FAQ: Immunization Requirements

Immunization Requirement

Q: What immunizations and clearances are required?

A: Duke University requires that students be compliant with immunization requirements, in accordance with North Carolina General Statutes (§130A 152–157). Any student to whom this policy applies must provide a certificate of immunization for all of the immunizations listed below and complete the required screening:

Tetanus / Tetanus, diphtheria and pertussis (Td, DTaP, Tdap): Three doses of tetanus vaccines. At least one of the three doses must be a Tetanus, diphtheria, and pertussis (Tdap) vaccine administered within the past 10 years.
Measles: Two doses separated by at least 28 days with the first dose on or after the first birthday; or positive titer (laboratory evidence of immunity to disease). May be part of the Measles, Mumps, Rubella (MMR) vaccine.
Mumps: Two doses separated by at least 28 days with the first dose on or after the first birthday; or positive titer (laboratory evidence of immunity to disease). May be part of the Measles, Mumps, Rubella (MMR) vaccine.
Rubella: One dose on or after the first birthday; or positive titer (laboratory evidence of immunity to disease). May be part of the Measles, Mumps, Rubella (MMR) vaccine.
Hepatitis B (Hep B): Complete vaccine series required for all students born on or after July 1, 1994. Based on the type of vaccine, the series is either two or three doses. Titers are not accepted by the State of North Carolina for this requirement.
Meningococcal conjugate (serogroups A, C, Y, & W-135): At least one dose at age 16 or older is required for students born on or after January 1, 2003.
Varicella (chickenpox): Two doses separated by at least 28 days, with the first dose on or after the first birthday OR a positive titer is required for all students born on or after April 1, 2001. History of contracting the disease does not meet compliance.
Polio: Three doses required for any student who will be under the age of 18 on their first day of attendance at Duke. Both the Inactivated Polio Vaccine (IPV) and the Oral Polio Vaccine (OPV) meet this requirement.
Tuberculosis (TB) Screening: All incoming students must complete a tuberculosis screening questionnaire. Incoming students who are at higher risk for TB infection, as determined by the screening questions, must undergo testing for TB infection administered in the United States within 6 months of matriculation.

All Health Science students must meet additional vaccine requirements. This includes:

Influenza (flu): Required for spring entrance.
Hepatitis B (Hep B): In addition to a complete series, students are also required to have a positive quantitative titer. If the first titer is negative or equivocal, the student is required to get another dose of vaccine and repeat the titer in two months.
Tetanus / Tetanus, diphtheria and pertussis (Td, DTaP, Tdap): Three doses of tetanus vaccines. At least one of the three doses must be a Tetanus, diphtheria, and pertussis (Tdap) vaccine administered after age 18.

Q: What is the deadline for submitting immunization records?

A: Students will be required to submit their immunization records and complete the tuberculosis screening no later than the dates specified below for their first semester at Duke:

Summer semesters: June 1
Fall semester: June 15
Fall semester Nursing and Master of Biomedical Sciences students: May 7
Spring semester: December 15

Q: Which students are required to meet the immunization requirements?

A: In accordance with North Carolina General Statutes (§130A 152–157), all students who are enrolled in four or more credit hours of on-campus, day-time classes or who live on campus and are taking any number of courses are required to fulfill the state of North Carolina immunization requirements.

Students enrolled in weekend-only classes are not required to fulfill the immunization requirements.

Please note that your credit hour enrollment and your program modality are primary drivers of this requirement. So even if a few of your courses are virtual in a specific semester, you may still meet the overall requirement, per state regulations and Duke University policy.

Students who are required to complete this requirement will receive regular communications and reminders from Student Health until the requirement is met.

Q: Can I get an extension for the Immunization Submission deadline?

A: Immunizations are due on the dates specified. The immunization record submission deadline allows staff sufficient time to process all records before the first day of class in accordance with state requirements. Failure to meet this deadline may result in processing delays. If you have missed the deadline, submit your records as soon as possible.

Q: Can I get an extension for the Immunization deadline (30th day of class)?

A: We are unable to extend the deadline for compliance with the State of North Carolina's requirements. Failure to fully comply with the State of North Carolina and Duke University Immunization Requirements by the 30th day of class will result in the deactivation of your DukeCard.

For students who have completed the first dose of a multi-dose series and are unable to take additional action at this time, we will work with you to complete your series in a timely manner.

If you have additional questions about the deadline or concerns about your ability to meet the requirements, please email immunizations@duke.edu to discuss your situation with our immunization team.

Q: Why does Duke require immunizations and TB clearance?

