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Immunization Compliance

Home Health & Wellness Student Health Immunization Compliance

STEP 1: Complete the online Tuberculosis Screening Questionnaire

STEP 2: You will receive an email after completing the questionnaire. Print the PDF and follow the instructions provided. 

STEP 3: Have a doctor’s office, clinic or health department complete the correct Mandatory Immunization Requirements Form below. Forms cannot be signed by family members.

STEP 4: Log into the Student Health Gateway.

  • Click Medical Clearances. Under Items Required for Clearance, enter the date(s) you received your vaccines under each update button.
  • Click on the Immunization Requirements Form update button and upload your signed Mandatory Immunization Form and your TB Screening Questionnaire (along with any additional testing or documents if applicable).
  • If unable to upload, fax documents to 1-919-681-7386.

STEP 5: Monitor your Duke Email. Communications regarding your compliance status can be found by logging into the Student Health Gateway and clicking on “Messages” on the left tool bar. Your Duke email will notify you when a new message has been sent.

STEP 6: Register after July 1 for your My Duke Health

Is the COVID-19 vaccine mandatory?

Duke strongly recommends getting up-to-date vaccinations against COVID-19, especially for those with conditions that place them at higher risk. However, COVID vaccination is no longer a requirement for students, faculty, or staff working at Duke University or Duke University Health System. This includes the primary series and/or boosters.

Is the COVID-19 booster vaccine mandatory?

The COVID-19 booster vaccine is highly recommended but not mandatory for all Duke students.

Is the flu vaccine mandatory?

The flu vaccine is encouraged for all Duke students but is only mandatory for Duke Health Science students. You must receive a flu vaccine on or after 8/1/24 to meet this requirement. The deadline for receiving the flu vaccine is later than the deadline for receiving the other state-mandated vaccines and will be announced in the fall. You will have many opportunities to receive the flu vaccine on Duke’s campus. Medical and Religious exemption forms can be requested by emailing

What happens if I do not complete the online forms and send in the proper documentation?

Failure to comply with the State of NC and Duke University Immunization Requirements by the 30th day of class will result in the deactivation of your DukeCard. Your registrar will be notified and you will not be able to attend class or register for future classes.

What is my Duke Unique ID number? What is M.I.?

The Duke Unique ID number that Student Health uses is a seven-digit number that starts with either a zero or a one. M.I. stands for middle initial (common in the USA.) You can leave this field blank if you do not have an M.I. If you do not know your Duke Unique ID number, be sure your full name and date of birth are on your form so that we can access your chart.

What if I just send in my documentation but do not fill out the online forms?

Failure to complete the online forms may cause a delay in processing your records. Log into the Student Health Gateway by using your Net ID, password and birthday. Click the “Forms” tab on the left tool bar to complete the online forms. Please follow Step 4 under the Steps for Immunization Compliance.

Does my information need to be submitted on Duke’s Immunization Requirement Form?

This is the preferred method and will facilitate the processing of your record. This form can be found on the Duke Student Health Website under the Immunization Compliance tab.

Is the TB Screening Questionnaire part of the Immunization Requirements?

Yes. The form must be completed online, printed and submitted with your immunization record (along with any additional testing or documents if applicable). Please upload to your Student Health Gateway.

Do I have to submit my TB Screening Questionnaire even though I have submitted my TB test?

Yes. All pages of the TB Screening Questionnaire must be submitted.

There’s a question on the form asking about residence and the number of months I have lived in a certain country. Do I need to calculate 20+ years into months?

Yes, but an estimate is also okay. The question is really designed for a person who travels and not necessarily a person who has lived their entire life in a different country. In the instance that you have traveled, we do need to know the exact months you have been traveling to other countries.

Can I get my TB test and other required vaccines when I arrive at Duke?

We encourage domestic students to receive their immunizations and complete their TB testing before arriving on campus. International students will be given the opportunity to complete their TB testing and receive any necessary vaccines at Duke during the orientation week. Student Health does not place ppd skin tests. All TB testing will consist of an IGRA blood test. The cost of this test will be billed to the student’s insurance company.

How do I schedule my TB test if I need to get it when I arrive at Duke?

You will have an opportunity to receive any necessary vaccines, titers, and TB testing when you arrive at Duke. You will receive information from your program later this summer regarding the immunization event that will be held in August for those entering the fall semester. Those entering in the spring semester can schedule an appointment with our immunization nurse by calling 919.681.9355 option 2.

