(see reverse side)
Updated January 2018
Information about Meningococcal Disease, Meningococcal Vaccines, Vaccination
Requirements and the Waiver for Students at Colleges and Residential Schools
Colleges: Massachusetts requires all newly enrolled full-time students 21 years of age and under attending a
postsecondary institution (e.g., colleges) to: receive a dose of quadrivalent meningococcal conjugate vaccine on or after
their 16
th
birthday to protect against serotypes A, C, W and Y or fall within one of the exemptions in the law, discussed on
the reverse side of this sheet.
Residential Schools: Massachusetts requires all newly enrolled full-time students attending a secondary school who will
be living in a dormitory or other congregate housing licensed or approved by the secondary school or institution (e.g.,
boarding schools) to receive a dose of quadrivalent meningococcal conjugate vaccine to protect against serotypes A, C, W
and Y or fall within one of the exemptions in the law, discussed on the reverse side of this sheet.
The law provides an exemption for students signing a waiver that reviews the dangers of meningococcal disease and
indicates that the vaccination has been declined. To qualify for this exemption, you are required to review the information
below and sign the waiver at the end of this document. Please note, if a student is under 18 years of age, a parent or legal
guardian must be given a copy of this document and must sign the waiver.
What is meningococcal disease?
Meningococcal disease is caused by infection with bacteria called Neisseria meningitidis. These bacteria can infect the
tissue that surrounds the brain and spinal cord called the “meninges” and cause meningitis, or they can infect the blood or
other body organs. Symptoms of meningitis may appear suddenly. Fever, severe and constant headache, stiff neck or neck
pain, nausea and vomiting, and rash can all be signs of meningitis. Changes in behavior such as confusion, sleepiness, and
trouble waking up can also be important symptoms. In the US, about 1,000-1,200 people get meningococcal disease each
year and 10-15% die despite receiving antibiotic treatment. Of those who live, another 11-19% lose their arms or legs,
become hard of hearing or deaf, have problems with their nervous systems, including long term neurologic problems, or
suffer seizures or strokes.
How is meningococcal disease spread?
These bacteria are passed from person-to-person through saliva (spit). You must be in close contact with an infected
person’s saliva in order for the bacteria to spread. Close contact includes activities such as kissing, sharing water bottles,
sharing eating/drinking utensils or sharing cigarettes with someone who is infected; or being within 3-6 feet of someone who
is infected and is coughing or sneezing.
Who is at most risk for getting meningococcal disease?
High-risk groups include anyone with a damaged spleen or whose spleen has been removed, those with persistent
complement component deficiency (an inherited immune disorder), HIV infection, those traveling to countries where
meningococcal disease is very common, microbiologists who work with the organism and people who may have been
exposed to meningococcal disease during an outbreak. People who live in certain settings such as college freshmen living
in dormitories and military recruits are also at greater risk of disease from some of the serogroups.
Are some students in college and secondary schools at risk for meningococcal disease?
College freshmen living in residence halls or dormitories are at an increased risk for meningococcal disease caused by
some of the serotypes contained in the quadrivalent vaccine, as compared to individuals of the same age not attending
college. The setting, combined with risk behaviors (such as alcohol consumption, exposure to cigarette smoke, sharing food
or beverages, and activities involving the exchange of saliva), may be what puts college students at a greater risk for
infection. There is insufficient information about whether new students in other congregate living situations (e.g., residential
schools) may also be at increased risk for meningococcal disease. But, the similarity in their environments and some
behaviors may increase their risk.
The risk of meningococcal disease for other college students, in particular older students and students who do not live in
congregate housing, is not increased. However, quadrivalent meningococcal vaccine is a safe and effective way to reduce
their risk of contracting this disease. In general, the risk of invasive meningococcal B disease is not increased among
college students relative to others of the same age not attending college. However, outbreaks of meningococcal B disease
do occur, though rarely, at colleges and universities. Vaccination of students with meningococcal B vaccine may be
recommended during outbreaks.
Provided by: Massachusetts Department of Public Health / Division of Epidemiology and Immunization / 617-983-6800
MDPH Meningococcal Information and Waiver Form Updated January 2018
Is there a vaccine against meningococcal disease?
