The College of Osteopathic Medicine requires positive serologic proof of immunity in the form of positive antibody titers for measles, mumps, rubella, hepatitis B and varicella. This information is required to uphold Affiliation Agreements between OU-COM and clinical rotation sites.
Following matriculation, students are required to provide Academic Affairs with official documentation of serologic proof of immunity to:
1) Choose to be revaccinated with one dose of hepatitis B and have another titer drawn after one month, or they may: 2) Choose to repeat the 3-dose series and have the titer drawn 1 – 2 months after the 3rd dose. If the titer is again negative following Option 1, two additional doses of hepatitis B vaccine will be given, one at the time of the negative titer and one 5 months later. Antibody titers will be redrawn 1 month after the last dose of vaccine.
If the titer is <10 mIU/ml following a second series of the vaccine (Option 1 or Option 2), the student will be tested for the presence of Hepatitis B virus. If that test is negative, the student will be labeled a “non-responder” and instructed on procedures to follow if exposure to Hepatitis B occurs. According to the CDC, in the occupational setting, two doses of hepatitis B immune globulin (HBIG) initiated within one (1) week following percutaneous exposure to HBsAG-positive blood provides an estimated 75% protection from HBV infection.
If the test for hepatitis B virus is positive (HBsAg-positive and HBeAg-positive), the student’s enrollment status will not be affected. According to the CDC, there is one caveat for HBV-infected health professionals. Those who are HBsAg-positive and HBeAg-positive should not perform exposure-prone procedures (e.g., gynecologic, cardiothoracic surgery) unless they have sought counsel from an expert review panel and been advised under what circumstances, if any, they may continue to perform these procedures. Such circumstances might include notifying prospective patients of the health professional's seropositivity before they undergo exposure-prone invasive procedures.
Varicella. Students with negative antibody titers to varicella must obtain 2 varicella vaccinations at least 4 but no more than 8 weeks apart: Antibody titers in the equivocal range will be accepted as positive, as commercially available tests may not be sensitive enough to detect low levels of antibody. Post- vaccination serologic testing will cease at that time, based on the ACIP definition of “immune”.
Students who are vaccinated will be instructed that they may develop a rash 2-6 weeks after vaccination and that this rash may be either a localized rash at the site of vaccination or a diffuse varicella-like rash. Either rash may be atypical with macules or papules rather than vesicles. Students will be instructed to report immediately to the CCE Program Coordinator if a rash develops. Students with either an injection site rash or a generalized rash will have their CCE’s placed on hold until the rash resolves (usually in 2-3 days). The CCE Program Manager must verify that the rash has resolved and they are not potentially infectious to others before being allowed to resume CCE activities.
Students who are accepted to OU-COM and students on the alternate list will receive a letter explaining serologic proof of immunity requirements. Students are expected to receive tests to document serologic proof of immunity prior to the first Clinical and Community Experience. Time will be made available for testing to take place during the first 2 weeks of class. Charges for antibody titers are the responsibility of the student. The Office of Academic Affairs maintains immunization and serologic proof of immunity records and assists students as needed. A copy of the student immunization record (including serologic proof of immunity) is sent to the CORE where each Year III student is assigned. It is the responsibility of the CORE Assistant Dean to oversee student immunization requirements in Years III and IV, including those students from other osteopathic medical colleges who are in the CORE system.
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