Student Vaccination and Health Screening Policy

Policy Number: EC.12.05.170516

Applies to: Washington State University’s Elson S. Floyd College of Medicine students.

Date: 2/27/2025

1.0 Policy Statement

It is the WSU College of Medicine policy to ensure that its programs meet all legal, accreditation, and clinical training site requirements to permit students to provide high quality and safe patient care. As such, the college establishes as policy that:

1.1 In accordance with local, state, and national recommendations for health care workers, including students, and to comply with campus and training site vaccination and health screening requirements, the college requires all students be vaccinated or show evidence of immunity for the following:

• Hepatitis B: Proof of immunity by titer. Some clinical sites may require proof of vaccination.
• Measles, Mumps and Rubella (MMR): Proof of immunity by titer may be accepted in lieu of proof of vaccination.
• Tdap (Tetanus, Diphtheria, Pertussis)
• Varicella: Proof of immunity by titer may be accepted in lieu of proof of vaccination.
• Influenza (annually)

The college requires all students to maintain health screening for the following:

• Tuberculosis (TB) screening (annually); There are no exemptions for TB screening.

1.2 The COVID-19 vaccine is not required. However, as most of the college’s clinical partners have clinical site placement requirements that include proof of recent COVID-19 vaccination, the college strongly recommends this vaccine for students.

• For students unvaccinated for COVID-19, the college will seek alternate clinical sites for the student’s clinical rotations; however, alternate site placement will be subject to limited availability and may result in delayed rotation completion, which may impact the student’s timely curricular progression. Limitations within WSU affiliates may limit student choice.
• Additionally, the college cannot guarantee available alternate rotations at the student’s primary regional campus, which may require the student to be placed at one of the other college campuses for one or more clinical rotations.
• It is possible no alternative can be found impacting the student’s ability to meet graduation requirements.
• Any additional costs to the student associated with rotation placement at alternate sites will be the student’s responsibility.

1.3 The college reserves the right to require additional immunizations in the event of a public health emergency, updated local, state, and national recommendations for vaccinations and/or health screenings, changes in WSU Health Sciences Vaccination and Health Screening Admission Policy, and/or training site placement requirements.

1.4 Accepted applicants who do not comply with the college’s Student Vaccination and Health Screening Policy shall not be matriculated into the college.

1.5 Matriculated students who are non-compliant with an ongoing college vaccination (e.g., influenza) or health screening requirement will not be able to continue to progress in the college and will be immediately removed from a clinical rotation.

1.6 Matriculated students who are compliant with college vaccination and health screening requirements but who are non-compliant with an ongoing clinical site vaccination (e.g., COVID-19) or health screening requirement will be immediately removed from the clinical site.

• The college will subsequently seek alternate clinical sites for the student to complete their rotation; however, alternate site placement will be subject to availability and may result in delayed rotation completion, which may impact the student’s timely curricular progression.
• Additionally, the college cannot guarantee available alternate rotations at the student’s primary campus, which may require the student to complete one or more clinical rotations at one of the other college campuses.
• Any additional costs to the student associated with rotation completion at alternate sites will be the student’s responsibility.

1.7 For the MD program, no member of the college, other than the delegated representative within the Office of Compliance, will have access to the student’s personal immunization records uploaded to CastleBranch. For Nutrition and Exercise Physiology (NEP), there are members of the department who have access to these records stored in other databased in accordance with their roles.

1.8 Students submitting vaccination and health screening information, or requesting a medical exemption are required to follow college policies and procedures for submitting this information.

1.9 Failure to comply with the college’s timelines and processes may result in delay or denial of admission to the college.

1.10 The college reserves the right to request additional or supporting documentation and information from a student.

1.11 False, misleading, or inaccurate information submitted pursuant to this policy may result in, among other things, a referral to the College of Medicine Student Evaluation, Promotion and Awards Committee (SEPAC) or other promotions committees or the WSU Center for Community Standards for appropriate investigation and/or discipline.

1.12 Submission of false or inaccurate information may be a violation of the law and may result in a referral to appropriate law enforcement agencies or professional licensing boards.

2.0 Definitions

None.

3.0 Responsibilities

Vice Dean, Office of Student Experience.

