ACCEPTABLE FORMS OF PROOF OF IMMUNIZATION AND/OR VACCINATION

1. Legible copy of a school or public health immunization record (i.e. yellow book/immunization card)
2. Legible copy of an official health care provider’s record
3. Legible copy of an official laboratory test to show evidence of protective serology
4. Pharmacy documentation of immunization(s)

Serology/titer documentation must be within the last 5 years.

Failure to find records of your immunizations will require you to repeat the series of the specific immunization.

Negative, equivocal or indeterminate serology results will require re-vaccination of the series.

Please allow 7-10 business days for processing/review of immunization records. You will be sent confirmation that your records have been received and informed of any additional requirements if needed.

All required documentation must be submitted to UHP by the June 1st  deadline (subject to change). University Health Partners do not grant extensions.

How do I find my immunization records?
Check with previous school, hospital or clinic records

How long does it take to process immunization requests?
7-10 business days from the date of receipt to when the UHP immunization office will submit to the designated party.

How old can my lab results/titers be?
Titers must be within 5 years from the date of matriculation.

What is required to submit my immunization records?
All records should have your name and an identifier (e.g. DOB).  We will  not accept screenshots of medical records without student identifying information such as name and date of birth.

Note that all records should be legible and in English to ensure vaccination compliance. Records should originate from US or US territories.  If international, please contact JABSOM Immunization at JABSOMMR@ucera.org for more information.

List of where you can find prior immunization records (be sure to submit both sides of each document):

1. • Official State / Country Immunization Records
   • Prior medical records or lab records
   • Yellow Book / Immunization Cards
   • Pharmacy documentation of immunization

How do I request my immunization records?

Please submit request from your @hawaii.edu email address to JABSOMMR@UCERA.ORG. Records are sent encrypted with the subject line of ESECURE. You will need to create a password in order to open the document.

Please be advised that each facility may have their own unique immunizations requirements beyond what we are currently asking.

Disclaimer: Please note secure documents using ESECURE will automatically be deleted within 14 calendar days

Please contact the JABSOM Immunization office for further instructions at JABSOMMR@UCERA.ORG 

Tdap vaccination is required to be within the last 10 years regardless of the last Td you have on file.

TB screening is required annually. A hospital facility may require a TST (Tuberculosis Skin Test) more current within a certain time frame of 3 months.

Quantiferon GOLD or T-Spot blood test in lieu of PPD testing? Yes, this is acceptable with submission of test results. However, this test must be done every 364 days (same as one-step TB). If your Quantiferon or T-Spot result is positive, you will need a current chest x-ray and complete the  State of Hawaii Document H TB Symptom Screen.

For more information, please see IGRA facts. 

If TB Screening was positive prior, will I still need to do an annual TB screening?  If your follow up chest X-ray is negative or you have completed treatment, you are only required to complete annually the State of Hawaii Document H TB Symptom Screen. Depending on your answers, you may need to repeat a chest X-ray.

What is a two-step TB, and when would I need it?

Please refer to the Center for Disease Control (CDC) for more information: https://www.cdc.gov/tb/publications/factsheets/testing/skintesting.htm

Results of a TUBERCULIN SKIN TEST (PPD) and/or Chest X-ray performed within three months prior to matriculation in accordance with Hawaii state regulations:

• An initial two-step PPD is highly recommended for matriculation, not less than one week and not more than three weeks apart if the initial PPD is negative and annually thereafter, read within 364 days of the last negative PPD; OR
• A chest Xray if the initial PPD is positive; OR
• If there is a history of a positive PPD, documentation of a follow-up chest X-ray, and antimicrobial therapy for tuberculosis and subsequent chest X-rays if applicable.

https://youtu.be/iLpNZHGDwjs  

The CDC recommends that the tuberculin skin test (TST) or the interferon release assay (IGRA) can be done before or during the same time as the vaccine administration. 

However, if the live vaccine vacciation has already been administred, please defer the TST or the IGRA until at least 4 weeks after completion of said vaccination.  This is due to the unknown reliability of a negatie TST or IGRA result after receiving said vaccination.  

As of January 31, 2022, all JABSOM and Imi’Hoola Student will require a COVID-19 Booster

If you are confirmed positive for COVID, please inform Dr. Jill Omori (jill.omori@hawaii.edu) and Dr. Lee Buenconsejo-Lum (lbuencon@hawaii.edu) as soon as possible. 

Please be aware that there is a processing time on reviewing the records and that if you have not had your COVID vaccinations you will have to wait 4 weeks for TB placement and 2 weeks for any re-immunizations. Extensions will be based on review of records as there may be complications that will arise if you have not had your COVID vaccination and communication as to where you are at in the process of completing them.

