USI » Student Immunization

Immunization

All students entering the University of Southern Indiana for the first time and/or living in University Housing must meet the immunization requirements of the University and Indiana Code 20-12-71 enacted by the 2002 Indiana General Assembly.

To comply with the requirements, you must provide current documentation of the following immunizations:

two measles, one mumps, and one rubella (2 MMR vaccines acceptable; first MMR must be given after 1967 and not before first birthday), or a physician’s written statement of immunity to measles and mumps due to having had the infection. Students born before January 1, 1957, are exempt from the MMR requirement.
tetanus/diphtheria (Td booster) within past 10 years, tetanus toxoid NOT ACCEPTABLE
tuberculin skin test (Mantoux only) prior to the start of the first semester at USI, within 6 months for American citizens and 6 weeks for international students; must be administered and read in the United States by a registered nurse or physician within 48-72 hours. Need signature of doctor or nurse reading results.

Acceptable documents consist of one of the following:

copy of your immunization record from high school or another postsecondary institution

physician’s statement showing the month, day and year during which the vaccinations were administered or infection was experienced. Generally, physicians do not charge for this service.

completion of the USI student immunization form with doctor’s signature

personal record maintained by you or your family showing the month, day, and year during which the vaccinations were administered

Exceptions for Immunizations
Exceptions may be made for meeting state requirements under certain conditions, such as health circumstances which contraindicate immunization, pregnancy, or participation in a current sequence of immunizations. A written statement from a physician is necessary in all health circumstances. Further information may be obtained by contacting the Student Immunization Office at 812/461-5285 or in Room 102 in the Health Professions Center (across from the Student Health Center).

The documentation must be mailed, delivered, or faxed to the USI Student Immunization Office prior to the start of your first semester at USI. The fax number is 812/461-5284. Please confirm that a complete immunization record is on file in the Student Immunization Office.

Beginning January 2003 all students MUST read and sign the Meningococcal and Hepatitis B Risk Acknowledgement Form and return it with the Immunization Form in order to complete the file.

You must comply with the immunization regulations in order to be eligible to enroll at the University of Southern Indiana.

Student Immunization Form
Hepatitis B Letter
Meningococcal and Hepatitis B Risk Acknowledgement Form

Please note the forms above are in Adobe Acrobat format (pdf) and require the Adobe Acrobat Reader plug-in to view and print. If you do not have this plug-in, please click on the button to download.

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