Revisiting the timetable of tuberculosis

Purdue University Student Health Service

State Immunization Requirements for Enrolled Students  Immunization Records Reminder

Students are reminded to submit proof of immunizations against rubeola (10-day measles), rubella (German measles), mumps, meningitis, diphtheria and tetanus to the PUSH immunization portal prior to completing your Purdue 101 online orientation program. If you do not submit proof of immunization, a hold will be placed on your account and you will be unable to register for classes.

To comply with immunization requirements, you must complete the medical clearances section in your Patient Portal. Log into the portal, look for the "Medical Clearances" tab on the left and update any items marked "Non Compliant" by submitting documentation. Further instructions can be found here.

If you need a tuberculosis test or vaccines that cannot be completed at home, they may be completed at PUSH as soon as you arrive to campus. If you need to receive a particular vaccine, please make an appointment with PUSH or another local pharmacy.

Indiana state law requires all new, regularly enrolled students attending residential campuses of Indiana public universities be immunized against Rubeola (10 day measles), Rubella (German measles), Mumps, Meningitis, Diphtheria, and Tetanus. This law requires the university to block the enrollment of any student who does not comply with immunization requirements. If your record is held for immunization noncompliance, registration for future courses cannot be completed until all requirements have been met.

Immunization proof must be legible, in English, and include the student's name. Students may upload their official immunization record OR a completed immunization information form signed by an MD, DO, NP, or RN. The official immunization record does not need to be signed by a provider. 

Immunizations required by the state of Indiana: Vaccine Requirement Rubeola (Measles, MMR) 2 doses of live vaccine administered after first birthday and at least 28 days apart. Rubella (MMR) 2 doses of live vaccine administered after first birthday and at least 28 days apart. Mumps (MMR) 2 doses of live vaccine administered after first birthday and at least 28 days apart. Tetanus Diphtheria (Td or Tdap) No more than 10 years before starting classes. Meningitis (Men Quad/Conjugate, MCV4) One dose on or after 16th birthday, if 23 years or younger. Meningococcal B (Separate from Meningitis) 2 doses of the same brand (Bexsero or Trumenba), if 23 or younger. International students only Tuberculosis Clearance International students must have a QFT (Quantiferon blood test) or T-Spot (not PPD) with a negative result. This test must be completed in the United States and no more than 3 months before classes start. Test must be completed on the same date, or at least 28 days after any live vaccine. Those with an abnormal TB test result, will have additional steps to complete. Students not in compliance will not be able to register for future courses until the requirement has been met. Learn more about Tuberculosis.

State-required immunizations are available at the Student Health Center and through other healthcare providers.

FAQS MENINGOCOCCAL VACCINES Why Men B?

Purdue requires 2 doses of the Meningitis B vaccine for all incoming students under the age of 24. College students are at an increased risk of being infected with the rare, but serious disease. Please click here to access our Meningitis B fact sheet.

Does MCV4 (Menveo or Menactra) meet the Men B requirement?

No. Meningococcal B is a separate vaccine. MCV4 protects against variants A,C,W, and Y. Meningococcal B protects from the B variant. The brand names for Meningococcal B are Bexsero and Trumenba.

If I am 24 or older when I start classes, am I required to complete meningococcal vaccines?

No, this is only required for students under 24 when classes start.

Will I be able to register for classes if I have completed the 1st dose of Men B, but cannot complete the 2nd dose before classes start due to the vaccine's dosing schedule?

Yes. If you have started the vaccine but are unable to complete the 2nd dose because of the dosing schedule (28 days or 6 months between vaccines), PUSH staff will give you more time to complete the series when we review your submission.

TB TEST If I am registered as a domestic student, am I required to complete a TB test?

No, the TB test is only required for international students.

Can I complete the TB test in my home country?

No, Indiana law requires that the TB test be completed in the United States.

Why do I see TB test as a requirement in Medical Clearances even though I'm a domestic student?

