The Texas Department of State Health Services requires that all students enrolled in health-related courses which involve direct patient contact submit a signed physicians' record documenting all immunizations listed below. This law applies to the Dental Assistant Program. All DA students are required to turn in immunization records prior to registering in the DA Program. These records should be turned in to the ADMISSIONS & RECORDS OFFICE OF TSTC and to the Dental Assisting Program. The following immunization form may be used as a guide to assure that you have the required immunizations:

HEPATITIS B Alone or Hepatitis A&B combo vaccine

All health care workers and any student, who will have patient contact or contact with potentially contaminated body fluids, are required to have had the Hepatitis B or Hepatitis A/B combo vaccine series prior to patient contact. The TSTC Dental Assistant Program requires written and signed documentation (by a health care provider) showing a complete series of 3 Hepatitis B or A/B vaccines with positive titer results 1.2 months post vaccination. The post-vac­cine titer is desired, but not mandatory. Titers will be necessary only in certain circumstances. Please certify the date and type of vaccine. Please note the date and result of quantitative antibody titer if one was obtained. A positive titer alone is not acceptable to satisfy the Hepatitis B requirements.

Name of vaccines received: Date of vaccine

1. _____________________________________________________

2. _____________________________________________________

3. _____________________________________________________

Post-vaccine quantitative antibody titer: Date/Results

_______________________________________________________

TUBERCULOSIS

A skin test for tuberculosis is required of all students within 12 months prior to registration. All students are required to be tested on a year­ly basis. Students who have not been tested within the last year are restricted from registration. Students testing positive for tuberculosis are required to undergo further medical evaluation which may include retesting, chest X-ray, liver function tests, anti-tuberculin drug thera­py, and/or other tests as indicated.

Date of Reading: _________________ Results: _________________

If PPD is positive, date & result of most recent Chest X-ray (must be within 12 months):

_______________________________________________________

VARICELLA (Chicken Pox)

Prior to registration, all students must submit one of the following:

1. Documentation of two immunizations administered on or after the first birthday and at least 30 days apart, or

2. Documentation from a health care provider on the date of the pre­vious disease (chicken pox or zoster), or

3. Laboratory report of positive immune serum antibody titer (IgG).

Date of first immunization: __________________________________ AND

Date of second immunization: _______________________________

OR

Date & result of Varicella titer: _______________________________

OR

Date of disease: _________________________________________

DIPHTHERIA-TETANUS (Td) or DIPHTHERIA-TETANUS-ACELLULAR PERTUSSIS (TdaP)

Proof of booster shot with either the TD or TDAP within the past 10 years is required prior to registration. Adults 19.64 years of age can substitute TdaP for one booster of Td. Health care workers who have direct patient contact should get one dose of TdaP. A 2-year interval since the last Td is suggested but not required.

Date of Diphtheria-Tetanus booster: __________________________

MEASLES (Rubeola)

All students must submit one of the following:

a) Signed physician's record documenting two (2) immunizations

administered on or after their first birthday and at least 30 days apart.

OR

b) Laboratory report of positive immune serum antibody titer (IgG).

Date of first immunization: __________________________________

AND

Date of second immunization: _______________________________

OR

Date & result of Rubeola titer: _______________________________

MUMPS

All students must submit one of the following:

a) Signed physician's record documenting immunization.

b) Laboratory report of positive immune serum antibody titer (IgG).

Date of mumps vaccine: ___________________________________

OR

Date & result of Mumps titer: ________________________________

RUBELLA

All students must submit one of the following:

a) Signed physician's record documenting immunization.

b) Laboratory report of positive immune serum antibody titer (IgG).

Date of Rubella vaccine: ___________________________________

OR

Date/result of Rubella titer: _________________________________

Decline vaccination (Init): __________________________________

 

Policy on Blood Borne and Infectious Diseases

In working as a dental assistant you will be exposed to blood borne pathogens, infectious diseases and materials. These include but are not limited to, Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) as well as human body fluids, tissues and contaminated materials. Therefore, as a student you will learn and follow the proper health and safety measures and precautions in working with patients and others.

It is the policy of TSTC not to discriminate against students who are HIV-positive. It is also the policy of the college to increase awareness and provide education to its students and employees about HIV infection and AIDS virus with the express purpose of preventing infection and limiting the consequences of infection. Copies of this policy are available in the Counseling & Testing Center and at Student Health Services.