The campus President is responsible for any amendment or interpretation this policy.

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POLICY The purpose of this policy is to provide clear direction and consistency in the enforcement of the prematriculation immunization requirements for students. The California State University Executive Order No. 803. This supercedes CSU Executive Order No. 730. Sections 120390, 120390.5, and 120390.7 of the Health and Safety Code. The campus President is responsible for any amendment or interpretation this policy. of ~~ Karen Haynes, President Second revision: 11/09/07 First revision: 07/01/02 Implemented initially: 08/01/00 CSUSM Policy & Procedures 1

The confidentiality of material utilized in the operation of these procedures will be maintained in accordance with federal and state laws, and campus policy. 1. Measles and Rubella All students born after January 1, 1957 are required to present proof of full immunization to Measles and Rubella prior to their first enrollment. Full immunization is two (2) doses of measles/rubella vaccine that has been given after 12 months of age and at least one month apart. This includes all students applying for admission and readmission to the university. Conditional enrollment for those who have not been fully immunized may be granted for students admitted in the Fall or Spring with the understanding that within the first semester of enrollment, the student will present proof of full immunization against measles and rubella. For students whose first enrollment is during the summer, conditional enrollment may be granted with the understanding that before the end of the fall semester of that year, the student will present proof of full immunization against measles and rubella. Students enrolled in a California public school for the seventh grade or higher on or after July 1, 1999 will have satisfied this requirement. 1.1.1 Written information regarding this requirement will be available in various means. These include, but are not limited to: Mailed flyers to prospective students with their acceptance information. Printed information in the University Catalog. Printed information in the Class Schedule. Printed information in the Student Guidebook. Information accessible through the Student Health and Counseling Services Web page.

REQillREMENT Presentations delivered at New and Transfer Student Orientations. Recorded information on the Student Health and Counseling Services phone tree. Calling the main clinic number (Ext. 4915) and selecting the appropriate information box accesses this information. When a student is providing proof of full immunization, the required documentation must be presented to Student Health and Counseling Services. Student Health and Counseling Services is responsible for the official verification of the documentation. All proof of immunization and immunity must be submitted to Student Health and Counseling Services (SHCS) to be properly entered into the Student Information System. The required documentation may be presented to the clinic for clearance by: Bringing the documentation to the clinic for staff review Having the documentation reviewed by SHCS staff member during orientation Mailing the documentation to SHCS for review Faxing the documentation to SHCS Proof of full immunization consists of the first immunization given after the first birthday and the second injection given at least one month after the first one, but will most likely have been given after age four. Examples of acceptable documentation include: State or international immunization record that lists the dates the immunization were given (month, day, year) with a MD, NP, RN, or LVN signature, or clinic stamp Pediatrician's statement or copy of medical records with date injection was given Military medical records documenting the injection Copy of laboratory test that documents immunity to measles and rubella Secondary school records Clearance documentation from another college or university attended

Unacceptable documentation includes: Babybook Copy of medical bill for services Handwritten note from parent or guardian If a student is unable to locate acceptable documentation of the immunizations, then the student may fulfill this requirement by obtaining the immunization at: Student Health and Counseling Services after the start of their first academic term Private Medical Provider County Health Clinic Community Health Clinic 1.2.5 Provisions for temporary or permanent exemptions in fulfilling this requirement are available based on medical considerations, religious or personal beliefs. Permanent exemptions may be granted in instances such as, but not limited to, permanent medical conditions or religious beliefs. Temporary exemptions may be given in instances such as, but not limited to, pregnancy. For medical considerations, a written statement by a physician or surgeon is required indicating that the physical condition(s) of the person or medical circumstance(s) relating to the person are such that immunization is not considered safe. It also must indicate the specific nature and probable duration of the medical condition or circumstances that contraindicate the immunization. For exemptions due to religious or personal reasons, a letter from the student, if an adult, or parent or guardian, if a minor, stating that the immunization is contrary to the beliefs of the student or parent or guardian is required. Students electing to claim an exemption will be given the opportunity to meet with a medical provider, initially, to discuss risks associated with not being fully immunized, they will be instructed as to the campus actions in the event of a measles outbreak on campus and to insure that the letter is included with the completed exemption form. Students with exemptions will be excused from all classes in the event of a campus outbreak: of measles. Students who have previously been granted a temporary exemption will not need to

meet with a provider on subsequent occasions where the letter needs to be resubmitted 1.3.1 If documentation of full immunity has not been presented to the Student Health and Counseling Services Office by approximately four weeks prior to the start of priority registration for either the Spring or Fall academic term, a registration hold will be placed on the student's record. Student Health and Counseling Services will lift this hold if proof of immunity is presented to the clinic, by receiving the injection, or by receiving a permanent waiver. Holds will be temporarily lifted, for one semester, for those students who have been granted temporary waivers by SHCS staff members. Students must submit a letter of request for waiver, either temporary or permanent. For temporary waivers, students must submit a request for a temporary waiver each semester that they are enrolled. A permanent waiver may be granted for certain medical conditions and for religious reasons. 2. Hepatitis B All first time enrollees who are eighteen (18) years of age or younger on August 1 of the year of their admission to CSU San Marcos, are required to present proof of immunization against Hepatitis B prior to their first enrollment. Immunization against Hepatitis B consists of three (3) injections, which are given over the period of six (6) months. Conditional enrollment for those who have not been fully immunized may be granted for students admitted in the Fall or Spring with the understanding that within the first year of enrollment, the student will present proof of full immunization against Hepatitis B. For students whose first enrollment is during the summer, conditional enrollment may be granted with the understanding that before the end of the first year of enrollment, the students will present proof of full immunization against Hepatitis B. Students enrolled in a California public school for the seventh grade or higher on or after July 1, 1999 will have satisfied this requirement 2.1 Information Dissemination