A: In accordance with North Carolina General Statutes (§130A 152–157), Duke University requires that students are compliant with the immunizations listed below. This requirement is not an admission requirement but is a condition of enrollment at Duke for students in all undergraduate programs as well as designated graduate, doctoral, professional, post-baccalaureate, and advanced certificate.

Q: I am enrolled in a hybrid or online program. Do these requirements apply to me?

In general, students who are enrolled in online-only programs of study are not required to meet the immunization requirement. Please note, this is based on program modality, not the modality of individual courses.

For students in hybrid programs, it varies based on the amount of in-person courses that are involved in the program. Students to whom this requirement applies will receive regular reminders from Student Health until the requirement is met.

Q: My medical provider or pharmacist says I don’t need these or that what I already have should be acceptable. What do I tell them?

A: Duke University follows North Carolina General Statute 130A-155.1.(a) and the Centers for Disease Control & Prevention (CDC) guidelines on vaccine administration and timing of doses. You can provide a copy of the Duke Immunization Clearance form to your medical provider and advise them that this form details what is required for enrollment at Duke University.

You can also advise them that you are required to comply with these requirements exactly as they are specified.

We recognize that in some cases the requirements exceed the CDC Adult Vaccine Schedule requirements. The CDC has identified colleges and universities as higher risk environments because of the large number of individuals who live, study, and work in close proximity to each other. For this reason, and in accordance with North Carolina regulatory requirements, students must be vaccinated with the number of doses specified by Duke and on the schedule specified.

Immunization Clearance forms are available here:

Q: I had chickenpox, so I don’t have the vaccine. Why isn't history of chickenpox enough to meet the requirement?

A: Duke University requires documentation of age appropriate varicella vaccinations or laboratory confirmation of immunity through a Varicella IgG Titer. Most students who were born after 1995 received this vaccination as part of their childhood vaccine series.

If you have previously had chickenpox, you are able to get a blood draw or titer to show laboratory evidence of immunity. Positive laboratory evidence is obtained through a simple and inexpensive blood test called a titer. This test shows whether you have enough antibodies in your blood to be immune to a certain disease. If the test is positive (with antibodies equal to or greater than a defined value), you have immunity for that condition. If the test is negative (no immunity) or equivocal (not enough immunity), you will need to be vaccinated.

Please work with your medical provider to obtain this titer and submit your laboratory results to meet this requirement if you do not have proof of vaccinations. Please note your submission must include the lab report with your full name and date of birth, in English, as well as the laboratory results so we are able to confirm your immunity.

For students in the United States, you may also be able to order this testing yourself through a retail laboratory provider such as Labcorp, Quest Diagnostics, or RequestATest without needing to connect with a medical provider. Please note that these are typically cash-pay services and insurance is not accepted / processed for this testing. You may be able to submit the cost of the test to your insurance company for reimbursement or use a flex spending or health savings account to cover the cost.

Q: What is the difference between the Td and Tdap requirements?

A: Td protects against tetanus and diphtheria. Tdap protects against tetanus, diphtheria, and pertussis. Pertussis, also known as whooping cough, is a highly contagious respiratory disease that continues to circulate globally, so this additional protection is important for the health and safety of our community.

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 or in the Durham community once you arrive at Duke. The State of North Carolina requires 3 doses of a tetanus vaccine for college entry. One of these three doses MUST be a Tdap given within the last 10 years.

Q: My record was rejected because it wasn’t in English. How do I get it translated? Does it have to be an official translator or can I translate it myself?

A: All vaccine records must be in English. We encourage you to have your home provider complete and sign Duke's immunization form. We will accept documents that have been officially translated.

Immunization Clearance forms are available here:

Q: My immunizations are compliant with the immunization schedule in my country. Why isn’t this accepted for Duke?

A: Duke University follows North Carolina General Statute 130A-155.1.(a) and the Centers for Disease Control & Prevention (CDC) guidelines on vaccine administration and timing of doses. While your immunizations may be compliant with the requirements for your country, you must meet the Duke and North Carolina requirements in order to maintain enrollment at the university.

You can provide a copy of the Duke Immunization Clearance form to your medical provider and advise them that this form details what is required for enrollment at Duke University. You can also advise them that you are required to comply with these requirements exactly as they are specified.

Immunization Clearance forms are available here:

Q: Can I request an exemption?

A: Yes, students are permitted to seek exemptions to the above vaccination requirements for medical or for sincerely held religious beliefs in accordance with North Carolina General Statutes. Students seeking an exemption will be required to submit an Exemption Request Form to the university. Exemption requests must be submitted by the same deadlines as outlined above. All medical exemptions must be approved by a physician licensed in the state of North Carolina and may include a review by the State Health Director. To request an exemption form, please email immunizations@duke.edu and specify the type of exemption you are seeking.

