Health Records

Immunization Requirements for Post-secondary Students

NY State Public Health Law 2165

This law requires all post-secondary students born on or after January 1, 1957, and enrolled in six or more credit hours, to provide proof of immunity to measles, mumps, and rubella.  Appropriate documentation must include ONE of the following:

  • Documentation of TWO (2) MMR vaccinations.  To be considered valid, the first vaccination cannot be administered any more than four days prior to the student’s first birthday, and the second dose must be given at least 28 days after the first dose. 
  • Documentation of TWO (2) doses of the measles vaccination, ONE (1) dose of the mumps vaccination, and ONE (1) dose of the rubella vaccination.  To be considered valid, neither vaccination can be administered any more than four days prior to the student’s first birthday, and the SECOND dose of the measles vaccination must be given at least 28 days after the first dose.
  • POSITIVE blood titer results for measles, mumps, and rubella.  Copies of a lab report(s) validating these results must be submitted.

 
 NY State Public Health Law 2167

This law requires all post-secondary students enrolled in six or more credit hours to submit a “Meningococcal Disease Response Form”.  This law also requires all post-secondary institutions to distribute information about meningococcal disease and immunization to all students (or parents/ guardians of students under the age of 18). 

This is not a mandatory vaccination, however, all students (regardless of age) enrolled in 6 or more credits are required to provide one of the following in response to the meningococcal/meningitis vaccination:

  • Documentation of a meningococcal/meningitis vaccination within five years prior to your entry into NCCC.
  • After acknowledging the risks of meningococcal/meningitis disease, you may decline the vaccination by completing/signing the below Meningococcal Disease Response Form.

Where can I get a copy of my immunization record?

To assist you in obtaining this required information, please refer to the “Frequently Asked Questions”. 

Penalty for non-compliance with NY State’s Public Health Laws 2165 and 2167

All required documentation must be submitted to the Health Records Office at NCCC by the established deadline date upon the student’s first attendance date at the college.  Students not in compliance with NY State Public Health Laws 2165 and 2167 by this deadline date will be prohibited from attending classes at NCCC until all required documents have been submitted.  Additionally, a hold will be placed on their NCCC student account, which means they will not be able to receive any financial aid refund monies they are due, they will be unableto register for another semester at NCCC, and their grades and any transcript requests will be put on hold until this information has been submitted.

Where/how to send your immunization documents to NCCC

Mail to:  NCCC Health Records Office, PO Box 89, Saranac Lake, NY  12983
E-mail:   healthrecords@nccc.edu
Fax:        518-891-7405

Questions?
Call Kathy Goodrow at 518-891-2915, ext. 1204

NORTH COUNTRY COMMUNITY COLLEGE
Meningococcal Disease Declination Form

NY State Public Health Law 2167 recommends that all post-secondary students enrolled in six or more credits of ON-CAMPUS classes to submit proof that they have received a Meningococcal vaccination within five years of their attendance at a post-secondary institution.  This law also requires all post-secondary institutions to distribute information about Meningococcal disease and immunization to all students (or parents/ guardians of students under the age of 18).

OR

Since this is NOT a required immunization, this requirement can be met by signing and dating the declination statement on the bottom of this form. Signing this webform fullfills your requirement to submit a Meningococcal Disease Declination Form to North Country Community College.

Please provide the student's full name as it appears on medical records.
Please provide the student's current street address including apartment number, if applicable.

[Note:  The Advisory Committee on Immunization Practices recommends that all first-year college students up to age 21years should have at least one dose of the Meningococcal vaccine not more than five years before enrollment, preferably on or after their 16thbirthday, and that young adults aged 16-23 years may choose to receive the meningococcal B vaccine series.  College students should discuss the Meningococcal B vaccine with a healthcare provider.]

Signature
Please click below to verify declination of recommended Meningococcal vaccination.
Enter your full name - Parent/guardian signature if student is under 18 years of age.
Please write today's date.