I am in the process of completing the requirements on my Health Screening Record but I won’t be finished by the submission deadline date. Do I wait and hand everything in at once or submit what I have?

Please complete as much of the form as possible and be sure to submit your Health Screening form on time. Once we review the form, we will notify you if any additional vaccinations and/or lab tests are required. We may be able to grant a provisional clearance when certain requirements such as vaccinations cannot be completed until after your program start date.

What are the mandatory requirements which must be completed before I can participate in clinical activities?

1. COVID-19:  Proof of vaccination with a full series of a COVID-19 vaccine according to NACI guidelines OR McMaster approved medical/non-medical exemption, see: https://fhs.mcmaster.ca/healthscreening/

2. Tuberculosis:  EITHER negative two-step tuberculin skin testing (TST), and additional single TST if required (see below); OR positive TST or other positive TB history, and a negative chest x-ray dated subsequent to the positive TST or other positive TB history, and verification of no symptoms of TB disease.

3. Pertussis: One adult tetanus-diphtheria-pertussis vaccine (Tdap) age 18 years or older.

4. Measles, Mumps, Rubella:  Two measles vaccines, two mumps vaccines, and one rubella vaccine given at age 12 months of age or older and spaced at least 28 days apart is mandatory for Undergraduate/Graduate health professional programs and Non-Professional programs.  Vaccination is also recommended for visiting undergraduate medical students and postgraduate medicine, however positive serology for immunity (IgG antibody) will also be accepted.

5. Varicella: Two vaccines given at age 12 months of age or older and spaced at least 28 days apart, OR positive IgG antibody serology.

6. Blood Borne Viruses: Tests for Hepatitis B infection (HBsAg), HIV and Hepatitis C (required for Midwifery, Physician Assistant and Undergraduate Medicine programs ONLY).

Are there other requirements I can complete after I start my program?

7 Tetanus-Diphtheria-Polio:  Must have completed 1 dose of a 3 dose series prior to program start. The second and third doses may be completed after your program start date.

8. Hepatitis B: Must have completed baseline anti-HBs serology and 1 dose of a 3 dose series prior to program start. The second and third doses and your post-immunization test for immunity (anti-HBs serology) may be completed after your program start date.

9. Influenza: Annual influenza immunization with seasonal vaccine to be completed in the fall and before November 30th.

 

I had blood tests in the past which showed immunity. Do I have to have this repeated?

• Previous serology for measles, mumps, rubella, and varicella immunity should not be repeated.  
• Serology for measles, mumps, and rubella immunity is not recommended either before or after vaccination.
• Serology for varicella immunity is not recommended after vaccination. 
• Positive serology for Hepatitis B (anti-HBs) tested after a documented vaccination series should not be repeated; positive serology alone is not considered proof of immunity if documented vaccines are missing or incomplete and should be repeated after completion of a documented series.

I had all my childhood vaccines but they are not in English. Will you accept them?

Yes, but please provide an official translation with your documentation.

I am an international visiting elective student or postgraduate fellow and the mandatory vaccines are not available in my home country. What do I do?

The vaccines must be completed after you arrive in Canada. Please leave sufficient time to complete the requirements before your start date. International Postgraduate Medical students can visit McMaster's Student Wellness Centre for a fee. Please contact hrsadmin@mcmaster.ca for further information. 

 

1. Tuberculosis (TB):

What tests do I need for TB screening? 

All students without previously documented positive tuberculin skin testing (TST) or other positive TB history need to provide a fully documented two-step TST. A two-step TST is two separate tests given between 7 days and 12 months apart (ideally 7-28 days), requiring four visits to your health care provider. A TST must be given either before, or at least 28 days after a live vaccine (e.g. MMR, Varicella). A two-step TST from any time in the past is accepted and does not need to be repeated.  

NOTE:  We accept IGRA serology (QuantiFERON, T-Spot) for international visiting elective students and fellows ONLY in place of a two-step TST who cannot access skin testing in their home country, we recommend completing a two-step TST after arriving in Canada (may be completed after program start).

I have completed a negative two-step TST.  Do I need any further testing? 

• Undergraduate/Graduate health professional programs:You need to document TST dated within 6 months prior to your program start date.
• Postgraduate Medicine: New trainees and international elective students need to document TST dated within 12 months prior to submitting the form.  Visiting elective students from other Canadian Universities need to document TST dated within 12 months of their home school postgraduate program start date.
• Non-professional programs:  You need to document TST dated within 12 months prior to submitting your form.

