AFMC Student Portal Immunization and Testing

 

Key Messages | Immunization Form | Guideline | FAQS
 

Key Messages

  • Some immunization and testing requirements may require months to fulfill.
     
  • Other than when students of Quebec medical schools apply to another Quebec medical school, visiting medical electives applications to Canadian medical schools must include the AFMC Student Portal Immunization and Testing Form ("Form"). Check the Host school's Institution Profile for additional details.
     
  • Use only the most recent version of the Form available on this page.
     
  • Students for whom the 2018 AFMC Student Portal Immunization and Testing Form was already completed may continue to use the 2018 version until the end of the 2018-19 academic year. All others are required to use the 2019 version of the Form once it becomes available on November 23rd, 2018.
     
  • Most of the Form must be completed by an appropriate health care professional (HCP) whose scope of practice includes immunization. Close family members and postgraduate residents are not permitted to complete any part of the Form.
     
  • The student must complete Section A on page 1 and if required for a student's circumstances, Appendices A, B and D.
     
  • The student is responsible for ensuring that all sections are complete prior to submitting the Form.
     
  • Once complete, the student must upload the Form and required appendices and reports as a single PDF file.
     
  • Additional documentation (e.g., immunization or testing records) is attached to the Form only when specifically requested on the Form or when requested by the host school.
     
  • Each student is encouraged to take a copy of the completed Form when traveling to another medical school for a visiting elective.

Immunization Form

AFMC Student Portal Immunization and Testing Form 2019

Note: McMaster University students should not download or complete the form, your home school will complete the form for you.

Guideline

AFMC Student Portal Immunization and Testing Guidelines 2019
 

School Specific Immunization and Testing Requirements

University of Alberta

  • Mumps -- In the event of an outbreak during a visiting elective at the University of Alberta a visiting student may not be allowed to commence or complete the elective if the student’s evidence of mumps immunity is based on serology alone, rather than a complete and documented immunization series or laboratory evidence of infection.

University of British Columbia

  • Seasonal Influenza Vaccine -- Requires either a documented influenza immunization or a mask be worn for electives November to June inclusive.

University of Calgary

  • Mumps -- In the event of an outbreak during a visiting elective at the University of Calgary a visiting student may not be allowed to commence or complete the elective if the student’s evidence of mumps immunity is based on serology alone, rather than a complete and documented immunization series or laboratory evidence of infection.

University of Dalhousie

  • Seasonal Influenza Vaccine

University of Manitoba

  • Seasonal Influenza Vaccine

McGill University

  • Seasonal Influenza Vaccine

McMaster University

  • Seasonal Influenza Vaccine

  • Human Immunodeficiency Virus and Hepatitis C Testing – on or after March 1 of the year of entry into medical school and valid for four years.

Memorial University of Newfoundland

  • Seasonal Influenza Vaccine

  • Mumps -- In the event of an outbreak during a visiting elective at the Memorial University of Newfoundland a visiting student may not be allowed to commence or complete the elective if the student’s evidence of mumps immunity is based on serology alone, rather than a complete and documented immunization series or laboratory evidence of infection.

Northern Ontario School of Medicine

  • Seasonal Influenza Vaccine

University of Ottawa

  • Seasonal Influenza Vaccine

  • Tuberculin Skin Test (TST) – For students without contraindications, if the most recent TST was given over 12 months prior to the elective start date, a single TST will be required for students attending an elective at the University of Ottawa

Queen’s University

  • Seasonal Influenza Vaccine

  • Human Immunodeficiency Virus and Hepatitis C Testing – within 12 months of the elective application date

University of Saskatchewan

  • Seasonal Influenza Vaccine

University of Toronto

  • Seasonal Influenza Vaccine

Western University

  • Seasonal Influenza Vaccine

  • Screening for Latent TB Infection – An interferon gamma release assay (IGRA) test is not acceptable for international students when a TST is indicated.

  • Tuberculin Skin Test (TST) - If a student answers “Yes” to any of the three TB exposure questions found in Section F. Tuberculosis (TB) of the AFMC Form, Western University requires a repeat TST for students without contraindications. The TST must be performed eight or more weeks after the last known possible contact with infectious TB disease (e.g., return from an international elective). 

  • Repeat Chest X-ray - Students with a positive TB history must submit a chest X-ray report that is current within six months of entry into medical school.

  • Western University requires international trainees to upload actual proof of all immunizations, titers and physician letters together with the fully completed Immunization Form. 

 

FAQS

  1. General

Question 1: How do I know that my personal health information is kept confidential?

Answer: The Canadian medical schools are obligated by law to keep your personal health information confidential, and only the minimal number of individuals required at each medical school will access and use the information provided.


Question 2: Can I just attach documentation of my immunizations and tests without having the Form completed if the information is the same?

Answer: No. All students must submit the completed Form. It is also not appropriate to attach original immunization and testing documentation (e.g., serology reports) to the Form other than when requested. This helps ensure that every student is following the requirements set by the medical schools and enables schools to determine that no documentation is missing.
 