Before classes start, all incoming students see the same items in medical clearances. Once classes start, students will be placed in their final populations and the requirements will correctly reflect the student's status. The TB test requirement is listed so that those that are required to complete this have a location to submit.

What TB tests are accepted?

Purdue will only accept a TB blood test meaning that your blood must be drawn by a lab. The TB skin test (PPD/Mantoux) are not acceptable.

IMMUNIZATION PROOF Does my provider need to sign my immunization records before submitting?

No. If you are submitting your immunization record, no hand-written signature is required. This is only required on the immunization history form.

How do I upload additional proof once I have completed the initial submission?

Additional records will be added using the green update box next to the immunization proof line in Medical Clearances. This is the same location records were originally submitted. Even though it states compliant now, the student can continue to submit additional records as needed.

If I upload proof of immunizations, do I still need to enter the dates each vaccine was completed?

Yes. Your submission cannot be reviewed until proof is submitted and immunization dates have been entered.

I submitted immunization proof several days ago. Why does it still say Awaiting Review?

The review process can take up to 10 days to review. If there are any problems with the student's submission, PUSH staff will send the student a secure message.

Why am I unable to access the patient portal?

Grad students do not have access to the patient portal until classes start. Please hold on to your record until then and submit once portal access is available. If you are an undergrad and cannot login to the portal, please contact us at shc@purdue.Edu.

I have logged into my patient portal and there is no way to submit immunization proof in Medical Clearances.

Students who took previous classes through Purdue, either on campus or as an online student, will be considered "former students" until classes start. Once classes start, the student's population will correct itself and they will be able to enter immunization dates. If you'd like to submit immunization dates before classes start, please email shc@purdue.Edu.

EXEMPTIONS

In the event of an outbreak of any of the vaccine preventable diseases covered by this law on or near campus, students holding exemptions will be excluded from all campus activities, for their protection, until the outbreak is declared to be over.

How do I apply for a religious exemption from immunizations?

Students, or their parent/guardian if the student is a minor, will write a statement indicating the reason that they cannot obtain immunizations. The statement must be hand-signed and dated. Once reviewed, the student will find the response in the letters section of their patient portal.

How do I apply for a medical exemption from immunizations?

A medical exemption will be granted upon receipt of a written statement from a healthcare provider indicating the nature and duration of the medical condition which contraindicates an immunization, as well as the specific vaccine identified as detrimental to the student's health or certifying pregnancy or suspected pregnancy. Medical exemptions expire when the medical condition(s) contraindicating immunization change in a manner which permits immunization.

Contact Info:PURDUE STUDENT HEALTH CENTER601 Stadium Mall DriveImmunization Office - Room 138W. Lafayette, Indiana 47907-2052Email: shc@purdue.EduFax: (765) 496-1907Telephone: (765) 494-1837

Your Guide To HCG Levels In Pregnancy

Low hCG, or hCG that's rising abnormally—in other words, not at the rate it should be—is usually caused by two factors. These include:

An Early Miscarriage

When hCG isn't rising fast enough, it could indicate a miscarriage or nonviable pregnancy. "hCG may be low at the outset or rise slowly and end up at a lower than expected level if the embryo is not viable and is not going to result in a successful pregnancy," explains Lucky Sekhon, M.D., a double board-certified reproductive endocrinologist and infertility specialist and OB/GYN at RMA of New York in Manhattan.

She says this can occur if there is something inherently wrong with the embryo—like having the wrong number of chromosomes—or other, sometimes unexplained, reasons that the embryo or pregnancy is not viable.

A Pregnancy in the Wrong Location

Sometimes, when hCG levels aren't rising as they should be, it could mean the pregnancy is growing in the wrong place. "When we have an inappropriate rise, or not an exact doubling, it could mean the pregnancy is in the wrong location," says Dr. Sullivan, referring to a pregnancy that grows outside the uterus. "We call this an ectopic pregnancy."

What Does A Faint Line On A Rapid COVID-19 Test Mean?

During the summer of 2022, after more than two years of evading COVID-19, I tested positive at home on a rapid antigen test.