4.0 Procedures

(subject to change—see the Office of Student Experience for updated procedures)

4.1 Submission of Documentation and Monitoring

• Each incoming MD student or current student is responsible for submitting appropriate medical documentation evidencing vaccination and completing their health screening in the college’s information systems that maintain immunization and health screening information (e.g., CastleBranch). Students in NEP and Speech and Hearing Sciences (SHS) follow their designated processes.
• For MD students, final admission to the college is contingent on the college receiving confirmation that the student has completed the required medical documentation for vaccination and health screening. NEP and SHS students follow the processes and timelines outlined by their departments.
• For MD students, CastleBranch will approve vaccination and TB screening records, while a member of the Student Affairs Unit will monitor the status of approval to ensure students meet all program requirements within the deadlines given and that they remain current throughout the educational program. CastleBranch will contact each student when deficiencies arise.

4.2 Applying for Medical Exemption

• Students applying for a medical exemption must do so prior to the start of the academic year in which they have been conditionally admitted or, if the exemption need arises after that time, at the earliest reasonable time the need is identified.
• A request for a medical exemption requires that the student submit appropriate documentation from a qualified and licensed health care provider that establishes that a specific vaccination is contraindicated due to an underlying medical condition.
• CastleBranch and/or Washington State University Cougar Health Services review and determine if the submitted documentation supports a medical exemption.
• If the submitted documentation supports a medical exemption, the college will determine whether it can reasonably accommodate the student.
• If the college determines it can reasonably accommodate the student, the college will admit the student so long as they can maintain the determined accommodation.
• If the college determines that the accommodation will cause a direct threat or undue hardship and therefore cannot accept the accommodation, the accepted applicant will not meet this condition of acceptance and can either comply with the vaccination or have their admittance rescinded.
• Religious exemptions are not allowed; those who have been granted them previously will be honored.

4.3 Approved Medical Accommodations

• Students receiving an approved accommodation are not guaranteed a clinical placement and must comply with the terms and conditions of the accommodation plan, which may include use of Personal Protective Equipment, donning appropriate masks, and periodic testing/screening.
• Failure to follow an approved accommodation plan may subject the student to appropriate corrective action up to and including termination or revocation of the accommodation and the student being referred to the Student Evaluation, Promotions, and Awards Committee (SEPAC).

4.4 Current Immunization Requirement Protocols

Infection	Protocol for Vaccinations*
Influenza	One dose annually prior to October 15.
Tetanus-Diphtheria Pertussis	Proof of Tdap once and then Td booster every 10 years
Varicella	Proof of 2 doses of varicella vaccine after the 1st birthday OR Positive titer confirming immunity
Measles, Mumps, Rubella (MMR)	Proof of 2 doses of live MMR vaccine separated by more than 28 days OR Positive titer confirming immunity
Hepatitis B	Proof of 3 dose sequence for hepatitis B vaccine AND Positive titer confirming immunity**

TB Screening Protocols

Subject	Protocol
Initial Screening 1	Two-step Tuberculin Skin Test 3 (PPD) OR Interferon Gamma Release Assay (IGRA)
Annual Screening 2	PPD skin test OR IGRA
Equivocal PPD skin test	IGRA may be required
Prior BCG Vaccination	PPD skin test can be done but the IGRA is preferred
Documented prior positive PPD	TB symptoms screening Chest X-ray if not previously done
PPD conversion (new positive)	TB symptoms screening Chest X-ray Referral to physician for potential treatment of Latent TB

4.5 Payment for Immunizations and TB Screening

• Pre-Clerkship Years: Students are eligible to receive clinical services each semester (fall and spring) using their WSU Spokane Student Health Fee. Students eligible for health services must present their WSU identification card at the time of visit to WSU Spokane Student Health Clinic. Any additional vaccine costs not covered by the WSU Spokane Student Health Fee contract will be the student’s responsibility.
• Clerkship Years: Because the WSU Spokane Student Health Fee is only available for students registered at the Spokane Campus, students registered for Everett, Tri-Cities, and Vancouver will be responsible for utilizing their health insurance for covering the costs of any immunizations needed during the Clerkship years.

5.0 Related Policies

• WSU Health Sciences Vaccination and Health Screening Admission Policy
• WSU Executive Policy 43 – Prevention of Infectious Diseases with Vaccines and Screening

6.0 Key Search Words

Vaccination, Health Screening.

7.0 Revision History

Original Approval: 5/16/2017
Policy Number: EC12.05.170516
Review/Revision: 3/3/2020, 12/15/2022, 2/27/2025