I have never had a two-step TST, but I had a single TST in the past. Do I just need a single-step test now?

If the single TST was less than 12 months ago, you just need another single TST now. If the single TST was more than 12 months ago, a full two-step TST is required.

What if I had a previous positive TST or other positive TB history?

The positive test must be fully documented with mm induration and date, otherwise you will need to initiate a two-step TST.  You need to provide a chest x-ray report dated subsequent to the positive TST. If the chest x-ray is negative and you do not have symptoms of active TB disease, you will be cleared for clinical activities without restrictions.

What if I am exposed to TB after I start my program?

• Undergraduate and Graduate health professional programs: If previous TB screening was negative, you need to have a single TST eight or more weeks after exposure to active (infectious) TB during your program. If your TST converts from negative to positive, you need to withdraw from clinical activities and report immediately to your Program Manager and the Health Screening Office; the Health Screening Office will determine when you may return to clinical activities.
• Postgraduate Medicine: Report to the hospital Employee Health Services; documentation is not required by the Health screening Office.  If your TST converts from negative to positive, you need to withdraw from clinical activities and report immediately to your clinical supervisor.
• Non-Professional programs:  Report to your clinical supervisor; documentation is not required by the Health Screening Office. If your TST converts from negative to positive, you need to withdraw from clinical activities and report immediately to your clinical supervisor. 

Do I need to have a repeat TST during my program?

• Undergraduate/Graduate health professional programs: Annual TB risk assessment is required for all students.  For students with previous negative screening, you will need to have a single TST only if you answer yes to any of the questions (NOTE: some placement sites may require a more recent TST; students are responsible to be aware of their placement site’s requirements). For details, click on Annual TB Screening Form
• Postgraduate Medicine: Repeat screening is not required by the Health Screening Office unless you are returning to McMaster after an absence of 12 months or more.
• Non-Professional programs:  Repeat screening is not required by the Health Screening Office.

2. Pertussis:

What if I am under 18 years old – do I still need the adult pertussis vaccine?

If you are under age 18 years when the Year One Health Screening Record or Non-Professional Health Screening Record is completed, you are required to document an adolescent Tdap vaccine (tetanus-diphtheria-pertussis) given age 14-17 years. A booster dose of vaccine will be required after you turn 18 years old.

I am over 18 years old but I had a pertussis booster when I was 14 and my doctor said it is good for ten years. Do I still need the adult pertussis vaccine?

Yes. The Ontario Hospital Association requires that all adult health care workers/learners (age 18 years or older) receive a single dose of pertussis vaccine (Tdap), if not previously received in adulthood, even if not due for a booster. The interval between the adolescent tetanus diphtheria booster and the adult Tdap vaccine does not matter.

I had a pertussis booster when 17 years and 11 months old. Do I still need the adult pertussis vaccine?

Yes. Even though you are nearly 18 years old you must be age 18 years or older.

 

3. Measles/Mumps/Rubella:

Should I get serology tests for immunity to measles, mumps and rubella?

• Undergraduate/Graduate health professional programs and Non-Professional programs:  No, we only accept vaccination for measles, mumps and rubella. 
• Postgraduate Medicine:  We recommend you have two MMR vaccines spaced at least 28 days apart, regardless of age. Serologic testing for immunity (IgG antibody) either before or after vaccination is not recommended but will be accepted. 

4. Varicella:

I had chickenpox as a child, do I still need the varicella vaccine?

We do not accept a history of chickenpox or shingles as proof of immunity to Varicella. You need to have serologic testing for immunity (Varicella IgG antibody). If you are not immune you must receive two doses of Varicella vaccine spaced at least 28 days apart (6 weeks recommended).

What if I do not remember if I ever had chicken pox?

We recommend you have a test for immunity first anyway (Varicella IgG antibody), if you are not immune you must receive two doses of Varicella vaccine, spaced at least 28 days apart (6 weeks recommended). It is also safe to get vaccinated for Varicella without having any testing first.  Remember it can take a few weeks to get the serology test results back and then another month to have the vaccines completed.

I had one Varicella vaccination as a child, do I need another varicella vaccine?

You must have a second vaccination now. The interval from the first vaccine does not matter. Serology for immunity is not recommended either before or after the second vaccine. Note the cost of the vaccine is covered by the Ontario health plan for students born after Jan 1, 2000.

