All students of Missouri Western State University that are to reside in residence halls are required to provide the following BEFORE moving into residence halls:

• A completed Health History Form (downloadable)
• A completed Immunization Policy Commitment to Comply Form (downloadable)
• Documentation of immunizations:

  • Measles/Mumps, Rubella (MMR) - Two doses at least one month apart usually administered at 12-15 months of age and again at 4-5 years of age.

  • Meningococcal disease (meningitis) - administered within the last three years.

  • Tetanus/Diphtheria/Pertussis (Tdap) or Tetanus/Diphtheria (TD) booster - administered within the last 10 years.

  • Tuberculosis Skin Test (with test results) - administered within the last 6 months for students who are considered to be high risk as defined by the Center for Disease Control and Prevention; those having been exposed, immediate family member with tuberculosis, had a positive skin test, lived or traveled outside U.S. for more than two months, worked or lived in a prison/jail, nuring home/residential care, hospital, homeless shelter or from a country other than the United States.

To assess each student's individual risk for TB infection or disease, the student will be required to complete a tuberculosis risk assessment (see downloadable Health History Form). Students who have EVER had a positive tuberculin skin test must have a chest x-ray within six months prior to enrollment to confirm the absence of active tuberculosis. A copy of the x-ray report must be provided. 

Documentation of the above must be submitted with a completed Housing and Dining Accommodation Application to the Office of Residential Life prior to or at the time of registration. Acceptable documentation consists of a copy of childhood immunization records from a doctor's office, a public health department, or a high school, and must include dates the student was either vaccinated or had the actual disease(s). All documentation will become a part of the individual's MWSU student health record.

Students who object to immunizations because of cultural or religious beliefs must notify Esry Student Health Center in writing, and provide documented and notarized rationale for exemption (downloadable). A statement from clergy, on congregational letterhead, must accompany the exemption. Students who have medical problems that preclude immunization must present a statement signed by a physician. If a campus outbreak of measles, mumps, rubella, pertussis or meningococcal disease occurs, these students will be suspended from campus until the outbreak is over as declared by Missouri Department of Health and Senior Services or their designated agency.

All forms required by Missouri Western State University Esry Student Health Center are downloadable at www.missouriwestern.edu/HealthServ/.

It is further recommended (but not required) that all college students be vaccinated for the following and furnish proof to the Health Center for inclusion in their medical record:

• Hepatits B (series of three)
• Hepatitis A (series of two)
• Varicella (chickenpox), if there is no history of having had the disease
• Polio, everyone in childhood
• Influenza, yearly

HPV (human papillomavirus) (series of three), pre-adolescent and adult women 11-26 years old

In the event a required vaccine is not available due to unforeseen circumstances, the requirement for that immunization will be waived until such time as the vaccine again becomes available. When supplies have been replenished, students who received waivers will be required to comply with the policy immediately.