Important Information About Measles and New Requirements

Dear MIIS Faculty, Staff, and Students:     

We are writing to share some important information regarding measles. All faculty, staff, and students living and/or working on campus or MIIS housing must take steps now to ensure that they obtain valid proof of immunity by June 15. 

This requirement does not apply to Middlebury undergraduate students who have already provided proof of immunity to Middlebury’s Center for Health and Wellness.    

In this message we will provide information about the following:

• What’s changing?
• What is measles?
• Exclusion from work and school
• Proof of immunity
• Vaccination guidance
• Health insurance coverage
• Documented proof of immunity

More information can also be found on this website.

What’s Changing?

Measles cases have been recently documented in Vermont and California and are rising both domestically and internationally.

Middlebury is now requiring documented proof of immunity for all faculty, students and staff to avoid exclusion from work or school in the event of a measles outbreak on a Middlebury campus. 

Deadlines to submit proof of vaccination are as follows:

• June 15, 2024 for individuals working or learning during the summer programs
• August 15, 2024 for all other students and employees

We will provide a system for you to submit this information in advance of the start of our summer programs, and we will provide those instructions, along with frequently asked questions and answers, within the next two weeks.   

A measles case on a Middlebury campus would result in immediate exclusion of individuals who do not have valid proof of immunity and potentially cause significant disruptions in learning and operations. Proof of immunity can be provided through vaccine documentation or a blood test.    

What is Measles?

Measles is a highly infectious virus that causes fever, cough, conjunctivitis, runny nose, a classic rash, and sometimes ear infections and diarrhea. It can live for up to two hours in airspace where the infected person coughed or sneezed. If other people breathe the contaminated air or touch an infected surface, then touch their eyes, noses, or mouths, they can become exposed. While two doses of MMR vaccine are considered 97 percent effective at preventing measles and one dose is about 93 percent effective, non-immunized people have a high likelihood of becoming infected and spreading measles to others. For example, according to the Centers for Disease Control (CDC), measles is so contagious that if one person has it, nine out of 10 people of all ages around that person will also become infected if they do not have immunity.

As we move into the summer and welcome a whole new population to our campuses, including students, faculty, staff, and family members from locations around the world, it is especially important to protect ourselves and one another. Although the likelihood of an outbreak on campus remains low, the impact would be high for students, faculty, and staff.    

Exclusion From Work and School

In the event of a measles outbreak, Middlebury will enforce the restrictions from theCDC and the Vermont and California Departments of Health, which is exclusion from school and/or work for 21 days after the last case occurs for people without documented evidence of immunity. This includes people who have been exempted from measles vaccination for valid medical reasons. 

For example, if a student working on campus this summer attending one of our summer programs were exposed to measles and did not have valid proof of immunity, they would miss a minimum of three weeks of the session. This would have a significant impact on their ability to complete the program. Similarly, a Middlebury faculty or staff member exposed to measles who does not have proof of immunity, may not be eligible to work on a Middlebury campus for three or more weeks.   

Please note that while it is possible for unimmunized people to avoid exclusion if given the measles vaccine within 72 hours after exposure, measles vaccine supply cannot be guaranteed. Also, since measles patients can transmit the virus up to four days before knowing that they have measles, it is possible that someone who is exposed will miss the opportunity for post-exposure vaccination.

We understand that this is short notice, but we wanted to get this information to you now so that you can avoid exclusion from a Middlebury campus in the event of a measles outbreak.     

Proof of Immunity

All incoming students, faculty, and staff, as well as all current faculty and staff who will be working on the MIIS campus or on any Middlebury campus this summer must obtain documented proof of immunity for measles, such as blood test results showing antibody against measles (Measles IgG test) or a valid record of immunization. See instructions below. There will be a similar requirement for faculty and staff returning to MIIS in the fall, and we encourage those individuals to provide proof of immunity as soon as possible. Partners/spouses and children of summer faculty and staff who are living on a Middlebury campus must also have documented proof of immunity. Please obtain this documentation as soon as possible. You will receive instructions within the next two weeks about how to submit this information to MIIS.    

Note: Individuals born before January 1, 1957, are assumed to be immune to measles and do not have to provide proof of immunity, but they will still need to provide an attestation of their date of birth. Attestation instructions to follow.

Exemptions are for those who should not take the vaccine for medical reasons. Signed medical exemption forms must be submitted, but please note that a medical exemption will not prevent exclusion from campus during an outbreak. Individuals with medical exemptions should create and maintain a plan for immediate exclusion in the event of a measles outbreak on campus. Individuals will receive instructions for submitting medical exemption documentation within the next two weeks. 

Individuals should also have a conversation with their personal physician or health care provider about immunization and/or proof of immunity for other vaccine-preventable illnesses such as mumps, rubella, varicella, and pertussis.      

Vaccination Guidance

People who were vaccinated between 1957 and 1968 should be revaccinated with at least one dose of live attenuated measles vaccine (MMR). This recommendation is intended to protect those who may have received a killed measles vaccine, which was available between 1963 and 1967 and was not effective. 

Two doses of the vaccine are recommended for all international travelers, healthcare workers, K-12 students and undergraduate students living in dorms. Undergraduate students attending Middlebury are already subject to a separate documentation process and do not need to do anything further. 

The CDC has advice about how to get copies of vaccination records. The MMR vaccine is available through your doctor, and U.S. pharmacies offer easy online scheduling for vaccination.   

Health Insurance Coverage

Many health insurance plans cover the costs of vaccinations and/or antibody testing, but everyone should confirm if that is true for your insurance plan as well as how it should be billed (i.e. in-network, preventative care).

For Middlebury employees with Cigna, Green Mountain Higher Education Consortium has confirmed that Cigna allows for coverage on both the antibody lab testing as well as the vaccine for MMR as follows: Coverage benefits will be based on whether the provider is in or out of network. In-network will pay at 100 percent when billed as preventive. Be sure that you confirm that it is in-network and will be billed as preventative.   

For out of network providers: Gold and Silver plans pay 70 percent for immunizations after the deductible. Platinum immunization plans pay 100 percent.  

Documented proof of immunity  

All medical records must meet the following criteria: 

• Documentation MUST be in English and legible. Original documentation may be in a foreign language with translation attached   
• Show patient name and date of birth consistent with an official government ID (i.e. passport or driver’s license)  
• Show medical clinic, pharmacy, or laboratory contact information.
  • The Figure 1 vaccine record below meets documented proof of immunity requirements. 
  • The Figure 2 vaccine record below does not meet documented proof of immunity requirements    
• Lab results must be on an official report indicating that the result shows immunity to measles (rubeola)
• Vaccine records must show:
  • The vaccine provided  
  • The number of doses   
  • The date(s) provided  
  • Meet the recommended dosing schedule for immunity (see Table 3) 
• International travelers, undergraduate students, and healthcare workers require two documented doses of MMR vaccine. Others, such as short-term program summer students and employees who do not fall into those categories require one documented dose of MMR vaccine (Language Schools, BLSE, Writers’ Conference, etc.)   
• Verbal reports of vaccination without written documentation will not be accepted as presumptive evidence of immunity

Figure 1: Here is an example of a vaccine record that meets documented proof of immunity requirements.

Figure 2: Here is an example of a vaccine record that does not meet documented proof of immunity requirements.

For questions or support regarding any information in this message, please contact Middlebury’s Immunization Verification Team at immunizationverification@middlebury.edu.