: measles, mumps and rubella; meningococcus; varicella (chicken pox); and tetanus, diphtheria and pertussis (whooping cough).
“The University of California is committed to protecting the health and well-being of our students,” said Mary Knudtson, executive director of the UC Santa Cruz Student Health Center and chair of the UC Immunization Policy Committee. “Therefore, all of the UC campuses are implementing procedures to ensure that students are educated about, and receive, vaccinations to prevent potentially dangerous illnesses and undergo screening to identify those who may have infectious tuberculosis.”
Starting in fall 2016, all incoming UC students will be expected to have their required vaccines and enter the data into the university’s electronic medical record platform. But the plan is not to enforce the requirement until the following year. Starting in fall 2017, UC students who do not meet the vaccination requirement will have a hold put on their registration. The rationale for the phased approach is to ensure that the process runs smoothly before potentially impacting students’ ability to register for classes.
All UC campuses have experienced cases of vaccine-preventable diseases in recent years — something not unique among college campuses, which have varying vaccination requirements. For example, only about half of states have laws requiring all college students to be vaccinated against measles, according to a U.S. Centers for Disease Control and Prevention database.
“Despite the fact that many people receive the recommended vaccines, there are still documented cases of outbreaks of vaccine-preventable diseases in California and on the campuses each year amongst those who were not properly immunized,” Knudtson said. “All students are strongly encouraged to obtain the vaccines recommended by the California Department of Public Health prior to starting classes.”
Breaking down barriers
While getting such vaccines has long been considered a good public health practice, the cost of vaccines and the difficulty for student health staff to obtain and verify the information have been barriers to implementation.
Two developments have broken down those barriers, Fleming said. Now that the Affordable Care Act provides insurance coverage for vaccines, the cost of vaccination is less of a problem. Also, a new electronic medical record platform soon will allow UC students to directly enter their vaccination date. Four campuses will be piloting the module for entering vaccination data this fall, and the remaining campuses anticipate being able to use it by fall 2016.
The issue of immunization has evolved into a hot topic of discussion in California and across the nation in recent weeks after a measles outbreak that started at Disneyland. On Wednesday, state Senators Richard Pan and Ben Allen announced they will introduce legislation that would eliminate the ability for parents of school children to opt out of vaccinating their kids based on a personal belief.
UC’s plan will allow exemptions for medical or religious purposes, Fleming said. In the coming months, officials will discuss how to handle requests for other exemptions and how to validate the vaccination information.
“We need to be mindful of the population we’re serving,” Fleming said.
UC’s plan might be extended to already enrolled students and additional vaccines could be added later, such as meningococcus B, Fleming said. Vaccines recommended for preventive care include vaccines for hepatitis A, HPV, influenza, polio and pneumococcal pneumonia.
Officials are determining whether additional approvals are needed to adopt the plan, Fleming said, even as they move forward with implementation.
Meanwhile, leadership in student affairs and student health centers are working with other campus departments to inform students about the plan.
“That’s really a critical piece,” Fleming said. “We can’t expect students to adhere to a requirement that they haven’t heard about. They need to know what the plan is.”