Yes, there are 2 different meningococcal vaccines. Quadrivalent meningococcal conjugate vaccine (Menactra and Menveo)
protects against 4 serotypes (A, C, W and Y) of meningococcal disease. Meningococcal serogroup B vaccine (Bexsero and
Trumenba) protects against serogroup B meningococcal disease. Meningococcal conjugate vaccine is routinely
recommended at age 11-12 years with a booster at age 16. Students receiving their first dose on or after their 16
th
birthday
do not need a booster. Individuals in certain high risk groups may need to receive 1 or more of these vaccines based on
their doctor’s recommendations. Adolescents and young adults (16-23 years of age) who are not in high risk groups may be
vaccinated with meningococcal B vaccine, preferably at 16-18 years of age, to provide short-term protection for most strains
of serogroup B meningococcal disease. Talk with your doctor about which vaccines you should receive.
Is the meningococcal vaccine safe?
Yes. Getting meningococcal vaccine is much safer than getting the disease. Some people who get meningococcal vaccine
have mild side effects, such as redness or pain where the shot was given. These symptoms usually last for 1-2 days. A
small percentage of people who receive the vaccine develop a fever. The vaccine can be given to pregnant women. A
vaccine, like any medicine, is capable of causing serious problems such as severe allergic reactions, but these are rare.
Is meningococcal vaccine mandatory for entry into secondary schools that provide housing, and colleges?
Massachusetts law (MGL Ch. 76, s.15D) and regulations (105 CMR 220.000) requires both newly enrolled full-time
students attending a secondary school (those schools with grades 9-12) who will be living in a dormitory or other
congregate housing licensed or approved by the secondary school or institution and newly enrolled full-time students 21
years of age and younger attending a postsecondary institution (e.g., colleges) to receive a dose of quadrivalent
meningococcal vaccine.
At affected secondary schools, the requirements apply to all new full-time residential students, regardless of grade
(including grades pre-K through 8) and year of study. Secondary school students must provide documentation of having
received a dose of quadrivalent meningococcal conjugate vaccine at any time in the past, unless they qualify for one of the
exemptions allowed by the law. College students 21 years of age and younger must provide documentation of having
received a dose of quadrivalent meningococcal conjugate vaccine on or after their 16
th
birthday, unless they qualify for one
of the exemptions allowed by the law. Meningococcal B vaccines are not required and do not fulfill the requirement for
receipt of meningococcal vaccine. Whenever possible, immunizations should be obtained prior to enrollment or registration.
However, students may be enrolled or registered provided that the required immunizations are obtained within 30 days of
registration.
Exemptions: Students may begin classes without a certificate of immunization against meningococcal disease if: 1) the
student has a letter from a physician stating that there is a medical reason why he/she can’t receive the vaccine; 2) the
student (or the student’s parent or legal guardian, if the student is a minor) presents a statement in writing that such
vaccination is against his/her sincere religious belief; or 3) the student (or the student’s parent or legal guardian, if the
student is a minor) signs the waiver below stating that the student has received information about the dangers of
meningococcal disease, reviewed the information provided and elected to decline the vaccine.
Where can a student get vaccinated?
Students and their parents should contact their healthcare provider and make an appointment to discuss meningococcal
disease, the benefits and risks of vaccination, and the availability of these vaccines. Schools and college health services
are not required to provide you with this vaccine.
Where can I get more information?
Your healthcare provider
The Massachusetts Department of Public Health, Division of Epidemiology and Immunization at (617) 983-6800
or www.mass.gov/dph/imm and www.mass.gov/dph/epi
Your local health department (listed in the phone book under government)
Waiver for Meningococcal Vaccination Requirement
I have received and reviewed the information provided on the risks of meningococcal disease and the risks and benefits of
quadrivalent meningococcal vaccine. I understand that Massachusetts’ law requires newly enrolled full-time students at
secondary schools who are living in a dormitory or congregate living arrangement licensed or approved by the secondary
school, and newly enrolled full-time students at colleges and universities who are 21 years of age or younger to receive
meningococcal vaccinations, unless the students provide a signed waiver of the vaccination or otherwise qualify for one of
the exemptions specified in the law.
After reviewing the materials above on the dangers of meningococcal disease, I choose to waive receipt of
meningococcal vaccine.
Student Name: _______________________________________ Date of Birth: _________ Student ID: _______________
Signature: __________________________________________________ Date: _________________
(Student or parent/legal guardian, if student is under 18 years of age)
click to sign
signature
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