Q: I am a fully online student. Does this still apply?

A: No, these requirements do not apply to online-only students. Please note: the immunization requirement is based on your academic program. If you are enrolled in an academic program that is included in the immunization requirement, you are required to meet this requirement in order to maintain your enrollment at Duke. The modality of your courses for a specific term (i.e. in-person, hybrid, virtual) does not change whether this requirement applies to you.

Q: I am a part-time or weekends only student. Does this still apply?

Students enrolled in weekend-only classes are not required to fulfill the immunization requirements.

Students who are required to complete this requirement will receive regular communications and reminders from Student Health until the requirement is met.

Q: I have a vaccine series in progress, but it won’t be finished before the deadline. What do I do?

A: Please submit all immunization records to your Student Health Gateway. A member of the immunization team will process your records and let you know when you are due for the next vaccine in your series. You will be considered partially compliant while you are working on your series. Being partially compliant does not impact your registration or class attendance.

Once you become due for the next dose in your series, you will have two weeks to complete this in order to avoid falling into non-compliance.

Q: Does Duke require the COVID-19 vaccine and/or booster(s)?

A: No, there is no requirement for the COVID-19 vaccine, whether primary series or booster.

Q: Does Duke require the annual flu vaccine?

A: The flu vaccine is strongly encouraged for all Duke students but is only mandatory for Duke Health Science students, who must receive a flu vaccine on or after August 1 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 each fall. For Health Science students, your academic program will communicate with you regarding your annual flu vaccine deadline and records submission process.

You will have many opportunities to receive the flu vaccine on Duke’s campus. Information about on-campus availability for vaccination will be sent to the campus community in early fall semester each year.

Q: I received a Measles, Mumps, & Rubella (MMR) or Varicella vaccine, but it was a few days before my first birthday. Is this ok?

A: This is very common in many parts of the world but in North Carolina, per law, it must be given on or 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.

Laboratory evidence of immunity is obtained through a simple and inexpensive blood test called a titer. This test shows whether you have enough antibodies in your blood to be immune to a certain disease. If the test is positive (with antibodies equal to or greater than a defined value), you have immunity for that condition. If the test is negative (no immunity) or equivocal (not enough immunity), you will need to be vaccinated.

If you wish to get a titer to demonstrate your immunity, please work with your medical provider to obtain this and submit your laboratory results to meet this requirement if you do not have proof of vaccinations. You will need a titer for each component of the requirement you are trying to meet. For instance, to meet the measles, mumps, and rubella requirements, you will need three different tests completed. All of these tests can be completed with one blood draw. Please note your submission must include the lab report with your full name and date of birth, in English, as well as the laboratory results, so we are able to confirm your immunity.

Q: Some of the vaccines have specific timelines for when the next dose can be given, such as at least 28 days between the two required doses of varicella vaccine. I got my second dose a few days before it was due. Is this ok?

A: For live virus vaccines, such as MMR or Varicella the minimum number of days between doses is 28. If a dose of MMR or Varicella was given before 28 days it is considered invalid and you will need another dose at least 28 days after the invalid dose. Please contact the Immunization team if you have any questions. Immunizations@duke.edu.

Q: I need to get another vaccine but I just had a live vaccine (e.g. Measles, Mumps, Rubella or Varicella) and now I’m being told I have to wait before I can get the vaccine I need. What do I do?

A: For those students who need a vaccine but are unable to take additional action at this time due to concerns of this nature, we will work with you while you complete your series in a timely manner. Please email immunizations@duke.edu to discuss your situation with our immunization team.

TB Requirement

Q: Is the TB Screening Questionnaire a requirement?

A: Yes. The Tuberculosis Screening Questionnaire 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.

Q: Do I have to submit my TB screening questionnaire even though I have submitted a TB test?

A: Yes. All pages of the Tuberculosis Screening Questionnaire must be completed and submitted.

Q: I completed the Tuberculosis (TB) Screening. Why do I have to take additional actions?

A: Based on the answers provided in your TB screening questionnaire and/ or your program of study you may be required to complete TB testing. Please note that determinations on when additional screening may be required is based on guidance from the Centers for Disease Control & Prevention (CDC) and the American College Health Association.

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

A: 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 number of months you have been traveling to other countries.

Q: I made a mistake on the TB Screening Form. How do I change my answer?

A: Please send a detail to our team via the Student Health Gateway and provide details on what mistake was made. Our team will provide guidance on next steps.

Q: I found out I need a TB test, but I just recently got a live vaccine (e.g. Measles, Mumps, Rubella, Varicella, Mpox, or Yellow Fever), and now I have to wait to get my test. What do I do?