The line was barely there. In fact, it was so faint that it didn't even show up in photos. Was I actually positive for COVID-19 or just tricking myself? Unfortunately, when I took another test the next day, it came back with a much darker line — and confirmed that I had COVID-19.

The whole experience got me thinking about how confusing it can be to take a rapid antigen test at home, especially if your results seem ambiguous like mine. I also wanted to know more about what the tests are actually measuring, what that line actually means and whether a darker or lighter positive line on a COVID-19 test can tell you anything about your individual infection.

Now that we're in our third summer with COVID-19 and data are once again showing an increase in COVID hospitalizations, it's important to make sure you know how to actually use and interpret those tests.

New omicron subvariants like XBB.1.5, XBB.1.16 (Arcturus) and EG.5 are fueling a small rise in COVID-19 cases and hospitalizations, data from the Centers for Disease Control and Prevention show. So, if you start to feel symptoms like congestion, cough or fever, being able to accurately test yourself for COVID-19 at home can help clarify which illness you might have.

Here's what you need to know about taking a rapid COVID-19 test and figuring out what your results mean — even if they're a little faint or hard to parse.

When to take a rapid COVID-19 test:

You should take a COVID-19 test at home in a few specific scenarios, the Centers for Disease Control and Prevention explain.

First, if you have noticeable symptoms that could be related to COVID-19, you should take a test. According to the ongoing ZOE Health Study, some of the most common COVID-19 symptoms associated with omicron subvariants include:

Sore throat.

Runny nose.

Congestion.

Sneezing.

Cough.

Headache.

Muscle aches.

Altered sense of smell.

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Keep in mind, though, that there are other possible symptoms of COVID-19. For instance, CDC says you might also experience:

Fever

Chills.

Shortness of breath.

Fatigue.

Nausea.

Vomiting.

Diarrhea.

You should also take a test if you're exposed to someone who has COVID-19, the CDC says. To avoid testing too early in an infection, the CDC recommends testing five days after the exposure. And, if your results are negative, consider testing again in 24 to 48 hours.

Finally, consider self-testing for COVID-19 before attending an indoor gathering or visiting someone. Try to take the test as close to the start time of the event as you can in order to get the most accurate results possible, the CDC advises.

It's especially important to test before gathering indoors with people who are at a higher risk for severe COVID-19 symptoms, such as older adults, people who are immunocompromised and children who are too young to be vaccinated, the CDC says.

How to take an at-home COVID-19 test:

When using a home rapid test, it's important to avoid some common mistakes, experts told TODAY.Com previously.

First, be sure to store the tests properly (and at the right temperature). If rapid antigen tests are stored in an environment that's too cold or too hot, they may give inaccurate results, including false negatives.

And when you're ready to take the test, read the instructions fully before starting. Tests from different brands may be similar, but they're not identical. So it's important to know what you're doing before you get into it.

Don't read the test too early or too late, the experts said, because that may give you a false-negative or false-positive result. Only read your results within the time window that the COVID-19 test instructions give you.

And, depending on your results and your exposure history, you may need to repeat the test again in 48 hours, the Food and Drug Administration says.

What does the line on a COVID-19 test actually measure?

At its most basic level, the positive line on an at-home rapid test "is showing the presence of targeted viral proteins," Omai Garner, Ph.D., associate clinical professor and director of clinical microbiology at UCLA Health, told TODAY.

"It's looking for a particular part of the virus that attaches to components of the test that are attached to a color," Dr. Emily Volk, president of the College of American Pathologists, told TODAY.

From there, the proteins "get caught on that line and show a color band," Dr. Amy Mathers, associate professor of medicine and pathology and associate director of clinical microbiology at the University of Virginia School of Medicine, told TODAY.

If that positive line shows up, it's very likely that you have coronavirus proteins in your nose — and that you have COVID-19.

Does a faint line count as a positive result?

Yes, the experts said.

"It's not a super-sensitive test, meaning you've got to have a good amount of virus there just to get the home antigen test to work at all," Garner said. Keep in mind that "any line early in the infectious process implies that somebody is very contagious."

But that doesn't mean it's always easy to read. "Sometimes it's not quite a line; it can be like a fuzz," Mathers said. "But if you see a line there, it's there."

It can also help to take in the context of what's going on around you. If COVID-19 transmission levels are high in your area, if you know you were exposed to someone with the infection or if you have noticeable symptoms, those are all good reasons to interpret a maybe-positive as a definitely-positive.

In order to confirm the result, the FDA recommends taking another rapid test 48 hours later. If you have symptoms that could be COVID-19 or you know you were exposed to COVID-19 recently, the FDA recommends taking yet another test 48 hours later.

If there's any confusion throughout the process, you can also skip the repeated rapid tests and go straight to your doctor or get a PCR test, the FDA says. However, the CDC notes that people who've had COVID-19 may continue to test positive on PCR tests for up to 90 days, so it may be difficult to use a PCR test to diagnose a new coronavirus infection.

If you took antiviral medications, like Paxlovid, you might test positive just a few days after getting a negative result. This is a phenomenon called Paxlovid rebound or COVID-19 rebound. Sometimes, people's symptoms return along with their rebound positive test, but not always.

The only situation in which you wouldn't assume that a faint line on a rapid test is positive is if it turned positive after the allotted testing period, Garner said. "If you just left the test for two hours, you can have some false positive binding," he explained. "But if the test is performed correctly, any line — no matter how faint — is a true positive."

Also, keep an eye on the expiration date on the rapid tests you're using. If you use a home test after its expiration date, you may not get accurate results. The FDA has information about the shelf life and expiration dates — including some that have been extended by several months — for all of the home tests that it has authorized.

Does it matter if the line on your COVID-19 test is super dark?

In theory, "the more viral proteins that are there, the darker the line would be," Garner said. And, from there, you might conclude that you're more or less contagious or that you might have a milder or more severe infection depending on how dark or faint your line is.

But these tests weren't really designed to measure any of that, the experts said. "These antigen tests are ... Not designed to give you an estimate of, 'Is there a lot of virus or is there a little virus?'" Volk explained.

They're really just meant to be read as a binary: positive or negative.

"We have some of these tests in our lab that we run as medical tests, and we do not interpret the strength of the (line) at all," Mathers added. Plus, there are a bunch of other reasons a test line might be darker or lighter that don't have anything to do with the actual amount of viral particles in your body, she said.

For instance, the consistency of the mucus in your nose may affect how many of those viral proteins collect. "So you might have a load of viral antigen in your nose," but that may not be an accurate reflection of how much virus is actually circulating in your system because your mucus is just extra thick, Mathers explained. (Mucus, like saliva, can be thicker or thinner depending on how hydrated you are, she said.)

Additionally, the pH of your nasal ecosystem "could change how well the virus binds," she said. "All of those variables in human specimens can alter the way the test may read."

The room temperature when you're running the test as well as how well the tests are stored can also affect the results.

We know that early on in the infection, people tend to be more infectious yet may have a lighter line on their rapid antigen test — or not test positive at all. They may even have symptoms for a few days before turning positive. "People can have bad COVID infections and a faint line, and people can have mild COVID infections and a really deep red line," Volk said.

With the convenience and availability of rapid tests, it's understandable that people will want to use them in ways they aren't necessarily intended, Garner said. "People are trying to use the antigen tests not only to assist in the diagnosis of disease but also to assist in their behavior after they've been infected." That's especially true in those tricky situations where people may be pressured to get back to work or have to make tough decisions about partaking in other activities — even if they're still testing positive, he said.

But you should not use the lightness or darkness of the line on your test to direct your behavior because the tests are simply not designed or FDA-authorized for that, Volk and Mathers agreed.

If your line is lighter, for instance, that doesn't mean you can ignore other precautions, like masking. "There's really no actionable information to be gained (from looking at whether your line is lighter or darker)," Volk explained.

If it's positive, it's positive — and you can probably leave it at that.

This article was originally published on TODAY.Com

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