UNIVERSITY OF CALIFORNIA
Office of the President
May 7, 1986

I.

PREAMBLE

While both measles and rubella may be mild diseases when they occur in childhood, measles, in particular, can have serious sequelae. Immunization programs, begun in 1963 for measles and in 1969 for rubella, have sharply reduced the incidence of these diseases, although neither has yet been eradicated. In California, children have been required to show proof of immunity of these diseases before entering school; since 1968 for measles and since 1980 for rubella. For adults, both diseases are of more consequence than they are to children; measles is a more serious illness in itself, and rubella poses the risk of fetal damage to pregnant women who contract the disease.

The University is concerned about measles and rubella because recent epidemiological data indicate that there is a cohort of adolescents and young adults who are vulnerable to these diseases. Many of this group, born between 1957 and 1967, are too young to have acquired natural immunity and just old enough to have missed participation in effective vaccination campaigns; others grew up in parts of the country or the world where immunization was not required. Although the incidence rates for measles and rubella on college campuses are low and susceptibility levels appear to be declining, the college-age population (student and non-student alike) is at some risk. Because outbreaks of measles and rubella are disruptive to campus activities, are expensive to control, and are a source of risk to other unimmunized populations both on the campus and in the community, and because effective vaccines are available for the prevention of these diseases, the following Measles and Rubella Policy is adopted.

II.

STATEMENT OF POLICY

A.

As a minimum, Chancellors shall ensure the provision of a program of health education about the risks posed by measles and rubella to the campus population and what can be done to reduce these risks. The educational program shall include, but need not be limited to, information about the following:

-- the risks associated with the two diseases as they occur in adults;
-- the susceptibility of the young adult population;
-- how immunity may be attained;
-- what constitutes proof of immunity, and the possible need for revaccination in certain circumstances;
-- the risks associated with vaccination; and
-- the availability of measles and rubella immunization, on campus and at other locations.

The education program shall be supplemented by the provision on campus of services that may be requested by students, such as testing for immunity to measles and rubella, and vaccination or revaccination against these diseases. The program shall be provided even on those campuses whose Chancellors elect to implement a mandatory campus policy (see B. below) for the benefit of the general campus community, and particularly for those individuals who may be exempt from the mandatory requirement.

The Chancellors shall report to the Office of the President on plans for the health education and voluntary immunization program being implemented on the campus, initially by September 1, 1986, and on the progress thereafter annually on July 1, beginning in 1987.

B.

Recognizing that, at a particular location or at a particular time, conditions may evolve that would warrant a mandatory immunization program, Chancellors are authorized, at their discretion, to require, by an effective date to be determined by them, all students (or all students in a high-risk group, such as health professions students) registering on their particular campuses to present appropriate documentation of immunity to rubella and, if born after 1956, of immunity to measles. If such a requirement is implemented, exemptions to it shall be granted only if (1) there are medical contraindications to immunization, in which case the exemption may be granted on a temporary or a permanent basis, depending on the nature of the contraindicating condition, or (2) the student presents a written statement to the effect that the requirement is contrary to his or her personal beliefs.

Prior to implementing this requirement, campus guidelines must be developed and disseminated. Such guidelines should be derived from the best available information and should include, but not be limited to, the following current information:

a.

With respect to measles:

(1)

Persons can be considered immune to measles only if they have documentation of:

-- physician-diagnosed measles,
-- laboratory evidence of measles immunity, or
-- adequate immunization with live measles virus vaccine on or after the first birthday.

Persons born before 1957 are likely to have been infected naturally and generally need not be considered susceptible.

(2)

Precautions and contraindications:

-- live measles virus vaccine should not be given to women known to be pregnant;
-- live measles virus vaccine should not be given to persons with a history of anaphylactic reactions to eggs or neomycin;
-- live measles virus vaccine should not be given to patients with immune deficiency diseases or with the suppressed immune responses that occur with AIDS, leukemia, lymphoma, generalized malignancy, and certain forms of therapy;
-- vaccination of persons with febrile illness should be postponed until recovery; and
-- vaccination should be deferred for three months after a person has received immune globulin, whole blood, or other antibody- containing blood products.

b.

With respect to rubella:

(1)

Persons can be considered immune to rubella only if they have documentation of:

--laboratory evidence of rubella immunity or
--adequate immunization with rubella vaccine on or after the first birthday.

Neither a personal nor a physician-certified history of disease is acceptable evidence of immunity.

(2)

Precautions and contraindications:

--live rubella virus vaccine should not be given to pregnant woman;
--live rubella virus vaccine should not be given to persons with a history of anaphylactic reactions to neomycin;
--live rubella virus vaccine should not be given to patients with immune deficiency diseases or with the suppressed immune responses that occur with AIDS, leukemia, lymphoma, generalized malignancy, and certain forms of therapy; and
-- vaccination of persons with severe febrile illness should be postponed until recovery.

Campus guidelines shall be monitored and brought up-to-date if and when new information becomes available.

If Chancellors choose to require documentation of immunity, they shall report this decision to the Office of the President when it is made, and shall report on the campus experience with the program annually on July 1, beginning in 1987.