Is the cost of vaccines and TB testing covered under the Health Fee?

The cost of vaccines and TB testing is not covered under the Student Health Fee. These services will be billed to the student’s insurance company.

How do I obtain a medical or religious exemption for required vaccines?

Send an email to to request the appropriate exemption form.

What is the Consent to Treatment document and why do I need to sign this form?

This form allows any Duke facility to treat you if you are in need of treatment and it gives Duke permission to bill your medical insurance company – including Student Health, Urgent Care, and the Emergency Room. It is not part of the immunization compliance process, but it is a form we are asking all incoming students to complete before you get here.

How do I complete the following fields on the Consent to Treatment document – DOS, MR number, and Account number?

You can leave those fields blank. You only need to sign the area that says Policy Holder or Guarantor and date. A parent or guardian should sign your form if you are under the age of 18.

I have submitted my documents and entered the dates of my vaccines. Why does my status still say Not Satisfied or Awaiting Review?

The status remains Not Satisfied or Awaiting Review because we have not yet reviewed your records. This can take up to 3 weeks. Once they are processed, you will get a secure message through the portal notifying you of your immunization compliance status. Please note that your TB testing will remain non-compliant until you complete the test and we receive the results.

I am getting an error message or “unable to locate your record” message in the Student Health Gateway, what does this mean?

You are receiving this message because the systems that are confirming your enrollment to the university have not yet synched with our health record. Please check back in a few days for access. We apologize for the inconvenience.

What if I receive additional immunizations after I have already submitted the Health Form?

Upload any additional immunization documentation to your your Student Health Gateway under the Medical Clearances- Immunization Reqs Form update button.

If I have completed the online immunization form, why do I need to submit my immunization records?

Student Health staff cannot verify your online submissions without your official immunization record.

Will I receive notification that my records have been processed?

You will receive a secure message on your Student Health Gateway when your records are processed notifying you of your immunization status. Please be patient as this can take up to 4 weeks. If you are non-compliant, the message will outline what you are missing. You must provide us with these missing items within 30 days of the first day of class. If you are partially compliant, the message will inform you of the date your next vaccine or titer is due. If you are compliant, the message will inform you that no further action is necessary.

Will these messages be sent to my Duke email account?

You will receive an email in your Duke account notifying you that you have received a secure message from Duke Student Health. Log into the Student Health Gateway and click on “Messages” on the left tool bar. It is extremely important that you read all messages sent to you from Student Health. Failure to do so is the primary reason students fall out of immunization compliance, which leads to disruption in their educational experience.

Will I be allowed to attend class if I am told I am partially compliant?

Yes. Being partially compliant means that you cannot receive any more required vaccines or titers until the necessary time has passed since your last vaccine(s).

What happens if I don’t get my vaccine when the next dose is due?

If you do not receive the vaccine in the time frame stated in the message you receive, you may be withdrawn from class and your DukeCard may be deactivated.

My registration is on hold OR my DukeCard has been deactivated. What do I do now?

Student Health only places holds on registration and deactivates DukeCards after the 30th day of class. If you are experiencing problems before the 30th day of class, please contact your registrar or the DukeCard office. If your card has been deactivated due to immunization compliance, you should immediately contact Student Health at 919.681.9355 option 2 to schedule an appointment with the immunization nurse

When I become compliant will my DukeCard be activated automatically?

It can take up to 24 hours for a hold to be removed once you have become compliant.

What is the difference between the Td and Tdap immunizations?

Td protects against tetanus and diphtheria. Tdap protects against pertussis, tetanus and diphtheria. Tdap vaccine was licensed in 2005 and is not available in all countries. If you need a dose of Tdap for immunization compliance, you can receive it at Student Health once you arrive at Duke. The State of NC requires 3 doses of a tetanus vaccine for college entry. One of these three doses MUST be a Tdap and one must have been given within the last 10 years.

I’ve received my MMR or varicella vaccine but it was before my first birthday, is that ok?

This is very common in many parts of the world but in NC, per law, it must be given after the first birthday. This doesn’t mean you received the dose inappropriately it just means it doesn’t match NC law. You will have the choice of either receiving another dose or testing your blood to prove immunity.

I can’t find the specific hepatitis B vaccine option for the one I received in the Student Heath Gateway, what should I do?

You can choose the dropdown box for hepatitis B unspecified. Rest assure that if you make any errors when you’re entering your vaccines (date or brand) our staff will correct on your record when we are reviewing.

