Deadline for Fall 2017 Flu Shots is October 23rd at 5 p.m. (NEW DATE)
To protect patients and provide a safe environment for students, staff, and the public, all students/faculty participating in clinicals/practicum during the Fall 2017 and Spring 2018 semester are required to get the current seasonal flu vaccine. Failure to have the immunization may have implications for clinical attendance.
One of the following forms of documentation is required and must be signed by the administering healthcare provider:
- Letter (on official letterhead) from the healthcare provider, pharmacy or clinic that issued the vaccination.
- Copy of immunization record showing student/faculty name as having received the vaccine.
The following information must be included: Lot Number, Expiration Date, and Site of Administration (examples below)
- 0.5 mL IM Influenze Virus Vaccine given in ____left ____ right deltoid–TIV or QIV
- 0.5 mL IM Influenze HIGH Dose Virus Vaccine given in ____ left ____ right deltoid (65+) TIV-SR
- 0.2 mL Live Attenuated influenza Virus Vaccine given intranasally (half each nostril)
- 0.5 mL Intradermal Virus Vaccine site ___________________________-TIV
- 0.5 mL FluBlok Influenze Virus Vaccine given in ____ left ____ right deltoid
Please note that even if the flu vaccine is received in a “public” clinic, the information on the form must be completed in order to meet the clinical agency requirements. Students/faculty are responsible for keeping their personal vaccine records until further instructions are provided. You may use the Vaccine record below, but you must have your receipt for proof/documentation. If you rotate to multiple agencies within the same semester, you may be providing the documentation at each agency.
If you receive the nasal flu vaccine (LAIV), inform your healthcare provider before receiving the TB skin test due to timing issues.
Students are not to give the record to their clinical instructor at this time. If you receive a receipt when you get the flu vaccine, please attach a copy to the Flu Vaccine Record.
MAINTAIN YOUR DOCUMENTATION AND KEEP A COPY WITH YOU AT CLINICAL AGENCIES AT ALL TIMES.
Below is the schedule for Austin/Travis County Health and Human Services Department. You may also contact your physician or other retail facilities offering flu vaccine (HEB, CVS, Walgreens, etc). Many are offering free or reduced shots to certain populations.
Department of Health and Human Services Flu Vaccine Finder
ACC Flu Shot Consent Form (updated 09-25-17)
Declination Form for Seasonal Influenza Vaccine
Influenza Vaccine—Vaccine Information Sheet