Student Immunization Requirements and Meningitis Response Form
Students born on or after January 1, 1957 who wish to register for more than 5 credits in any single semester are required to show proof of immunity to Measles, Mumps and Rubella diseases before registering. All students regardless of age, registering for more than 5 credits, must comply with the New York State Immunization Meningococcal Law.
Students please note:
- Proof of immunization AND a meningitis response are required of ALL students enrolling for 6 or more credits.
- An immunization hold will be placed on your record, which will only be lifted when acceptable proof of immunization is submitted and accepted by the WCC Health Office.
Instructions: You will be able to upload proof of immunization, as well as submit your meningitis response form, below. Where indicated, please upload a completed copy of the immunization form, OR a copy of your immunization records from doctors, schools, or serology lab reports.
Student Instructions & Information
PART I: Measles, Mumps & Rubella (MMR)/ Meningococcal Meningitis
InstructionsPlease upload a copy of your immunization records from doctors, schools, or serology lab reports below (scroll down to the bottom of this page).
Note: You may INSTEAD submit a completed copy of the immunization form, which you can obtain here: Obtain a Copy of the Immunization Form Here.
Only ONE of the following is required as proof of immunization:
- Proof of two doses of the MMR live vaccine, with the first dose given no more than 4 days prior to the first birthday, and the second at least 28 days after the first dose;
- (1) Proof of two doses of the live measles vaccine, with the first dose given no more than 4 days prior to the first birthday and the second at least 28 days after the first dose, AND (2) one dose of the live mumps vaccine received no more than 4 days prior to the first birthday, AND (3) one dose of live rubella vaccine received no more than 4 days prior to the first birthday;
- Serological proof of MMR immunity (titer).
NOTE: You will upload your immunization records below, after Part II.
PART II: Meningococcal Response Form
- Responses to receipt of meningococcal meningitis disease and vaccine information signed by the student, or the student's parent or guardian where applicable;
- Either (1) a certificate of immunization for meningococcal meningitis disease OR (2) an acknowledgement of meningococcal disease risks and refusal of meningitis immunization.
InstructionsPlease read the statement below and respond accordingly.
Note: While the meningococcal vaccine is optional, your response below is REQUIRED!
For all students regardless of age, who have not received vaccination against Meningococcal Meningitis in the past 5 years: NYS Public Health Law mandates that you read and sign PART II. Meningitis disease is a severe bacterial infection of the bloodstream or meninges (a thin layer covering the brain and spinal cord). It is a relatively rare disease and usually occurs as a single isolated event. Clusters of cases or outbreaks are rare in the United States. It is transmitted through the air via droplets of respiratory secretions and direct contact with an infected person. Direct contact, for these purposes, is defined as oral contact with shared items such as cigarettes or drinking glasses or through intimate contact such as kissing. Although anyone can come in contact with the bacteria that causes meningococcal disease, data also indicates certain social behaviors, such as exposure to passive and active smoking, bar patronage, and excessive alcohol consumption, may put students at increased risk for the disease. The early symptoms usually associated with meningococcal disease include fever, severe headache, stiff neck, red-purple rash, nausea, vomiting and lethargy, and may resemble the flu. Because the disease progresses rapidly and can be fatal, students are urged to seek medical care immediately if they experienced two or more of these symptoms concurrently. If it is caught early, meningococcal disease can be treated with antibiotics. But, sometimes the infection has caused too much damage for antibiotics to prevent death or serious long-term problems. The single best way to prevent this disease is to be vaccinated. Various vaccines offer protection against the five major strains of bacteria that cause meningococcal disease.
For more information, please go to https://www.health.ny.gov/publications/2168.pdf or www.cdc.gov/meningococcal/. If you wish to receive the meningococcal vaccine, contact your health care provider or the Westchester County Department of Health at 914-813-5000 or contact the Westchester Community College Health Office at 914-606-6610 for locations and phone numbers of local Neighborhood Health Centers.
For questions about immunization requirements, please call the WCC Health office at 914-606-6610 or email email@example.com.