A: Please wait 28 days from the date of the live virus vaccine to receive your TB test. If you have additional questions or if this will impact your ability to meet the immunization deadline, please contact us by emailing immunizations@duke.edu.

Q: Can I request an exemption for TB Testing?

A: No, exemptions are not available for the completion of the Tuberculosis Screening Questionnaire and TB testing, if required.

Q: Can I submit a TB Test performed outside of the United States?

A: All TB Testing must be performed in the United States, within 6 months of matriculation.

Health Science Students

Q: How do I know if I am in a Health Science program?

A: You are considered a Health Science student if you are in one of the following programs:

Medicine
Nursing, including Master of Nursing and Nurse Anesthesia - Doctor of Nursing Practice
Physical Therapy
Physician Assistant
Master of Biomedical Sciences
Occupational Therapy
Pathologists’ Assistant
Ophthalmic Technician
Orthoptic Training Certificate
Radiation Therapist

or your program coordinator informs you that you are in a Health Science program.

Q: Why do Health Science students have different requirements and a different deadline?

A: Because of the nature of their educational requirements and training, Health Science students are also required to fulfill the requirements of the Duke University Health System. Some health science programs have a different deadline based on when their clinical rotations begin.

Q: Why am I required to have a positive Hepatitis B titer when I have had a complete Hepatitis B vaccine series?

A: A complete Hepatitis B series AND a positive Hepatitis B Quantitative Surface Antibody Titer are required for all Duke Health Science students. These requirements align with requirements for Duke University Health System, which is due to the nature of the Health Science educational and training requirements. 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 Centers for Disease Control and Prevention (CDC) guidelines.

Please work with your medical provider to obtain this titer and submit your laboratory results to meet this requirement. Be certain that your provider orders the correct type of titer. It must be a Hepatitis B Quantitative Surface Antibody Titer. There are a range of Hep B blood tests, so it is essential you get the correct test. Please note your submission must include the lab report with your full name and date of birth, in English, as well as the laboratory results so we are able to confirm your immunity.

Q: Why is my HepB titer being rejected?

A: The most likely issues for your titer not being accepted are either the incorrect test was ordered and performed or lack of complete documentation.

There are 2 types of Hep B surface antibody titers – quantitative and qualitative. Duke requires the quantitative titer. Please be sure your provider orders the correct test.

Please send the full 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. (Example: Reactive = >9.9.) We must also be able to see the full result, including your name and date of birth clearly showing on the record. We do not accept written notes from medical providers stating that you have a positive titer or immunity. We must see the actual test results and reference range.

Q: Can I submit a PPD Skin Test instead of an IGRA blood test?

A: All Health Science students at Duke must submit an IGRA TB blood test (T-spot or QuantiFERON Gold) done within 6 months of matriculation. This testing must also be completed within the United States. The only Health Science program that will accept a PPD skin test is NAP-DNP. The NAP-DNP program requires that this skin test is within 6 months of matriculation as well.

For students in the United States, you may also be able to order IGRA TB blood testing yourself through a retail laboratory provider such as Labcorp, Quest Diagnostics, or RequestATest without needing to connect with a medical provider. Please note that these are typically cash-pay services and insurance is not accepted / processed for this testing. You may be able to submit the cost of the test to your insurance company for reimbursement or use a flex spending or health savings account to cover the cost.

Q: I just had an IGRA blood test done last year. Why isn't Duke accepting this result?

A: Duke requires that all TB testing be completed within 6 months of matriculation. Please work with your medical provider to get new testing completed.

Immunization Forms, Record Submissions, & Login

Q: How can I access the Student Health Gateway portal where I need to submit my immunizations and TB info?

A: The Student Health Gateway can be found at https://shc.duhs.duke.edu/. You will need to log in with your Duke NetID login info, which includes the DUO authentication process.

Q: Is the Student Health Gateway the same as My Duke Health? How do I sign up for My Duke Health?

A: No, the Student Health Gateway is used as your immunization compliance portal. 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. If you are having challenges setting up your My Duke Health account, click here for assistance or call 1-800-782-6945.

Q: I am having login issues and keep getting an error message. Can you help me?

A: For incoming students, it does take some time after you are registered for your account to become active in the Gateway. If your account is not yet active, you will receive the following error message once you get past the Duke NetID login:

Your profile is not yet activated in our system. Your profile should be active 1-2 business days after your program advisor completes the matriculation process. This usually occurs in mid-May to early June for incoming fall students and mid-December to early January for incoming spring students. You should be able to see your matriculation status in DukeHub.

