Brown University requires all medical students to provide written documentation of the following on the Medical Student Immunization, Titers & Tuberculosis Screening Record. 

Vaccine Requirements:

COVID-19

A record of a one or two dose COVID-19 vaccine series AND a booster dose if >5 months after initial series completion. Please know that some clinical sites will require a Bivalent booster dose.

Hepatitis B

A record of Hepatitis B vaccine series. After series completion, a quantitative Hepatitis B Surface Antibody titer must be completed, a copy of the lab report must be submitted.

Measles, Mumps and Rubella

A record of two (2) MMR vaccines OR two (2) doses of Measles, two (2) doses of Mumps and one (1) dose of Rubella; OR serologic proof of immunity for Measles, Mumps and Rubella. History of disease is not acceptable.  A copy of the lab reports must be submitted.

Meningococcal A, C, Y, W-135

Required for students 22 years old or younger: dose must be given after 16th birthday.

Tetanus/Diphtheria/Pertussis

One dose of adult Tdap. If the last Tdap dose is more than 10 years old, then a Tetanus Diphtheria (Td) or Tdap booster is required.

Varicella

A record of two Varicella vaccines OR if a history of chickenpox disease, serologic proof of immunity for Varicella (chickenpox) is required. History of disease alone is not acceptable.  A copy of the lab report must be submitted.

Tuberculosis Screening

A record of two tuberculosis skin test (TST) – two tests 1-3 weeks apart OR one IGRA blood test (Quantiferon/T-Spot), completed within 6 months of arrival at Brown. If there is a positive result to either test, documentation of a negative chest x-ray and history of latent TB treatment must be attached.

Influenza

The Influenza vaccine will be required this upcoming Fall. Flu vaccine clinics will be held at the medical school, information will be forthcoming.

Recommended, Not Required Vaccines 

Document any additional immunizations on page 2 of the immunization record form

Submission Requirements:

• If you attended Brown in the past, login to the Brown Health Services Patient Portal and click on immunization history to verify that you have received all required vaccines and titers. If not, please obtain the missing vaccine(s) and titer and upload the documentation. 
• Print the Medical Student Immunization, Titers & TB Screening Record and review the requirements for immunizations and serologic testing.
• Contact your medical provider for form completion and for further immunizations and testing if indicated. We will also accept official immunization records from your provider, previous school, or health department.
• Rhode Island state law requires all students to provide written documentation of their immunizations.  Brown University requires serologic testing for all medical students. Two-step tuberculosis screening is required within the past 6 months, if indicated. 
• Log onto your patient portal at https://patientportal.brown.edu
  • Select “Upload” to submit your immunization records and serology lab results
  • Select “Immunizations” to enter the dates of your immunizations, titers, and TB testing

We will also accept official immunization records from your provider, previous school or health department, but please be sure to fulfill all requirement as documented on the Brown form.

The information on this form provides our staff with an overview of your health status and past medical history, allows us to provide you with the best care possible and to meet your health care needs. All medical information is strictly confidential, and cannot be released to anyone (including your parents, professors) without your authorization.

This form must be completed by the student only. It does not need to be completed nor reviewed by your medical provider.

• Log onto your patient portal at https://patientportal.brown.edu
  • Select “Forms” and complete the Health History Form

• Log onto your patient portal at https://patientportal.brown.edu
  • Select “Forms” and complete the Authorization for Medical Care and Treatment Form

This form must be completed prior to N95 Mask Fitting which will occur during orientation.

• Log onto your patient portal at https://patientportal.brown.edu
  • Select “Forms” and complete the Respiratory Medical Evaluation Form

• Log onto your patient portal at  https://patientportal.brown.edu
  • Select “Upload” to submit your Medical Insurance Card or Prescription Benefit Card, if applicable
  • Upload of copy of both sides of your card(s)

If your insurance changes in the future, please upload a copy of your new card or bring the card to Health Services so we can update your information.