Question 3: If I have records of previous immunizations will these count, or do I need to have these immunizations repeated? 

Answer: Discuss this with the HCP assessing your immune status. In general, previous records will count so long as the immunization is properly documented and respects the minimal age and spacing intervals of that particular immunization series.
 

Question 4: I had immunizations administered previously but the records are not available. What should I do?

Answer: An attempt should be made to obtain immunization records from the previous clinician, facility, or public health unit. If this is not successful then in general, the immunizations should be repeated. Parental recall of prior immunization is known to correlate poorly with vaccines received and is not acceptable as evidence of immunization. Serological testing for immunity has a limited role in this area and for most immunizations is not recommended. The Canadian Immunization Guide states:

"Routine serologic testing to determine the immunity of children and adults without immunization records is generally not practical. The following approach is recommended: Children and adults lacking adequate documentation of immunization should be considered unimmunized and started on an immunization schedule appropriate for their age and risk factors."

Discuss this with the HCP assessing your status and completing your forms. If you are missing immunizations it is recommended you have this addressed early enough to permit you enough time to complete a series. For example, a complete routine adult polio series will take a minimum of seven months to complete if no previous doses are documented.
 

Question 5: Do I need to provide documentation of other immunizations other than what is listed?

Answer: No. You only need to provide documentation of immunizations and test results that are requested on the Form. For example, you do not need to provide documentation of Bacillus Calmette–Guérin (BCG), monovalent hepatitis A, meningococcal, pneumococcal, or rabies vaccines as part of this process.
 

Question 6: Due to a medical condition I cannot receive a specific immunization or test. Do I need to mention the specific condition when I submit the Form?

Answer: If you are not able to meet the requirements for a medical or health condition it is necessary for the HCP completing the Form to provide specific details; either in Section C of the Form, or by attaching relevant information from a physician. In addition, you would need to complete the Exceptions and Contraindications to Immunization and Testing Requirements, Self-Declaration Form (Appendix A), to acknowledge that you understand you may not be fully protected, and also that you may be subjected to additional precautions or restrictions during the proposed elective placement.
 

Question 7: I am infected with a chronic bloodborne pathogen. What do I need to do?

Answer: Students who have chronic infection with hepatitis B virus, human immunodeficiency virus (HIV), and/or hepatitis C virus must familiarize themselves with the policies of the medical schools where they wish to apply. In Canada, knowing one’s serological status with respect to HIV, hepatitis B and hepatitis C is an expectation of the medical profession, and if positive, must be reported to the appropriate authority. The appropriate authority, in some provinces may be independent of the medical school (e.g., the provincial regulatory authority). In other cases, the school will be that authority (see for example requirements for Queen’s University and McMaster University in Section J of the Form). All schools require reporting of chronic hepatitis B virus, as all students need to have hepatitis B surface antigen (HBsAg) test results documented by a HCP on the Form.
 

  1. Tetanus, Diphtheria, Pertussis, Polio

Question 8: Why do I need a tetanus/diphtheria/acellular pertussis (Tdap) immunization if I received one previously in adolescence?

Answer: All adult health care workers should receive a single dose of tetanus diphtheria acellular pertussis (Tdap) vaccine for pertussis protection, if not previously received in adulthood (age 18 years or greater), even if the individual is not due for a tetanus/diphtheria booster. The adult dose is in addition to the routine adolescent Tdap booster.


Question 9: Do I need a polio booster dose?

Answer: No. All students require a complete primary polio immunization series documented. For the purposes of satisfying the requirements listed on the Form students who have a primary polio immunization series documented do not require an adult booster dose of polio vaccine.
 

  1. Influenza

Question 10: Do I need to get an influenza immunization?

Answer: An up-to-date seasonal influenza immunization is required for electives occurring during November to June inclusive for the following medical schools: Dalhousie University, McMaster University, Memorial University, McGill University, Northern Ontario School of Medicine, Queen’s University, University of Manitoba, University of Ottawa, University of Toronto, and Western University. The University of British Columbia requires either documented influenza or a mask be worn for electives November to June inclusive. All other medical schools highly recommend influenza vaccination as it is considered a standard of professional practice in Canada.
 

  1. Tuberculosis

Question 11: I had a two-step tuberculin skin test (TST) to check for latent tuberculosis infection when I entered medical school. Do I need a repeat two-step TST?

Answer: Once a two-step TST has been properly administered and documented it does not need to be repeated; all future TSTs can be single TSTs.

Question 11-b : I had one or more tuberculin skin tests to check for latent tuberculosis infection when I entered medical school. Do I need a repeat TST now for electives?

Answer: Typically students do not need a repeat TST for the purposes of satisfying elective requirements. However, there are two exceptions to this:

University of Ottawa: If the most recent TST was given over 12 months prior to the elective start date, a single TST will be require for students attending an elective at the University of Ottawa.

