Health Sciences Immunization Program (HSIP)

Students accepted to a UW health sciences program must complete and document initial and annual immunizations and screening for tuberculosis, to protect themselves and their patients from illness.

During your coursework, training, and future health care career, you may be in close contact with clients and patients who have communicable diseases. You may be at high risk for certain infections, and if you become ill, you may pose a risk to vulnerable clients and patients.

For your safety and the safety of your clients and patients, the UW affiliation agreements with clinical and practicum training sites require you to complete and document immunizations, as well as initial and annual screening for tuberculosis, as recommended by the Centers for Disease Control and Prevention (CDC) for healthcare personnel.

The Health Sciences Immunization Program (HSIP) tracks immunization and TB testing compliance for students enrolled in health sciences schools or programs. Students pay a health fee, which covers the cost of program administration.

Entry requirements for students new to a health sciences program

Notice to students starting June 1, 2018 (summer quarter) or later: Please follow these steps to prepare for document submission while HSIP transitions to our new vendor service. DO NOT follow the instructions below or submit any documentation to Forms and documents will be rejected.

If you are entering a health sciences program prior to June 1, 2018 (summer quarter), contact HSIP staff for further instructions.

You will not be allowed to begin coursework unless you complete the HSIP immunization and TB-screening requirements.


Annual immunization and TB screening requirements

Annual Tuberculosis (TB) Screening

Students must provide initial TB screening documentation before they enter any clinical/practicum settings or begin patient/client contact. After the initial requirement is met, documentation of annual TB screening is needed to continue registering for classes. Each school/program sets different due date “windows” for TB screening. This ensures students remain compliant throughout their quarterly placement at clinical or practicum sites.

Students starting summer quarter 2018 or later: Students must wait until the start of their school or program’s period of documentation acceptance before they begin to meet the TB screening requirement. Documentation of TB screening completed early (before their school/program’s defined period of documentation acceptance) will be rejected. The initial requirement can be met with an IGRA blood test or 2-step PPD skin test (4 visits to provider over 1-3 weeks). Students with documented previously positive results will find specific instructions and an optional downloadable form on the CB website.

Continuing students: HSIP is transitioning to a vendor service for document submission. Do not submit any documentation to after May 1, 2018. Forms and documents will be rejected. You will receive an e-vite from the vendor, CastleBranch, containing a unique link that allows you to create a web-based account. Students will submit proof of their annual TB screening by uploading documentation to their individual CastleBranch account. HSIP staff will transfer each student’s current information to CastleBranch so records are complete.

In order to create a CastleBranch account, each student pays a one-time $35 set-up fee. Even students who already have accounts with CastleBranch have to pay this one-time fee for their HSIP documents. HSIP reduced all annual HSIP fees by at least $35, so after one year with CastleBranch all students in HSIP will pay an overall lower annual HSIP fee.

The annual TB screening requirement can be met by completing any of the following:

  • TB skin tests
  • IGRA (Interferon Gamma Release Assay) blood tests
  • Symptom reviews (for those who have already sent documentation of a positive TB test)

Submit TB Screening Documentation

  1. Submit a PDF attachment to Document must include:
  • TB skin tests: date placed, date read, results in mm, screener’s authentication/office information; “self-reads” are not accepted


  • IGRA blood tests: lab report showing results/interpretation, including date of blood draw

     2.  Include in the body of your email: your name, your UW Student ID# and the name of your health sciences academic program.

     3.  In the email subject line, please write “Annual TB test results.”

Positive TB Test Results

If you have sent documentation of a previously positive TB skin test or IGRA, please submit your answers to the annual TB Symptom Survey questions. Students with a documented positive TB screening test do not need to have another TB screening test; they need only to complete the annual TB symptom survey.

Annual Influenza (Flu) Vaccine

Students are required to receive an annual influenza vaccination between August 1st and October 31st. Students who do not complete this requirement will not be allowed to register for winter quarter.

Continuing students: HSIP is transitioning to a vendor service for document submission. Do not submit any documentation to after May 1, 2018. Forms and documents will be rejected. You will receive an e-vite from the vendor, CastleBranch, containing a unique link that allows you to create a web-based account. Students will submit proof of their annual flu shot by uploading documentation to their individual CastleBranch account.