What if I am unable to locate my childhood immunization records?

You can have blood titers drawn to prove immunity to measles, mumps, rubella, and varicella. Please send the lab reports, complete with reference ranges.

The State of NC does not allow us to accept titers for other required vaccines. If you are unable to find your documentation, you will need to restart those vaccine series. Please receive as many doses as possible before your arrival and we will help you complete the series at the appropriate time frames when you arrive at Duke.

What if my immunization records are under my maiden name and I am registered at Duke under my married name?

You will need to attach a copy of your marriage certificate or proof of name change to verify that the record is yours.

I am pregnant but not up-to-date on my immunization requirements. What can I do?

You will need a note from a physician verifying your pregnancy and your approximate due date. Contact the Student Health Center for more information by emailing

What is My Duke Health and how do I sign up for it?

My Duke Health is a secure online portal that gives you access to Student Health Appointments, access to your medical health record, and fast communication with your health care team.

Register for your My Duke Health account after July 1. Click here for assistance or call 1-800-782-6945.

I am enrolled in a hybrid or online Duke academic program; does NC immunizations apply to me?

Great question and one that is hard to answer – the short answer is really dependent on how many hours you are taking on Duke’s campus in NC. Please check with your academic department as there are many different Duke Hybrid programs and it is hard to give a single answer. 

For Health Science Students only

(Med, Nursing- ABSN, R-NAP-DNP, PT, PA, A-MBS, A-OPT, A-PH, OD-T):

Am I required to have a positive Hep B titer even though I have had the Hep B vaccines?

Yes. A complete Hep B series AND a positive Hep B Quantitative Surface Antibody Titer are required for all Duke Health Science students.

If your titer returns negative, you will need to receive the first dose of the second Hep B series and repeat the titer 2 months later (per CDC guidelines.)

Why is my Hep B titer being rejected?

There are 2 types of Hep B surface antibody titers – quantitative and qualitative. Duke requires the quantitative titer. Please send the lab report, complete with reference ranges.

We will only accept a qualitative titer if the report defines what numeric reference they use to determine a positive or reactive result. Ex: Reactive = >9.9.

Can I submit a ppd skin test instead of a IGRA blood test?

All Health Science students at Duke must submit an IGRA TB blood test (T-spot or Quantiferon Gold) done within 6 months of matriculation. The only Health Science program that will accept a ppd skin test is NAP-DNP.

Important things to remember:

  • You must complete the online TB Screening Questionnaire and follow the instructions you receive in the email.
  • Upload all documents to
  • Each record submitted must be written in English and have your full name and date of birth on every page.
  • Do not submit your records more than once.
  • Due to high volume, it may take up to 4-6 weeks to process your records.
  • Staff will review your records and send you a secure message notifying you of your immunization status. You will need to log into the Student Health Gateway to read these messages.
  • For further immunization questions, please contact us at

Are you in compliance?

North Carolina State Law (General Statutes §130A 152–157) requires that all students entering college present a certificate of immunization that documents that the student has received all immunizations required by law. While your state or country of origin may have different immunization requirements, you must comply with North Carolina laws and Duke requirements.


The following immunizations are required for Duke undergraduate students:

Name of Vaccine

Number of Doses Required

Hepatitis B (if born after 7/1/94 & for all health science students)2 or 3 Doses depending on brand
Measles2 Doses
Meningococcal ACWY1 Dose (after 16th birthday)
Mumps2 Doses
Polio3 Doses (if younger than 18 years old)
Rubella1 Dose
TD/DTAP/TDAP3 Doses (one TDAP in the last 10 years)
Varicella (if born after 4/1/2001)2 Doses or positive IgG titer

Students who wish to receive additional vaccines including flu, HPV, and Meningitis B, or need clearance for shadowing and volunteering,  should wait until after Oct 1 to schedule an appointment with Student Health.

Graduate students and health science students should refer to their respective immunization forms.

Click on the Steps for Immunization Compliance tab above.

Deadline to submit immunization records:

Student Health Gateway access opens on 6/3/24 for all first-year undergraduate students.  Log in and submit your forms at that time.

  • Fall Semester: June 15 (Deadline for Nursing, Physical Therapy, and MBS Students is May 7th)
  • Spring Semester: December 15
  • Summer Semester: April 15

Students have 30 days after the first day of class to meet immunization compliance and TB requirements.