To review your status, go to the Shopping Cart in the Enrollment dropdown menu. If you do not see available terms in the Shopping Cart dropdown, you have not yet been matriculated. Please reach out to your program advisor if you have questions regarding your matriculation status. We apologize for the inconvenience.

Q: I can’t find the form I need to complete for compliance. Where is it?

A: Immunization Clearance forms are available here:

Q: Does my medical provider have to sign this form?

A: Yes, your form needs to be signed and dated by your medical provider. This may include any of the following medical professionals: Medical Doctor (MD or MBBS), Osteopathic Doctor (DO), Physician Assistant (PA), Nurse Practitioner (NP), Registered Nurse (RN), or Licensed Practical or Vocational Nurse (LPN / LVN).

Q: What is my Duke Unique ID number? How do I find it?

A: Your Duke Unique ID number is a unique seven-digit number and can be found on the back of your DukeCard as well as on the profile page of your DukeHub. If you cannot locate your Duke Unique ID number, be sure to include your full name and date of birth on all forms submitted.

Q: Does my information have to be submitted on Duke's immunization form?

A: Yes, your information needs to be submitted on Duke’s immunization form. Immunization Clearance forms are available here:

If you are having challenges accessing your healthcare provider, please contact our team at immunizations@duke.edu for assistance.

Q: Who can sign this form for me?

A: Your form needs to be signed and dated by your medical provider. This may include any of the following medical professionals: Medical Doctor (MD or MBBS), Osteopathic Doctor (DO), Physician Assistant (PA), Nurse Practitioner (NP), Registered Nurse (RN), or Licensed Practical or Vocational Nurse (LPN / LVN). This form cannot be signed by a family member, even if they are a medical provider.

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

A: 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 5 under the Steps for Immunization Compliance.

Q: My immunization record only lists the month and year it was given, but the Student Health Gateway is asking me for the day. What do I put?

A: Please list the first of the month for your immunization. For instance, if your record says your vaccine was given 06/2000 or June 2000, please add it to your profile as June 1, 2000.

Q: There are some immunizations that are not required for me based on my date of birth. Will Duke automatically clear those requirements for me?

A: Yes, our team will automatically clear those requirements. You do not need to take any action.

Q: I have submitted my immunization dates. Why do I need to upload a copy of my records?

A: Student Health staff cannot verify your online submissions without your official immunization record and we must verify in accordance with North Carolina state regulations.

Q: Where can I email my information?

A: Students must upload their records via the Student Health Gateway, which can be found at https://shc.duhs.duke.edu/. If you are struggling with the record upload process, please contact our team at immunizations@duke.edu.

Q: I don't see the specific Hepatitis B vaccine I received as a selection option in the Student Health Gateway. What should I do?

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

Q: I made a mistake when entering my vaccine dates in the Student Health Gateway. What should I do?

A: If you make any errors when you’re entering your vaccines (date or brand) our staff will correct your record when we are reviewing.

Q: Do you have step by step instructions for uploading and submitting my information?

A: 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
All students who will be under the age of 18 when they start at Duke should complete and upload both the Minor Consent to Treat Form and the Conditions of Admission form, which is the consent form to be seen at Student Health. All other students are strongly encouraged to complete the Conditions of Admission form now, as this will be required to be seen at Student Health.
As needed, upload additional records to the Immunization Reqs Form Update Button.

Q: I am getting a file upload error. What is the issue?

A: The system only supports .PDF, .PNG, .JPG, .JPEG, and .GIF files. Please ensure your file size is limited to 4MB or smaller. We also recommend using short filenames without any special characters (#, @, $, %, *, etc.). Consider using just your last name.

If you are having trouble due to file size, you may find it helpful to take a screenshot and upload that instead.

How to Screenshot: Apple iOS
How to Screenshot: Android

Please note that Apple screenshots are typically in .HEIC file format, which is not a format the system currently accepts. There are a number of free online tools to help you convert your .HEIC file to a .JPEG or other supported format.

Q: If I get an immunization at Duke Student Health, do I have to upload it into the system?

A: No, our staff will update your Student Health record with any vaccines you receive at Student Health. If you get vaccines at Duke University Health System medical offices, however, you will need to upload your immunization documentation to the Student Health Gateway.

Q: I have been a patient at Duke Health System, and they have my vaccine records. Do I have to submit them, or do you already have them?

A: Student Health does not have access to your My Duke Health account, and your records from your primary care provider do not automatically transfer to us. Please go to your My Duke Health account, click Health Summary, then click Immunizations. If you print this page or print to PDF, it will contain your full name and date of birth. You can upload that file to the Student Health Gateway.

Q: I submitted immunizations as an undergrad / when I previously attended Duke. Why don’t you still have them?