 

5. Tetanus/Diphtheria/Polio:

What if I can’t find my childhood vaccination records for tetanus/diphtheria/polio?

• Undergraduate/Graduate health professional programs:  You must complete a fully documented vaccination series (three doses each).  All previous documented vaccinations count towards the total series as long as minimum spacing requirements are met. Note, the adult pertussis vaccine (Tdap) counts as one tetanus/diphtheria dose.  This may be in process at the time you start your program, deadlines are determined by the Health Screening Office. 
• Postgraduate Medicine and Non-Professional programs:  We recommend you complete a documented vaccination series (minimum 3 doses).  This may be in process at the time you start your program. 

6. Hepatitis B immunization:  Note, if you have chronic Hepatitis B infection or are immune due to previous natural infection, you are not required to be immunized.

What if I have never been vaccinated for Hepatitis B?

• Undergraduate/Graduate health professional programs:  You must complete a fully documented vaccination series plus serology for immunity (anti-HBs) at least 28 days after the series is completed. This may be in process at the time you start your program, deadlines are determined by the Health Screening Office.   
• Postgraduate Medicine and Non-Professional programs:  We recommend you have a fully documented vaccination series plus serology for immunity.  This may be in process at the time you start your program. 

What if the anti-HBs serology is positive but my immunization records are missing or incomplete?

You are considered susceptible to infection. You should complete a fully documented vaccination series plus repeat anti-HBs serology at least 28 days after the series is completed. All documented doses of vaccine count towards the total series as long as minimum spacing requirements are met.

What do I do if I am not immune to Hepatitis B (anti-HBs < 10 IU/L)?

If you have not documented a Hepatitis B vaccination series, this needs to be completed first, plus repeat anti-HBs serology at least 28 days after the series is completed. All documented doses of vaccine count towards the total series as long as minimum spacing requirements are met. If you are not immune after one documented vaccination series, you will need up to three booster doses vaccine plus repeat anti-HBs serology.

What if I am not immune to Hepatitis B after one documented vaccination series?

If the series was completed more than six months ago, you need ONE booster plus repeat anti-HBs serology one month later. If not immune after the first booster, you need TWO additional boosters spaced five months apart plus repeat anti-HBs serology one month after the third booster. If the series was completed between one and six months ago, you need a second vaccination series plus repeat anti-HBs serology one month after completion of the second series.

What if I am not immune to Hepatitis B after two documented vaccination series?

You are considered a vaccine non-responder and are unlikely to benefit from further immunizations. Repeat serology is not required. It is possible that a person who does not respond to the vaccine may already be infected with Hepatitis B, therefore testing for HBsAg (Hepatitis B surface antigen) is recommended.

 

7. Influenza:

Do I need a flu shot?

The flu shot is the best defence to protect you and your patients from infection with influenza virus. Annual influenza immunization for clinical placements occurring between November and June is mandatory for health professional programs. The McMaster Student Wellness Centre and most pharmacies provide the flu vaccine at no cost. Provide documentation of immunization to the Health Screening Office and keep a copy for your own records as placement sites may require proof.

 

8. Blood borne viruses Hepatitis B, Hepatitis C, and HIV:

Do I need to have testing for blood borne viruses?

• Midwifery, Physician Assistant and Undergraduate Medicine programs:  Testing is required dated after March 1st the year of program entry.  Tests are valid for 4 years during your program and also need to be repeated if you are returning to your program after a leave of more than 12 months.  Note, test for Hepatitis B infection (HBsAg = surface ANTIGEN) is a different test than the test for immunity (anti-HBs = surface ANTIBODY) and is required even if you are immune. You must report positive test results to your Assistant Dean before you start your program.
• Postgraduate Medicine:  Serologic testing for blood borne viruses is not required by the Health Screening Office. Learners who have been tested must SELF-REPORT any positive serology to the Associate Dean of Postgraduate Medical Education PRIOR to program/elective start; reports are not required by the Health Screening Office.
• All other programs:  Testing and/or reporting is not required.

What do I do if my tests are positive?

You need to report the results to the Assistant/Associate Dean of your program; you do not need to report the results to the Health Screening Office.  You cannot participate in clinical activities until cleared by your program.  NOTE:  This only applies to Midwifery, Physician Assistant, Undergraduate and Postgraduate Medicine programs; reporting is not required for other programs.