As the COVID vaccinations are becoming more accessible, the administration of the TB screening timeline has been affected. TB screenings include the Mantoux, Interferon-γ release assay (IGRA) QuantiFERON IGRA, and T-Spot tests. Please see the most current guidelines as listed below:

Currently, CDC recommends deferment of all TB testing until 4 weeks after the second dose of the COVID vaccination.  Therefore, students are recommended to schedule
their TB screening according to the aforementioned guidelines.    Please note that these guidelines may change based on CDC’s findings.

If a student’s TB clearance expires during the COVID vaccination series, the student should still complete the COVID vaccination and request for a temporary TB clearance exemption letter from UHP.  The student will need to complete the State of Hawaii Department of Health Tuberculosis Form G (it can also be found here).   Please note that if the student exhibits any COVID symptoms, they should see their provider.  If student exhibits any TB Risk factors, then the student would still require TB testing. 

Once completed, please send completed form G and proof of COVID vaccination to UHP Immunization at JABSOMMR@UCERA.ORG.  Upon receipt, UHP Immunization will generate the TB clearance letter and return signed letter to the student.   Please note usual processing time is typically 7 days. 

As the COVID situation evolves, where can I find more information on the applicable vaccinations?

https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html

Where can I receive more information about COVID in Hawaii?

https://hawaiicovid19.com/Vaccine/

The TST and IGRA are not expected to affect the effectiveness of the COVID vaccination

The CDC recommends that the tuberculin skin test (TST) or the interferon release assay (IGRA) can be done before or during the same time as the vaccine administration.  However, it is recommended to wait at least 4 weeks for any TST or IGRA after the COVID vaccination.

• Healthcare personnel that are going to be in a setting that poses a high risk for transmission should complete the series of vaccinations.
• Serologies must include patient name, date of results, name and address of performing lab, and reference ranges. Screenshots and flowsheets are not acceptable documentation.
• Some elective sites may have strict serology requirements that could preclude the student from participation.
• If serologies are negative, non-immune/reactive or equivocal you must get re-immunized, following another serology.
  • Example: if your MMR (Measles, Mumps, Rubella) were negative you must get 2 MMR immunizations, following a serology one month after the second shot.
  • Note: 2^nd shot must be taken 28 days after first shot was taken.
• Varicella: must get 2 varicella immunizations and serology one month after second immunization shot.
• Hepatitis B: must repeat series of 3 (see below)
  • 2^nd shot taken one month after 1^st
  • 3^rd shot taken 6months after 2^nd
  • Serology taken 1 month after completing 3^rd 
• 2-dose Hepislav-B series may also be administered as long as you have documentation of the first 3 childhood Hepatitis B vaccinations.

Note that matriculation is not affected if documentation of the first immunization is submitted by July 1st.  You will still be responsible to complete the series.  

Initial completion of a series of immunizations followed by a negative serology. Then a completion of a 2nd set of immunizations followed by another serology that is negative.

Talk to your healthcare provider if a 3rd set of immunizations would be necessary.

We will gladly assist in completing your forms upon request. Please understand that processing and sign-off may take up to 10 business days after we have received the requirements below. 

We will need the following before we submit your forms for signature:

• Complete demographic portion of the AAMC Standardized Immunization Form.
• Confirm your demographic information (address, phone number, etc)
• Quantitative Hep B Serology (ex 10 mIu/mL) or additional labs based on Hep B status (i.e. non-responder or chronic active)
• Your immunization and serologies on file may be sufficient for AAMC submission
• Please submit any additional required immunizations, boosters, or serology updates. 
• For more information please review our AAMC Powerpoint. 

Note: Skin test or IGRA results should not expire during proposed elective rotation dates or must be updated with the receiving institution prior to rotation.

JABSOM only requires a qualitative serology but if you plan for an away rotations generally in your 3rd year of medical school you will need to have a quantitative one to submit with the AAMC form. The lab value must be > 10 mIU/mL.

Link to AAMC form : https://www.aamc.org/system/files/c/2/440110-immunizationform.pdf

Please note that you will also need to complete State of Hawaii Department of Health Tuberculosis Form G and Form H

You will need to request the specific lab order from either an MD, DO, or APRN to write you a lab order. Please make an appointment with your healthcare provider. 

Depending on your insurance it may be possible to have a repeat serology ordered at a Minute Clinic or Urgent care. It is unlikely that insurance will cover the cost.

Fit testing for N95 respirators is required at least once and will be arranged by the school. 

Note that N95 mask fitting can be obtained at health care facility, such as Kapiolani Medical Center or Queens Medical Center.  For more information, please contact your site coordinator. 

Please forward the response you received to JABSOMMR@ucera.org so we may review your records on file. Then we will contact OSA to have them contact the Manoa Health Service Office to take care of it.