A: We may have your previously submitted immunization records, depending on when you first submitted them. Log in to your Student Health Gateway to see if your immunizations are listed. All newly matriculating students will need to complete a new TB Screening Questionnaire, which can be found on our website.

Q: I am a Duke Employee. Do I have to submit my immunization records?

A: Yes, you will need to submit these, as Student Health does not have access to Employee Health records. Be sure the immunization records you submit to us from Employee Health contain your name and date of birth. All titer results must be documented on the official lab report.

Q: I have already submitted my signed form, but now I need to submit additional immunizations. How do I do this?

A: Upload any additional immunization documentation to your Student Health Gateway under the Medical Clearances- Immunization Reqs Form update button. You do not need to have your medical provider sign a new form; we just need a formal immunization record or proof of immunization in order to update your record.

Q: I don’t have a copy of my immunization records. Where can I find them?

A: If you recall getting immunizations as a child, but are unsure where to locate your immunization records, we recommend checking the sources below. Keep in mind that in order to obtain these records, you may need to complete a Release of Information form. That process can take several days to complete, so plan accordingly.

Your Medical Provider’s Office
- Your doctor’s office will often have a copy of these records on hand. If you turned 18 recently (within the last ten years or so) and switched from a pediatrician to another primary care provider, your pediatrician’s office may still have these records.
Your Elementary, Middle, or High School
- In many states, students are required to submit proof of vaccination at some point during their primary and secondary education. Many of the vaccines we require are the same ones you would have needed to attend school. For students who have graduated from high school within the last several years, try contacting your school system and asking for a copy of your vaccination records.
Your Previous College or University
- If you have previously enrolled in or attended another college or university, you may have been required to provide them with immunizations. Records are often held for seven to ten years. You may also have received immunizations at their health center that could help you meet Duke’s requirement. We recommend starting with the health center or the admissions office to locate these records.
The Military
- If you enlisted in any branch of the military and completed military service, you very likely have vaccine records on file with them. These should be available in your online military medical record. The military tends to prefer titers (blood tests) and we are happy to accept those tests that show positive immunity. And thank you for your service!
Your State Immunization Registry
- In many states, medical provider offices and schools are required to upload vaccines given to children directly into a statewide vaccine registry system. Many states have portals where citizens of that state (or former citizens of that state) can access records. The list of websites for each state’s immunization registry is available here. Don't forget--you want to contact the registry for the state where you lived when you were a child. Many of the vaccines Duke requires were likely given when you were a small child, though some of the vaccines would have been given during your middle and high school years.
Your Parents / Guardians
- Many parents maintained their own vaccine records for their children. This is especially common for students who were vaccinated before doctors’ offices had computerized records. Very often, these immunization cards will be long fold-out cards that medical providers used stamps and old-fashioned handwriting to document vaccines given. We can sometimes accept entries from these records, but it depends on how your provider documented on your record. These are not preferred records, but we will review them if you have not been able to locate any other records.
Have Your Blood Drawn
- If you cannot locate records, but you recall getting vaccinated as a child, you can work with your medical provider to order blood tests in lieu of records for certain vaccines. The State of North Carolina will only accept laboratory evidence of immunity to Measles, Mumps, Rubella, and Varicella (chickenpox).

Q: My immunization records have a different name than my Duke University registration, such as a maiden name. What do I need to do?

A: In order to have these records accepted for verification, you will need to attach a proof of name change document, such as a marriage certificate. Upload this in the Additional Documents section.

Review & Clearances

Q: I have submitted my documents and entered my dates. Why does my status still say not satisfied or awaiting review?

A: All immunization records must be reviewed by our staff before the compliance status changes. Once you have successfully submitted your immunization dates and uploaded your documentation, you will see your immunizations remain in Not Satisfied status while awaiting our review.

The compliance status will change after our staff reviews your records and you will receive a secure message on the Student Health Gateway notifying you of your immunization compliance status.

Q: How long does it typically take to review my immunizations after I submit?

A: Review typically takes 7-10 business days. To help expedite this review, please upload your documents as completely as possible and as soon as you have them.

Q: Can you expedite the review of my upload?

A: We are unable to expedite this review. We process and review records in the order that we receive them. To help us expedite this process, be sure that you have fully submitted all of your materials and completed all required forms.

Q: How will I know when I’m compliant?

A: You will receive a secure message on your Student Health Gateway that confirms your compliance. You will also see the status of your Immunizations show as Compliant in the Medical Clearances section.

Q: How will I know when you’ve sent me a message about my compliance?

A: 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 toolbar. 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.

Q: I submitted my info but still keep getting messages I’m not compliant. What am I missing?