Western University: If a student answers “Yes” to any of the three TB exposure questions found in Section F: Tuberculosis (TB) of the AFMC Form, Western University requires a repeat TST. The TST must be performed eight or more weeks after the last known possible contact with infectious TB disease (e.g., return from an international elective).

For each of the above schools: the TST does not need to be submitted until the elective is officially approved. Students with a documented contraindication to a TST do not need to have a repeat TST (e.g., previous positive TST).

Question 12: I had a positive tuberculin skin test (TST) a few years ago, and I had a chest X-ray right afterwards. Do I need a repeat chest X-ray? 

Answer: Not necessarily. You would need to have a HCP document on the Form your positive TST and chest X-ray (attaching the chest X-ray report). You will also need to complete and submit the Tuberculosis Awareness, and Signs and Symptoms Self-Declaration Form (Appendix B) (to be completed by the student). If abnormalities are noted on the chest X-ray or in your symptom review then a repeat chest X-ray may be necessary, at the discretion of the HCP. Most students will not have any abnormalities noted, and therefore they would not require a repeat chest X-ray. However for Western University students with a positive TB history must submit a chest X-ray report that is current within six months of entry into medical school.
 

Question 13: I had a positive TST. Do I need to be treated for latent tuberculosis infection (LTBI)? Do I require an interferon gamma release assay (IGRA) test?

Answer: For the purpose of the Form treatment for LTBI and/or an IGRA test is not required. If either of these services were provided documentation of such does not need to be included with an application. Please see question #12 for more information on the requirements for a student with a positive TST.
 

  1. Measles, Mumps, Rubella, Varicella

Question 14: I had two doses of measles vaccine documented, but then my measles serology (immunoglobulin G [IgG]) was tested and was negative. Do I need a third dose of measles vaccine?

Answer: Generally the answer is no, but discuss this situation with the HCP offering you services. For measles, mumps, rubella and varicella post-immunization serology is not necessary and should not be performed for the purposes of occupational health requirements. The HCP assessing you should ensure that the measles immunizations were properly documented and spaced (two doses given a minimum of four weeks apart, starting on or after the first birthday). The negative measles serology most likely represents a false negative and in most cases can be ignored.
 

Question 15: I had chickenpox as a child, and I am certain about this. Do I need to have serology tested for chickenpox (varicella)?

Answer: Yes. It is possible that a history of chickenpox infection is not accurate. A test for varicella antibodies (immunoglobulin G [IgG]) is necessary to verify that a student is indeed immune. If the test is positive, no further action is required for varicella. If the test is negative, a student will require two doses of varicella vaccine administered six or more weeks apart.
 

Question 16: I had a single dose of varicella vaccine as a child and I was informed this was a complete series. What do I need to do?

Answer: In the past a single dose of varicella vaccine provided to a child between ages 12 months and 12 years was considered a complete series. Canadian guidelines have changed and now recommend such individuals receive one more dose of varicella vaccine to complete a two-dose series. Varicella serology should not be tested before or after the second varicella immunization.
 

  1. Hepatitis B

Question 17: What do I need to do if I do not have documentation of my hepatitis B immunizations, but I had serology showing immunity to hepatitis B?

Answer: Documentation of a hepatitis B immunization series is required for all students. Positive serology (hepatitis B surface antibody [anti-HBs]) alone will not be accepted if there is an incomplete or absent record of immunization (exception: students immune due to natural immunity, i.e., positive anti-HBs AND positive antibody to hepatitis B core antibody [anti-HBc], or students with hepatitis B infection do not require immunizations documented). Students with an incomplete or undocumented hepatitis B series must proceed to obtain a hepatitis B immunization series; those who are part way through completion of the series must complete the Hepatitis B Not Immune, Self-Declaration Form (Appendix D) when submitting the Form.


Question 18: I already had positive antibodies to hepatitis B. Why do I need to be tested for hepatitis B surface antigen?

Answer: All health care workers should be tested for antibody to hepatitis B surface antigen (anti-HBs) to ensure immunity to hepatitis B. It is also a good idea to test for hepatitis B surface antigen (HBsAg), to determine which individuals may be chronic carriers of the hepatitis B virus; this has been made a requirement on the Form. It is possible that a chronic carrier of hepatitis B will be positive for both anti-HBs and HBsAg (this occurs in about 5% of chronic carriers). Testing for both anti-HBs and HBsAg will permit a student’s specific status to be determined. Some students who were not tested for HBsAg will need to have this test performed now. If a student previously had a test for anti-HBs and was positive (immune), the test for anti-HBs should not be repeated when testing for HBsAg occurs (false-negative anti-HBs results are possible in this situation and may lead to unnecessary booster doses).
 

  1. Additional Information

Question 19: Whom can I contact if I have additional questions or concerns about this area?

Answer: Questions about the Form, requirements, or process followed can be referred to your home medical school, the school(s) to which you are applying, or the HCP completing the Form for you.

 

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