Immunizations and TB testing for Rivier clinicals
Rivier University asks every clinical student for proof of immunity to measles, mumps, rubella, varicella and hepatitis B, a current Tdap, a flu shot each year by September 30 and a TB test every year. Most of it is gathered once; the flu shot and TB test come back every year you are in clinical courses. Here is what each item takes and where files get held up.
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The shots and tests Rivier asks for
Rivier's Nursing Student Handbook sets one medical standard for students in clinical and practicum courses, graduate and undergraduate alike. It lives in your CastleBranch (myCB) record with the rest of your file, which the CastleBranch requirements guide covers item by item. This page stays with the six medical items and the choices each one gives you.
| Item | What counts | Repeats? |
|---|---|---|
| MMR | Two doses, or titers | No, once the standard is met |
| Varicella | Two doses, or a titer | No, once the standard is met |
| Hepatitis B | A positive titer | No, once the standard is met |
| Tdap | Tdap; add a Td booster when the Tdap is over 10 years old | When the 10 years run out |
| Influenza | The season's vaccine, by September 30 | Every year |
| Tuberculosis | 2-step skin test, QuantiFERON or T-SPOT | Every year |
Start with anything that needs a blood draw. Titers take a lab visit and a wait for results, and those results decide whether more doses are needed.
MMR and varicella: two doses or proof of immunity
For measles, mumps and rubella, Rivier accepts either two documented doses or titers. Varicella follows the same pattern: two doses, or a titer. If your childhood vaccine records have gone missing, a titer can settle the question with one blood draw instead of a search through old pediatric files.
Upload the lab report itself rather than a summary, with your name, the test and the result visible. A handwritten note that a test was done leaves the reviewer guessing.
If a titer comes back negative or equivocal, ask the Clinical Practicum Coordinator what Rivier will accept before you book extra doses, so the work only happens once. Keep the original report even after the question is settled; it answers the same question at every site you rotate through.
Hepatitis B: the titer has to be positive
Hepatitis B deserves the earliest start of anything on the list. Rivier's Handbook asks for a positive hepatitis B titer, a blood result showing immunity, rather than a list of vaccine dates. Plan on the lab test even if you finished the vaccine series years ago as a new nurse.
A negative titer is not the end of the road, but it can add weeks or months while you sort out the next step with your PCP. Talk to your primary care provider and the Clinical Practicum Coordinator as soon as the result arrives, because resolving it can take longer than any other item here.
A hepatitis B vaccine card on its own does not meet Rivier's standard. The Handbook asks for a positive titer.
Tdap, and when a Td booster comes in
Rivier asks for a Tdap. If your Tdap was given more than 10 years ago, you also need a Td booster. The date matters across your whole program, not only the coming semester.
Work it out once: add ten years to the date of your last Tdap and compare the result with your final practicum semester. If the ten-year line falls before the end of your program, the booster comes due partway through, and it is simpler to handle it in a break than in the middle of a rotation. Your PCP's office or the pharmacy that gave the shot can usually print the record. Upload the Td record as soon as you have it, so your file never shows an expired Tdap.
The flu shot, every year by September 30
The flu vaccine is the one item with a fixed calendar date: every year by September 30. It applies to every clinical student and resets each fall for as long as you are in clinical or practicum courses.
Exemptions are narrow. The only waiver Rivier accepts is a medical waiver from your primary care provider. A waiver keeps you in line with Rivier, but it does not bind a clinical site, which can apply its own vaccine rules.
Fall practicum students should ask the Clinical Practicum Coordinator how this date fits the four-month upload rule for graduate records, because the two do not line up neatly for a September start. Spring and summer students simply carry the fall shot forward, then repeat it the next September.
TB testing: three options, once a year
Rivier accepts three TB tests: a 2-step tuberculin skin test, a QuantiFERON blood test or a T-SPOT blood test. Whichever you pick, it repeats every year you are in clinical courses.
The 2-step skin test takes several visits for placing and reading, while either blood test needs a single draw. That difference can matter if you work shifts or live far from a clinic.
A positive TB history changes the requirement. You provide a chest X-ray taken within the past 5 years and a yearly symptom check by your PCP. Watch the X-ray date: once the film is more than five years old, you need a new one before your next practicum semester.
Exemptions and clinical sites
A site can hold you to a stricter standard than Rivier does. The Handbook says clinical agencies may refuse students who have vaccine exemptions, and that Rivier is not bound to arrange a different placement if one does. The older 2018 practicum form goes further: where an agency's rules and Rivier's differ, the agency's win.
If you hold any exemption, raise it before a site is chosen rather than after. The steps that follow a refusal are covered in when an agency says no, and the timing pressure behind all of this is set out in Rivier's placement deadlines.
When you tell us about an exemption at the start, we ask each site about its vaccine policy before we present it, so the preceptor you meet works somewhere that can take you. Tell us about your placement through the form below, or see how our search works.
Questions Rivier students ask
Does Rivier accept a COVID vaccine exemption for clinicals?
Rivier's Handbook speaks to this from the clinical site's side. An agency may refuse a student who has a vaccine exemption, and if it does, Rivier is not required to find the student somewhere else. Whether a given hospital or practice takes students with exemptions is its own decision, so ask each site directly and tell the Clinical Practicum Coordinator early.
Can I use a TB test from my job for Rivier?
Rivier's rule is about the kind of test and the yearly cycle, not where it was done. If your workplace result is a 2-step skin test, QuantiFERON or T-SPOT and is still current, ask the Clinical Practicum Coordinator whether it can go into your myCB record, and upload the official result rather than a summary.
Do I need titers if I have my MMR vaccine records?
Not for MMR or varicella. Two documented doses meet Rivier's standard for each, and titers are the alternative when dose records are missing. Hepatitis B is the exception: the Handbook asks for a positive titer whatever your vaccine history shows, so plan that blood draw even with a complete record.
Do online Rivier NP students have to meet the flu deadline?
Yes. The immunization standard applies to students in clinical and practicum courses whether they study on campus in Nashua or online from another state. Get the shot wherever is convenient, from your PCP or a pharmacy, and upload proof to your myCB account by September 30. Only a medical waiver from your PCP replaces it.
Where do I upload immunization records for Rivier?
In CastleBranch. Rivier stores clinical requirements in a myCB account at castlebranch.com, and graduate students upload them four months before practicum courses. Keep your own copies as well: the yearly items come due again, and a clinical site may ask to see records during its own onboarding.
Related pages
Last checked 2026-09-26
We check these pages against Rivier's own Nursing Student Handbook, program sheets, catalog, academic calendar and State Guide. Your program of study, your course faculty, your Program Director and the Clinical Practicum Coordinator have the final word.
Rivier asks you to identify a qualified preceptor. We make that the easy part.
Tell us your Rivier track, where you live and which semester your next practicum starts. We find preceptors who meet your track's rules, check early whether the site can contract with Rivier, and prepare everything the Preceptor Request Form asks for, well ahead of August 1 and December 1.
- Preceptors matched to the track: an MD, DO or FNP in outpatient family practice for
NURS 511, a psychiatrist or PMH-certified NP forNURS 521, a hospitalist or intensivist forNURS 638P - Preceptor license, credentials and CV ready for the Preceptor Request Form, with the site's contact details for the contract
- In your own area, in New Hampshire or any state Rivier's State Guide accepts
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