In order to create a CastleBranch account, each student pays a one-time $35 set-up fee. Even students who already have accounts with CastleBranch have to pay this one-time fee for their HSIP documents. HSIP reduced all annual HSIP fees by at least $35, so after one year with CastleBranch all students in HSIP will pay an overall lower annual HSIP fee.

Submit Flu Vaccination Documentation

  1. Submit a PDF attachment of your flu vaccine documentation to
  2. Document must include: date given, vaccine type (including year), administrator’s authentication and office information
  3. Include in the body of your email: your name, your UW Student ID#, and the name of your health sciences academic program.
  4. In the email subject line, please write “Annual flu vaccine.”

Flu Vaccination Waivers

Waivers are only given for valid medical contraindications. A flu waiver request form (available on the CastleBranch website after you create your account) must be signed by a provider and submitted to CastleBranch. School compliance staff are notified of all student waivers.

NOTE: Egg allergy is no longer a contraindication; egg-free vaccine is available.


Health Fee

Once you enter a participating health sciences school or program, you will pay a HSIP fee to cover the cost of administering the Health Sciences Immunization Program.

The amount of the fee is subject to change on a yearly basis and is attached to your tuition account for as long as you remain in your UW health sciences school or program.

See the table below for the 2018-19 HSIP fee for your health sciences program.*

HSIP Health Fee


School of Dentistry (DDS and Post-Doc)


School of Medicine (MD)


Nursing (ABSN/BSN/DNP/Certificate) $76

Other Health Sciences Programs

Med Lab Sciences/Lab Med $72
Pharmacy (PharmD) $72
Rehab Medicine (PT, OT, P&O) $72
School of Public Health (MPH/GH/HIHIM/Nutrition) $72
Social Work-Seattle and Tacoma (BASW/MSW) $72
Speech & Hearing (CoreSLP, MedSLP, AuD, AuD-PhD) $72

* The annual rate is divided into 3 or 4 quarterly amounts per year (depending on HS program), and then attached to student's account during enrolled quarters.

These fees vary based on several factors. For example, if you are in a field of study or clinical or practicum service with a high risk of exposure to bloodborne pathogens, you will pay a higher fee than students who are at low risk.

Click here for more specific details about how the health fee was calculated for the current school year.

Please note that the health fee is not health insurance. More information about getting health insurance coverage can be found on the Hall Health Center website.

We recommend students learn what health services are offered at the student health center on their “home” campus and in the community. Our Health Care Resources information sheet may also be of assistance for students who need initial or ongoing services in the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) region.


Reimbursements for uncovered expenses following a bloodborne pathogen exposure or needlestick/sharps injury

If you sustain a bloodborne pathogen (BBP) exposure during a clinical or practicum experience, and if your personal insurance doesn’t cover the full cost of the expenses related to treating the exposure, HSIP can reimburse you for uncovered expenses.

  • HSIP assistance with medical expenses is only for BBP exposure; it does not include other types of injuries or illnesses that may be related to your clinical or practicum experience.
  • HSIP does not cover after-insurance reimbursement for exposures related to international travel. Students are strongly encouraged to obtain and carefully review the terms of supplemental travel insurance prior to each trip.
  • Health sciences students are not considered employees while they are engaging in education-related activities at clinical sites and are, therefore, not covered by workers’ compensation.
  • Students are eligible for the reimbursement described in this section only if they are enrolled and have paid the health fee.

If your insurance does not cover all the fees associated with post-exposure care, or if you have questions about reimbursement for expenses related to a BBP exposure, needlestick or sharps injury, please contact HSIP staff by email at and note in the email subject line: “Reimbursement Question.” Alternatively, you can leave a voice mail message at 206.616.9074.

For more information about what to do after a BBP exposure, needlestick or sharps injury, see the Bloodborne Pathogen Exposure page.

Health care resources

The information provided at the link below is intended to assist students in obtaining further information about available healthcare resources. We are not endorsing or referring students to any specific clinic or service, and we do not guarantee that the options listed are exhaustive.