A: If your status indicates Not Satisfied or Awaiting Review, we have not yet reviewed your records. This can take up to a few weeks during periods of the year where we are receiving a high volume of records (typically May through August). Once your submissions have been processed, you will get a secure message through the portal notifying you of your immunization compliance status. This message will outline any vaccines that you are missing. Please note that your TB testing will remain non-compliant until you complete the test and we receive the results. Please ensure you carefully read the messages from our team regarding any outstanding requirements.

Q: Which vaccines am I missing?

A: Refer to the message that you received on your Student Health Gateway where our team has outlined any items that are missing or outstanding. To review this message, log into the Student Health Gateway and click on “Messages” on the left toolbar.

Q: What happens if I do not meet the requirement?

A: Failure to comply with the State of North Carolina 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.

Q: I was non-compliant and my DukeCard was deactivated, but now I have resolved that and I am compliant. Will my card be automatically reactivated? How long will this take?

A: It can take up to 24 hours for your DukeCard to be reactivated once you have become compliant.

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

A: 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). Once the next dose of your vaccine comes due, you will have two weeks to complete this before falling into non-compliant status, at which point your DukeCard will be deactivated and the Registrar will be notified that you are unable to attend class or register for future classes.

Q: What happens if I don't get my vaccine when the next dose is due? How long do I have to get the vaccine after it becomes due?

A: You have 2 weeks after the due date to complete the requirement. If you fail to complete the requirement after 2 weeks, your DukeCard will be deactivated and you may be removed from class.

If you get the next required dose with Student Health, you will not need to make any updates to your record. We will automatically capture this information. If you get the next required dose somewhere other than Student Health (including other Duke University Health System medical providers), you will need to upload this documentation to your Student Health Gateway under the Medical Clearances- Immunization Reqs Form update button.

Q: My registration is on hold or my DukeCard has been deactivated. What do I do?

A: Student Health only places holds on registration and deactivates DukeCards after the 30th day of class for students who are not compliant with the immunization requirement. 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.

If you are unaware why you are not compliant with the immunization requirement, refer to the message that you received on your Student Health Gateway where our team has outlined any items that are missing or outstanding. To review this message, log into the Student Health Gateway and click on “Messages” on the left toolbar.

Q: I am not up to date with my immunizations, but I am pregnant or have another temporary medical condition that prevents me from getting vaccinated right now. What do I do?

A: If you are pregnant, you will need a note from a medical clinician (MD, MBBS, DO, NP, PA) verifying your pregnancy and your approximate due date. If you have another medical condition that prevents you from being vaccinated, you will need to request a medical exemption. Contact the Student Health Center for more information by emailing immunizations@duke.edu.

Available Immunizations / TB Testing

Q: What vaccines or immunizations does Student Health have available to administer?

A: Student Health has all the required vaccines available.

Tetanus
Tdap
Measles, Mumps, Rubella (MMR)
Hepatitis B
Meningococcal ACWY
Varicella
Polio
Seasonal Influenza (only required for Health Science students).

Student Health has the following recommended vaccines available:

COVID-19
Meningococcal B (Bexsero)
Human Papillomavirus (HPV) (Gardasil-9)
Hepatitis A & B (TwinRix)
Hepatitis A
Seasonal Influenza (for non-Health Science students)

To schedule an appointment with the immunization nurse, contact Student Health at 919.681.9355 option 2.

Please note that Student Health processes insurance, so the cost of these immunizations will be billed to your health insurance provider.

Student Health offers complete Travel Consultations for students traveling internationally. Please see our website to schedule a travel consult.

Q: Can I get my TB testing and other required vaccines when I arrive at Duke?

A: To avoid delays and interruptions in your program, we strongly encourage you to complete as many of the requirements as possible before you arrive. However, you will have an opportunity to receive any necessary vaccines, titers, and TB testing after you arrive at Duke. You will receive information from your program later this summer about the immunization event scheduled for August for those entering the fall semester. Those entering in the spring and summer semesters can schedule an appointment with our immunization nurse by calling 919.681.9355 option 2.

Q: How can I schedule a TB test or vaccine if I need to get it after I arrive at Duke?

A: You can schedule an appointment with our immunization nurse by calling 919.681.9355 option 2 or you can attend one of the immunization events that will be held in August for those entering in the fall semester. You will receive information from your program later this summer regarding this immunization event.

Q: What is the cost for vaccination or TB testing at Student Health?

A: The cost of vaccines and TB testing is not included in your Student Health Fee. These services will be billed to your health insurance company.

Q: I need to get a Tuberculosis (TB) test (sometimes known as a TB Skin Test, Quantiferon, T-SPOT, or IGRA test). Can I get this done at Student Health?

