Recommendations for Institutional Prematriculation Immunizations

Vaccine	Age Indicated	Major Indications	Major Precautions
Measles, Mumps, Rubella (MMR)	1st dose at age 12-15 months or later; second dose at age 4-6 years or later.	All entering college students born after 1956.	Pregnancy, history of hypersensitivity or anaphylaxis to any of the components in the vaccine. Guidelines exist for vaccination of persons with altered immunocompetence.
Tetanus, Diphtheria, Pertussis -Diphtheria, tetanus toxoid, and a cellular (whole-cell) pertussis DTaP (DTP) -Diphtheria and tetanus toxoid (Td)	Primary series in childhood with DTaP or DTP, booster at age 11-12 years with Tdif at least 5 years has elapsed since the last dose of tetanus and diphtheria toxoid-containing vaccine, then every 10 years.	All college students	History of hypersensitivity to any of the components in the vaccine.
Polio Vaccine -Inactivated (IPV) -Oral poliovirus (OPV)	Primary series in childhood with IPV alone, OPV alone, or IPV/OPV sequentially, booster only if needed for travel after age 18 years.	IPV for certain international travelers	History of hypersensitivity to any of the components in the vaccine.
Varicella	Childhood, adolescence, young adulthood (two doses at least one month apart if 13 years of age or older).	All entering college students without history of the disease or without age appropriate immunization or with a negative antibody titer.	Pregnancy, history of hypersensitivity or anaphylaxis to any of the components in the vaccine. Guidelines exist for vaccination of persons with altered immunocompetence.
Hepatitis B Vaccine	Series of 3 doses (given at 0, 1-2 mo., and 6-12 mo.) prior to college entry. A series of 2 adult doses may be given to adolescents 11-15 years of age (given at 0 and 4-6 mo.). Combined hepatitis A and B vaccines may be given as a series of 3 doses (given at 0, 1-2 mo., and 6-12 mo.)	All college students	History of hypersensitivity to any of the components in the vaccine.
Hepatitis A Vaccine	Series of 2 doses (given at 0, 6-12 mo.) prior to college entry. Combined hepatitis A and B vaccines may be given as a series of 3 doses (given at 0, 1-2 mo., and 6-12 mo.).	Recommended for routine use in adolescents through the age of 18 in some states and regions and for certain high risk groups (i.e. persons traveling to countries where hepatitis A is moderately or highly endemic, men who have sex with men, users of injectable and noninjectable drugs, persons who have dotting-factor disorders, persons working with nonhuman primates and persons with chronic liver disease).	History of hypersensitivity to any of the components in the vaccine.
Pneumococcal Polysaccharide Vaccine- 23 valent	Childhood, adolescence, adulthood	Young adults with diabetes, heart disease, chronic pulmonary or liver disease. Revaccinate every 5 years for immunodeficiency states, renal failure, recipients of dotting factor, concentrates, asplenia, terminal complement component deficiencies, and HIV infection.	History of hypersensitivity to any of the components in the vaccine.
Influenza	Annually	College students at high risk of complications from the flu such as diabetics or asthmatics or patients with certain immunodeficiencies, and any student who wants to minimalize disruption of routine activities during epidemics. Health sciences students with patient contact.	History of hypersensitivity to any of the components in the vaccine.
Meningococcal Tetravalent (A,C,Y, W-135) -Conjugate (Preferred) -Polysaccharide (Acceptable alternative if conjugate not available) More info>	11-55 years (data for revaccination pending). Over 2 years of age, repeat every 3-5 years if increased risk continues	Populations at increased risk, including freshmen living in dormitories/residence halls, persons with terminal complement deficiencies or asplenia, laboratory personnel with exposure to aerosolized meningococci, and travelers to hyperendemic or endemic areas of the world. Nonfreshman college students under 25 years of age may choose to be vaccinated to reduce their risk of meningococcal disease.	History of hypersensitivity to any of the components in the vaccine.