Students are advised to call clinics or health service facilities for further information prior to making an appointment, to verify the type and cost of services available, and to ensure that their expectations can be met by that provider.

Please click here to access the Health Care Resources information.

Frequently Asked Questions (FAQ)

Health sciences students are not considered employees while engaging in education-related activities at clinical sites and therefore are not covered by workers’ compensation.

If an injury (such as tripping or falling) or exposure to illness occur during a clinical rotation, students should have coverage through personal health insurance , such as the  UW International Student Insurance Plan (ISHIP), the Graduate Appointee Insurance Program (GAIP), a Marketplace health plan, or coverage through a parent or spouse.

Seattle campus students who pay the quarterly Services & Activities Fee receive some services from Hall Health Center, including one visit per quarter for acute illness or injury. Please visit the Hall Health Center website for more information on services provided and the associated fees.

Hall Health is open to students and non-students, and they accept various health insurance plans. Hall Health's website includes information about the Affordable Care Act, obtaining insurance and the specific plans that are accepted there.

UW students who are not on the Seattle campus may have access to services at an affiliated student health center if they are currently attending classes on another campus. Check with your campus' facility to find out what services may be available to you. The Health Care Resources Focus Sheet offers information and links to clinics and pharmacies available to the general public in many of the communities where UW health sciences students are located.

Please note that if you choose to receive care at Hall Health or any other clinic/provider's office, such as immunizations, TB screening, or titers (lab tests), you will need to obtain your HIPAA-protected records showing documentation of any service received and submit it to HSIP. This will allow you to maintain your compliance with HSIP requirements and avoid a registration hold.


If you would like a copy of your HSIP immunization record, please send a request via email to Be sure to include your full name and UW student ID number. HSIP will send the record directly to you, and you can then share it further.

HSIP does not routinely send any records to outside persons or organizastions, per FERPA regulations. As needed, we share your HSIP record only with your UW health sciences program staff (and clinical or practicum site, if requested) before and during placement, as indicated on the HSIP release form you signed at the start of your health sciences program.

Hall Health’s E-care is part of the personal electronic medical record (EMR) used by Hall Health and all of UW Medicine. It will show only the immunizations received at a UW Medicine facility, and the immunizations you asked your provider to document in your personal health record, if you are a patient there.

Hall Health and HSIP are administatravely separate UW units, and HSIP does not share student records with Hall Health, per FERPA regulations. Likewise, Hall Health does not share your patient information with HSIP, per HIPAA regulations. Therefore, if you would like to have your HSIP immunization record in your personal medical record (at Hall Health or elsewhere), you should request your records from HSIP at and then share it with your healthcare provider.


Email Security: Students are encouraged to submit all forms and supporting documentation via email to We recommend students use their UW NetID email address ( to increase the security of electronic communication with HSIP.  We do receive HSIP forms from students who use gmail or other outside accounts. We use students’ UW email addresses whenever possible.

Records Security: Records are stored on a secured UW Medicine database server. Our data security program is in compliance with the HIPAA Security Rule [45 CRF Parts 160, 162, and 164], RCW 42.17 [Public Records – Personal Information – Notice of Security Breaches], and various other federal and state security laws.

Records Security and Confidentiality: Documentation occurs in a combined student/employee electronic database, which is stored on a UW Medicine server. Records are kept and maintained under the auspices of FERPA, federal law governing educational records.  Where these laws do not conflict, these records are also maintained in compliance with HIPAA. Information submitted to HSIP may be discussed, communicated, and/or shared with the students’ school or program and practicum or clinical training sites on a need-to-know basis prior to and during placement.

We recommend you receive one dose of Hepatitis B vaccine now, to boost your antibodies to a detectable level. This usually takes about a month. Then, four to six weeks after the booster dose, you should have the quantitative Hepatitis B Surface Antibody titer blood test drawn. Usually with this method there is a positive result (≥ 10 mIU/mL), and the documentation on the lab report should be adequate to prove your immunity to Hepatitis B for the rest of your health care career. This method of boost and titer is explained by the CDC in their latest guidelines (published in 2013) and summarized in this online algorithm.