A: Student Health offers the IGRA TB blood test (QuantiFERON Gold). We do not offer the PPD skin test. You can schedule an appointment for a TB blood test with our immunization nurse by calling 919.681.9355 option 2.

To find a local provider that offers a PPD skin test, we recommend reviewing the list of covered health providers on your insurance company’s website. You can typically find options available for occupational or employment testing or travel health that accept your health insurance. These care providers will often provide TB skin testing services.

Q: Does Student Health have flu shots available each year? How will I know when they are available?

A: Flu clinics will be offered throughout campus starting each September. These are free to Duke students. Check our website for clinic dates and locations. Students can schedule appointments with our immunization nurse to receive the flu vaccine after Oct 1.

Q: Where else can I get vaccinated / titers?

A: Vaccinations are available from your medical provider, many local pharmacies, and Student Health. In some cases, vaccines may also be available from your local county health department. The most convenient option for most students is local pharmacies, as they have many appointments available and can bill your insurance.

If you cannot locate records, but you recall getting vaccinated as a child, you can provide laboratory evidence of immunity to meet a few of the requirements. Your medical provider can order blood tests to check for immunity to the following:

Measles, Mumps, Rubella (you need titers for each of these three components)
Varicella (chickenpox)
Hepatitis B (per North Carolina law, students must still show proof of a complete Hep B vaccine series even if they have a positive Hep B titer)

Please note incoming students are not eligible to access Student Health for vaccinations and titers until:

August 1 for Fall start

January 2 for Spring start

May 1 for Summer 1 start

June 15 for Summer 2 start

Consent to Treat Form

Q: What is the consent to treatment document and do I need to fill it out / sign the form?

A: We ask all students to complete the Conditions of Admission form that you see in your Student Health Gateway. 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 as well as Duke University Health System Urgent Care and Emergency Room. It is not part of the immunization compliance process unless you are under the age of 18, but will help expedite your first visit to Student Health.

For students who are going to be under the age of 18 when they start at Duke, there is also an additional form we will need completed in order for you to access Student Health or other Duke healthcare services. The Minor Consent to Treat form, which authorizes care for those under 18, is also in your Student Health Gateway. These forms are part of the compliance process for students who will be under the age of 18 when they start at Duke.

Q: How do I complete the DOS, MR Number, and/or Account Number fields on the Consent to Treat document?

A: 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.

Recommended Vaccines

Q: I don't have all the recommended vaccines. Will this be an issue?

A: Only the vaccines listed in Section A of the Immunization Form are required for immunization compliance. It is not mandatory that you have all of the recommended vaccines.

Q: I submitted my recommended MenB vaccines, but they were rejected, and I was told that I do not have MenB. Can you help me understand the difference between MenB and MenACWY?

A: MenACWY covers the meningococcal strands A,C,W, and Y . This vaccine is required for students born on or after Jan 1, 2003. MenB vaccine covers the meningococcal strand B. This is a highly recommended vaccine, but not required.

The MenACWY vaccine is often referred to as Menveo, Menactra, or MenQuadFi. Sometimes you will see it listed on your record as MPSV4 or MCV4.

The MenB vaccine, often referred to as Bexsero or Trumenba, was not released until 2014. Sometimes you will see it listed as OMV (Bexsero) or Recombinant (Trumenba). Of note, MenB vaccine brands are not interchangeable. You must complete the whole series with the same brand.

Recently, two combination MenACWY / MenB vaccines (Penbraya and Penmenvy) were released. These vaccines will fulfill the Men ACWY requirement.

Q: I want to get some of these recommended vaccines. Can I get them at Student Health?

A: Student Health has the following recommended vaccines available:

COVID-19
Meningococcal B (Bexsero)
Human Papillomavirus (HPV) (Gardasil-9)
Hepatitis A & B (TwinRix)
Hepatitis A
Seasonal Influenza (for non-Health Science students)

To schedule an appointment with the immunization nurse, contact Student Health at 919.681.9355 option 2.

Some vaccines that are recommended for travel require a travel consult prior to administration (Chikungunya, Pneumococcal, Rabies, Typhoid,Yellow Fever, & Japanese Encephalitis). Student Health offers complete Travel Consultations for students traveling internationally. Please see our website to schedule a travel consult.

Please note that Student Health processes insurance, so the cost of these immunizations will be billed to your health insurance provider.

FAQ: Immunization Requirements

Immunization Requirement

TB Requirement

Health Science Students

Immunization Forms, Record Submissions, & Login

Review & Clearances

Available Immunizations / TB Testing

Consent to Treat Form

Recommended Vaccines

Other Questions