Bacterial Meningitis

Requirement for Bacterial Meningitis Vaccinations

Texas Education Code section 51.9192 states that all students attending an institution of higher education are required to provide proof of a current bacterial meningitis vaccination.

Bacterial Meningitis is a serious, potentially deadly disease that can progress extremely quickly. It is an inflammation of the membranes that surround the brain and spinal cord. The bacteria that causes meningitis can also infect the blood. This disease strikes about 370 Americans each year which is a decrease in the number of people infected due to people getting vaccinated. In 2016, there were 72 confirmed cases for youth between the ages of 16 and 23 years of age; 32 of these students attended college. Treatment for the disease is available, but severe health problems or disabilities are still possible.

Effective January 1, 2014, all entering students are required to show evidence of an initial bacterial meningitis vaccine or a booster dose during the five-year period preceding, and at least 10 days prior to, the first day of the first semester in which the student initially enrolls at a Texas higher education institution.

Under justifiable circumstances, an institution may grant extensions to individual students to delay the compliance date to no more than 10 days after the first day of the semester (or other term) in which the student initially enrolls (Texas Education Code 21.614).

An entering student includes a first-time student of a Texas public institution of higher education or private or independent institution and includes a transfer student or a student who previously attended an institution of higher education before January 1,  2014, and who is enrolling in the same or another institution of higher education following a break in enrollment of at least one fall or spring semester.

For more information on immunization requirements for students at institutions of higher education, visit the Texas Department of State Health Services (DSHS) website.

Exemptions to the Vaccination Requirement

A student is not required to submit evidence of receiving the vaccination against bacterial meningitis if the student meets any of the following criteria:

  • the student is 22 years of age or older by the first day of the start of the semester (effective 1/1/2014); or
  • the student is enrolled only in online or other distance education courses; or
  • the student is enrolled in a continuing education course or program that is less than 360 contact hours, or continuing education corporate training; or
  • the student is enrolled in a dual credit course which is taught at a public or private K-12 facility not located on a higher education institution campus; or
    • Note: Students in Texas are required to receive an MCV4 vaccine on or after the student’s 11th birthday.
  • the student is on active duty with the armed forces of the United States; or
  • the student is incarcerated in a Texas prison.

A student is not required to submit evidence of receiving the vaccination against bacterial meningitis if the student submits to the institution:

  • An affidavit or certificate signed by a physician who is duly registered and licensed to practice medicine in the United States, stating that in the physician’s opinion, the vaccination would be injurious to the health and well-being of the student; or
  • An affidavit signed by the student or parent stating that the student or parent declines the vaccination for reasons of conscience, including a religious belief. A conscientious exemption form from the Texas Department of State Health Services must be used, or
  • An Internet-based Texas Department of State Health Services exemption form claiming an exemption for reasons of conscience. Only students attending public junior colleges are eligible to submit this form.

For students attending a four-year university or college interested in requesting a conscientious objection exemption from DSHS may access the exemption form at DSHS exemption form. The DSHS exemption form may be ordered electronically, but it will be mailed to the address provided by the student. Please allow up to two weeks to receive the form. The form must be completed, notarized, and submitted to the designated school official at the institution the student will be attending no later than ten (10) days prior to the first day of the first semester in which the student enrolls at an institution. The institution will retain the original affidavit.

For public junior college students only: the secure on-line exemption form is available at DSHS exemption form. According to DSHS rules, a copy of the form must be submitted to the designated school official at the institution the student will be attending.

Exemption Form Q&A

DSHS has certain requirements about the handling of the exemption form as described below.

1. How long is the notarized DSHS affidavit exemption form valid?

This document is valid for two (2) years after the signature date of the notary. For the initial filing, the form must be turned into the school within 90 days of notarization to be valid and no later than ten (10) days prior to the first day of the first semester in which the student enrolls in an institution. A new form is not necessary if the student is continuously enrolled at the same institution.

2. Can the DSHS affidavit exemption forms be transferred from one university to another (as part of a student’s record)?

For students transferring between four-year institutions, it is possible to transfer the affidavit exemption form if it is still valid. However, due to the two-year validation period, it is not always possible to re-use an immunization exemption form at a second institution once it has been used at the first school.

The Texas Health & Safety Code does not address the confidentiality of exemption forms/affidavits after they leave the DSHS office. Institutions of higher education will need to speak to their own legal counsels about any concerns about legal requirements specifically related to the transfer of student records between institutions.

3. Can the DSHS public junior college exemption form be transferred to another institution?

The public junior college form is not transferrable as it is specific to the public junior college attended. Students will need to get a new exemption form in this instance.

4. Can the DSHS exemption forms be photocopied?

The DSHS affidavit is invalid if it is reproduced, but the public junior college form can be copied.

Meningococcal Serogroup B (MenB)

The meningitis college entry requirement of the Texas Administrative Code states that students must receive a “bacterial meningitis vaccination.” At the time that the rule and enabling statute took effect, only two types of bacterial meningitis vaccines were available to students: meningococcal conjugate vaccine (MenACWY) and meningococcal polysaccharide vaccine (MPSV4). According to the Centers for Disease Control and Prevention (CDC), MenACWY is the vaccine recommended for this age group of college students. However, both vaccines, MenACWY and MPSV4, protect against the same four strains of bacterial meningitis (A, C, W and Y).

Recently two additional vaccines became available that offer protection from strains of meningococcal serogroup B, commonly known as MenB. The CDC Advisory Committee on Immunization Practices (ACIP) recommends MenB vaccinations for certain at risk populations.

Students should consult a physician or medical practitioner to determine the optimum vaccination protocol for their individual needs. It is important to note that vaccinations for MenACWY and MenB are not interchangeable. MenB vaccines do not provide protection for MenACWY strains, and MenACWY vaccines do not provide protection for MenB strains.

Please consult the CDC website for the latest information on recommended vaccines,

Institutional Responsibilities

All public and private higher education institutions in Texas are required to notify new entering students about bacterial meningitis and document students’ receipt of that information. See the document below for additional guidance.

Multiple methods are suggested as the best means to ensure provision of important information and confirmation of information receipt, for example, online, postcards, electronic and paper application forms, student orientation, advisor forms, posters, etc..


Bacterial Meningitis Vaccinations

Inquiries regarding THECB guidance on bacterial meningitis vaccinations should be directed to Andrew Lofters.

Email Andrew Lofters