2.1.1 Written information regarding this requirement will be available in various means. These include, but are not limited to: Mailed flyers to prospective students with their acceptance information. Printed information in the University Catalog. Printed information in the Class Schedule. Printed information in the Student Guidebook. Information accessible through the Student Health and Counseling Services Web page. 2.1.2 Oral presentations of this information are available to students through: Presentations delivered at New and Transfer Student Orientations. Recorded information on the Student Health and Counseling Services phone tree. Calling the main clinic number (Ext. 4915) and selecting the appropriate information box accesses this information. 2.2.1 When a student is providing proof of full immunization, the required documentation must be presented to Student Health and Counseling Services. Student Health Services is responsible for the official verification of the documentation. All proof of immunization and immunity must be submitted to Student Health and Counseling Services to be properly recorded for entry into the Student Information System. The required documentation may be presented to the clinic for clearance by: Bringing the documentation to the clinic for staff review Having the documentation reviewed by SHCS staff member during orientation Mailing the documentation to SHCS for review Faxing the documentation to SHCS

Revised: 11109/07 2.2.2 Proof of full immunization consists of three (3) injections given in the standard sequence. Examples of acceptable documentation include: State or international immunization record that lists the dates the immunizations were given (month, day, year) with a MD, NP, or RN signature Pediatrician's statement or copy of medical records with date injections were given Military medical records documenting the injections Copy of laboratory test that documents immunity to Hepatitis B Secondary school records 2.2.3 Unacceptable documentation includes: Babybook Copy of medical bill for services Handwritten note from parent or guardian 2.2.4 If a student is unable to locate acceptable documentation of the immunizations, then the student may fulfill this requirement by obtaining the immunizations at: Student Health and Counseling Services after the start of their first academic term Private Medical Provider County Health Clinic Community Health Clinic 2.2.5 Provisions for exemptions in fulfilling this requirement are available based on medical considerations, religious or personal beliefs. Permanent exemptions may be granted in instances such as, but not limited to, permanent medical conditions or religious beliefs. Temporary exemptions may be given in instances such as, but not limited to, pregnancy, or for students in the process of completing the full series between their first and second academic terms. For medical considerations, a written statement by a physician or surgeon is

required indicating that the physical condition( s) of the person or medical circumstance( s) relating to the person are such that immunization is not considered safe. It also must indicate the specific nature and probable duration of the medical condition or circumstances that contraindicate the immunization. For exemptions due to religious or personal reasons, a letter from the student, if an adult; or parent or guardian, if a minor; stating that the immunization is contrary to the beliefs of the student or parent or guardian is required. Students electing to claim an exemption will be given the opportunity to meet with a medical provider, initially, to discuss risks associated with not being fully immunized and to insure that the letter is included with the completed exemption form. Students who have previously been granted a temporary exemption will not need to meet with a provider in subsequent occasions where the form needs to be completed. 2.3.1 If documentation of full immunity has not been presented to the Student Health Services Office approximately four weeks prior to the start of priority registration for either the Spring or Fall academic term, a registration hold will be placed on the student's record. Student Health and Counseling Services will lift this hold permanently if proof of immunity is presented to the clinic, or by receiving the complete series of three injections, or by receiving a permanent waiver. Holds will be temporarily lifted, for one semester, for those students who have been granted temporary exemptions by SHCS staff. Students, who submit a letter of request for temporary exemption, must submit the request for exemption each semester that they are enrolled. A permanent waiver may be granted for certain medical conditions and for religious reasons. 2.3.2 Students who are in the process of completing this requirement before the beginning of their second year and who need to register for their next academic term will be granted a temporary clearance to allow for registration. The student must come to Student Health and Counseling Services with documentation of completing at least one (1) of the injections. The student will be permitted to register after the Student Health Services staff annotates that the student is in partial fulfillment of this requirement. After students register, a registration hold for the

3. Meningococcal Disease following semester will be placed again until completion of the Hepatitis B series of injections. Beginning with the opening of university housing, California State University San Marcos will provide information regarding meningococcal disease to all incoming freshmen that will be residing in on-campus housing. Each incoming freshman who will be residing in on-campus housing is required to return to the campus a response form indicating that s/he has received the information provided; whether or not s/he has chosen to receive the vaccination; and s/he must sign the response form prior to returning it with all housing documents to the campus housing management partner. Failure to return the completed form will result in a delay in securing on-campus housing. California State University San Marcos will maintain the completed forms in accordance with the campus' health care records policy. 3.1.1 Written information regarding this requirement will be available in various means. These include, but are not limited to: Mailed informational letter and state approved information sheet that contains the response form sent to applicants for on-campus housing. Printed information in the University Catalog. Printed information in the Class Schedule. Printed information in the Student Guidebook. Information accessible through the Student Health and Counseling Services and the Student and Residential Life Web pages. 3.1.2 Oral presentations of this information are available to students through: Presentations delivered at New Student Orientations. Recorded information on the Student Health and Counseling Services phone tree. Calling the main clinic number (Ext. 4915) and selecting the appropriate information box access this information.

3.2.1 The response form regarding meningicoccal infection is to be signed and returned to the housing management partner as outlined in the directions for the completion of housing documents. Once received and processed, the form will be maintained by the housing management partner in accordance with the campus health records policy, and access to this information will be limited to the housing partner, Chief Housing Officer, or designee. 3.2.2 Students may elect to receive the vaccination prior to arrival for their first semester on campus. This vaccine may be obtained at: Private Medical Provider office County Health Clinic Community Health Clinic Student Health and Counseling Services after the start of their first academic term