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Student Immunization History Form

New York State law and/or New York University requires that all students (graduate, undergraduate and transfers) provide the University with:

  • Certification from a health care provider or other acceptable evidence that they have received immunization against measles, mumps and rubella ; or
  • Evidence of immunity by history of disease or serological evidence.



Student Immunization Requirements:

  • Two doses of MMR (Measles, Mumps and Rubella)
    - First dose must be on or up to four days before first birthday, AND on or after Jan 1, 1972;
    - Second dose must be at least 15 months after birth or later, AND at least 28 days after 1st dose.

- OR -

  • Measles - Physician diagnosed history of disease or immunity by serological evidence (must submit lab report).
  • Mumps - Physician diagnosed history of disease or immunity by serological evidence (must submit lab report).
  • Rubella - One dose immunity by serological evidence (must submit lab report).

Meningococcal Meningitis - Receive written information from the University about meningococcal meningitis and meningitis immunization, and complete a meningococcal meningitis response form certifying either that they have received such immunization within the past ten years, or that they have received the written information from the University and understand the risks of meningococcal meningitis but have chosen not to be immunized against it.

New UNDERGRADUATE Students Please Note - All newly admitted undergraduate students must provide evidence of vaccination for meningococcal meningitis.


Student Immunization History Form FAQs:

  • Where do I get the Student Immunization History form?
    The Student Health Center mails a packet of information regarding health requirements to all new incoming students. The Student Immunization History form is included in this packet for new students.


  • What if I never received the Student Immunization History form?
    If you are a new student and you did not receive the form in the mail, please send an email to health.requirements@nyu.edu and provide us with your complete address. We will mail a form to you.


  • Why do you need the information requested on the Student Immunization History form?
    To comply with New York State Public Health Law 2165, which requires all students taking six (6) credits or more in a degree granting program to provide proof of immunization to measles, mumps, and rubella;

    To comply with New York State Public Health Law 2167, which requires the distribution of information to students regarding meningitis and all students taking (6) credits or more in a degree granting program to provide a signed response regarding receipt of such information;

    To proactively address emerging health threats to a student residential population in a higher education campus setting; and

    To protect the overall health, safety, and welfare of the New York University campus and community.


  • Is the meningitis vaccination required?
    It is required for all new incoming freshmen.


  • Why is the meningitis vaccine only required for freshmen?
    Anyone can get meningococcal disease. For some college students, such as freshmen living in dormitories, there is an increased risk of meningococcal disease. Between 100 and 125 cases of meningococcal disease occur on college campuses every year in the United States; between 5 and 15 students die each year as a result of infection.


  • So then what are the immunization requirements for incoming undergraduate students?
    • Have your health care provider complete the immunization information for Measles, Mumps and Rubella (MMR) and Meningitis
    • Have your health care provider sign and date the form
  • So then what are the immunization requirements for incoming graduate students?
    • Provide a response regarding meningitis immunization
    • Have your health care provider complete the information in the immunization for Measles, Mumps and Rubella (MMR)
    • Have your health care provider sign and date the form
  • What if I only have my immunization information in an Immunization Record Card or baby book from my pediatrician?
    We will accept the information; however, you must fill the dates of immunization out on the Student Immunization History form and attach a copy of your permanent record. In addition, the Student Immunization History form requires a doctor's signature.


  • If I have my own copy of health and immunization records, is it still necessary to complete the Student Immunization History form?
    Yes (unless your records fall into the category above). The Student Immunization History form needs to be scanned and must be submitted in it's original format. You must complete the form and have it signed and stamped by a medical provider.


  • When is the Student Immunization History form due?
    We ask that you return the Student Immunization History form no later than August 15, 2009 if you are a new student for Fall 2009. Failure to comply with New York State and NYU requirements will result in denial of registration privileges.


  • Where do I drop off the required information?
    New students should return required documents in the envelope included in the packet of information they receive from the Student Health Center or it can be dropped off in person. Returning students should mail the information (or come in person) to:
            NYU Student Health Center
            Immunization Record Services
            726 Broadway, Suite 357
            New York, NY 10003-9502
  • Who can I contact if I have any questions?
    Send an email to health.requirements@nyu.edu.