Please send in your paperwork after the booster dose with a notation that the titer is pending. As long as we know that something is in-process, you will continue to be in compliance and allowed to register for classes. Send your titer report to us as soon as you receive the result. If the re-titer is negative, then you may need to be tested for the Hepatitis B Surface Antigen (“carrier” status, or prior exposure to Hepatitis B disease). Or, perhaps you need to continue on with receiving the 2nd and 3rd doses of another Hepatitis B vaccine series. There are some individuals who need two series before they will achieve a positive antibody titer.


Please put a note on the form under the Hepatitis B section that says “Dose #3 and titer pending” (or whatever the case may be). We will be able to tell by the dates on the documentation you send in when the next items are due. We’ll give you a temporary waiver of the requirement that lasts until the next item due date. As long as you keep sending us documentation when you complete each item, you will continue to be in compliance and able to register for classes. Our tracking database will report you as compliant to your school or program as long as we receive the further documentation from you on time. The CDC recommends students complete their three-dose series prior to contact with patients or body fluids. This means you should start meeting the requirement as soon as possible after admission to your program. Please put your name, student ID number, and school or program on all correspondence to us.

It sounds like either you had a light case that did not prompt your immune system to build permanent immunity, or perhaps the lab test just wasn’t sensitive enough to pick up your immunity.

If you had not previously had the chicken pox vaccine, you will need documentation of two doses now. You can send us your documentation after receiving one dose and write “Dose #2 pending” on the required immunizations form. There is a minimum wait period of one month between the two doses. If you forward the documentation of the second dose four to six weeks later, we’ll consider you to have remained compliant with the requirements.

Please note: You should not repeat the varicella titer after receiving the immunizations. The CDC has stated that the currently available titer test may not be sensitive enough to detect immunity for individuals who have received the vaccine. The current standard of “immunity” is either positive titer or two doses of vaccine. So if you show documentation of two doses of vaccine, there is no reason to have another titer.


Our waiver procedure is detailed in the “Requirements for Compliance” policy posted on our website. HSIP grants waivers only for documented medical conditions for which there is a vaccine contraindication, based on the standards of care at the University of Washington.

Students must submit a signed statement from a medical doctor stating what vaccine is medically contraindicated, the documented reasons for the contraindication, and the duration for which the vaccine is contraindicated. The HSIP medical director will review and determine if the standard for medical contraindication is valid, and the student will be notified. If the standards are not met, the student will need to comply with the requirements.

If the standards are met, the student and school or program are notified. Students may be limited in clinical sites/situations where they can be placed with a waiver but, if possible, the school or program accommodates the student based on their particular need.

Waivers for non-medical/personal reasons are outside the scope of HSIP. In general, most schools/programs do not allow personal waivers. However, students who wish to discuss personal waivers of certain requirements should speak with the compliance officer or contact person for their particular Health Sciences school or academic program. Each school or program has different policies regarding personal waivers.

In the U.S., receiving BCG vaccine is not considered a contraindication to TB skin testing. TB skin testing occurs unless there is documented evidence of a prior positive PPD test. Chest x-rays are not interchangeable substitutes for a PPD. A chest x-ray is obtained only in the event of a documented positive PPD test. A negative interferon gamma release assay (IGRA) blood test is an acceptable alternative for an annual TB skin test.

Some students have had a positive TB skin test in the past but are unable to obtain the documentation. In those cases, provider verification of history is acceptable. A provider must complete the HSIP form with this information and sign for authentication to meet the documentation guidelines for our program.


Some students start interacting with patients, clients and community members within two weeks of arriving on campus. We need to ensure a safe environment for these students and the patients and clients they serve, and this is a difficult goal to meet if students do not arrive having already met he immunization requirements. In addition, the legal affiliation agreements between the practicum/clinical sites of practice and the University state that health sciences students have already completed all health care personnel  immunization requirements.

Even with insurance coverage, some costs following accidental exposure to bloodborne pathogens (e.g., needle sticks) can be denied for reimbursement when claims are made. We have determined that it is more cost effective to use health fee funds to provide gap coverage in these instances, rather than to use these funds for pre-entry immunizations that are more likely to be covered by health insurance plans.



Health Sciences Immunization Program (HSIP)

(206) 616-9074