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유학생 예방접종

안녕하세요,

에모리 대학교 예방접종에 관해 아까 전화드린 사람입니다,

오늘 방문 예정인데, 학생이 한국어가 완벽하지 못하고 학생 어머니께서도 인쇄하기 어려우셔서, 정말 죄송하지만 밑의 폼 그대로 인쇄하셔서 체크해 주시면 감사하겠습니다.

감사합니다.

1: Measles, Mumps, and Rubella (MMR)
[All Student Immunization Requirement for Measles, Mumps, and Rubella]

Measles, Mumps, and Rubella Immunity

Measles, Mumps, and Rubella are serious communicable diseases that can spread in close living or classroom environments. All students must be immunized to prevent these outbreaks.

Combined MMR immunization or individual measles/mumps/rubella immunizations or serlogic (blood test) evidence of immunity for each are Entrance Medical Requirements if you were born on or after January 1, 1957. You can meet the requirements either by combined MMR immunizations or by individual immunizations or by test results.

If you have never been immunized for measles, mumps, and/or rubella, you should do so now and then complete this form with your updated immunization information.

Please provide the dates of your combined MMR immunizations below.

Please specify the dates of your MMR immunizations. Two doses are required.

Date for Dose 1:

Date for Dose 2:

2: Measles [Satisfies Immunization Requirement for Measles]

Individual Measles, Mumps, and Rubella immunizations are an alternative to combined MMR immunization. You can meet the Entrance Medical Requirements with a series of individual immunizations. If you received individual immunizations for measles, please indicate the date that each dose was given.

Please specify the dates of your Measles immunizations. Two doses are required.

Date for Dose 1:

Date for Dose 2:

3: Measles Serology [Satisfies Immunization Requirement for Measles]

Please specify the date and result of any blood test for Measles immunity. Please also include a copy of the lab test result.

Test Date:

Result:

Positive Negative

4: Mumps [Satisfies Immunization Requirement for Mumps]

Individual Measles, Mumps, and Rubella immunizations are an alternative to combined MMR immunization. You can meet the Entrance Medical Requirements with a series of individual immunizations. If you received individual immunizations for mumps, please indicate the date that each dose was given.

Please specify the dates of your Mumps immunizations. Two doses are required

Date for Dose 1:

Date for Dose 2:

5: Mumps Immunity [Satisfies Immunization Requirement for Mumps]

Please specify the date and result of any blood test for Mumps immunity. Please also include a copy of the lab test result.

Test Date:

Result:

Positive Negative

6: Rubella [Satisfies Immunization Requirement for Rubella]

Individual Measles, Mumps, and Rubella immunizations are an alternative to combined MMR immunization. If you received individual immunizations for Rubella (OK if combined with Measles), please indicate the date that the dose was given.

Please specify the date of your Rubella immunization.

Date for Dose 1:

Date for Dose 2:

7: Rubella Immunity [Satisfies Immunization Requirement for Rubella]

Please specify the date and result of any blood test for Rubella immunity. Please also include a copy of the lab test result.

Test Date:

Result:

Positive Negative

8: Diptheria and Tetanus (Td) Immunizations [All Student Immunization Requirement for Tetanus and Diptheria]

Use this section if your most recent Tetanus-Diphtheria booster was a Td (rather than a Tdap).

If you have not had a Td immunization booster within the last 10 years, you should do so now and then complete this form with your updated immunization information.

Due to the increasing incidence of Pertussis (whooping cough), the CDC currently recommends a Tdap (containing acellular pertussis) adult booster for all individuals needing a ten-year booster.

Tetanus-Diphtheria immunization is a three-dose primary immunization series (usually given during childhood) with booster doses every ten years thereafter. Please indicate the date of the most recent Td booster.

Date for Dose 1: