Immunization Requirement: Bacterial Meningitis (ACYW-135)
The State of Texas requires all incoming students to provide proof of vaccination against Bacterial Meningitis, or an approved exemption, at least 10 days before classes begin. Bacterial Meningitis is a serious, potentially deadly disease that can progress extremely fast. It is inflammation of the membranes that surround the brain and spinal cord, and can also infect the blood.
There are 5 primary types of bacteria, A,C,Y,W-135 and B, that cause meningococcal disease, also known as meningitis. There are different vaccines for each group type. There are vaccines that cover the ACYW-135 group, that meet the current state requirement, and there are vaccines for group B meningitis. Although the vaccine that protects against the ACYW-135 strains are currently required, we recommend both. Please consult with your healthcare provider about the benefits of both vaccinations.
Submit Your Immunization Record
Submit a vaccination record for bacterial meningitis if you:
- Are 21 years of age and younger and are entering TSU for the first time.
- Are 21 years of age and younger and returning to TSU after a break in enrollment of one fall/spring semester.
- Plan to live in campus housing.
Here’s how to submit your immunization record to Student Health Services.
- Print out and complete the Immunization Compliance Cover Sheet & Acknowledgement Form.
- Print out the Vaccination Administration Record and give it to the healthcare provider to record your immunization or provide a copy of your current immunization record.
- Upload your documents to the "My Tiger Health Patient Portal" at https://tsu.medicatconnect.com.
Remember to upload a copy of your Vaccine Administration Record and the Immunization Compliance Cover Sheet & Acknowledgment Form. You will not be considered compliant until this step has been completed. Send all immunization records directly to Student Health Services.
Important Points to Remember When Submitting an Immunization Record:
- Your shot record must be legible
- We cannot accept records older than 5 years old.
- The immunization must be administered at least 10 days before classes begin.
- All international records must be translated into English.
If you cannot login to the patient portal, submit your immunization record to: email@example.com
Please allow 3 business days for processing.
Have an exemption?Students who wish to submit an exemption for reasons of conscience, including a religious belief, must request the official Texas Department of State Health Services (DSHS) affidavit form. This may be done online, by mail or fax. Once requested, the form will be mailed to you from DSHS. Please allow 7 to 10 business days for delivery of the form. Please choose one of the following options to request the form from DSHS:
- Online request: https://co-request.dshs.texas.gov
- Fax the written request to: 512-776-7544
- Mail the written request to:
Once the affidavit is received, it must be completed and notarized. This form is a State of Texas Form and must be notarized by a State of Texas Notary. Student Health Services must receive the original affidavit, copies will not be accepted.
To accept a medical exemption, it must be signed by a physician who is duly registered and licensed to practice medicine in the United States. It should state that in the physician’s opinion, the vaccination would be injurious to the health and well-being of the student. It must include the physician’s contact information and it must be signed by the physician. Please choose from the following options to send in your medical exemption.
- Upload to the My Tiger Health Patient Portal at https://tsu.medicatconnect.com
- Mail to Texas Southern University, Student Health Services, 3100 Cleburne St, Houston, TX 77004
- E-mail to firstname.lastname@example.org
If you need additional assistance, Student Health Services is available at 713-313-7173.
Providing a valid immunization record for bacterial meningitis (ACWY) or an approved exemption is required by the State of Texas. Failure to submit the required documentation to Student Health Services will result in removal from classes.