Immunizations in College Health: The Remaining Tasks

Vaccine-preventable diseases, particularly measles and rubella, continue to have an adverse impact on health on college campuses. During 1985, 354 cases of measles (12.6% of the national total) occurred on 26 campuses in 14 states and the District of Columbia. Nearly two-thirds of college students with measles in 1985 had inadequate evidence of immunity. A total of 65 students (18.4%) required hospitalization; 3 died, accounting for all measles-related deaths in 1985. In 4 outbreaks accounting for 103 (29.1%) college cases, the index case was a student who acquired measles while traveling abroad. During 1983-1985, 7 rubella outbreaks were reported on the nation's campuses with 132 cases (6% of the national total). Three-quarters of college students with rubella had inadequate evidence of immunity. Measles and rubella can be eliminated from college campuses if college health services, clinicians, and public health officials (1) work to maintain high immunization levels, (2) improve surveillance and report suspected measles and rubella cases immediately, and (3) promptly intervene to control outbreaks. Ideally, college and university administrators, public health officials, and legislators should collectively work toward adoption and enforcement of college prematriculation immunization requirements. Maintaining accurate immunization records is also essential. In addition to measles and rubella immunization, prematriculation requirements should include mumps vaccine, tetanus-diphtheria toxoid (Td), which is needed every 10 years after primary immunization, and polio vaccine. Colleges should also educate their students at high risk for hepatitis B (such as homosexual males, health professional students, and students working in highly endemic areas). Finally, colleges should monitor the immunization needs of students traveling abroad.