Before the introduction of effective vaccines against measles, mumps and rubella in the mid- 1960s, these diseases and their complications were events endured by virtually all children before they reached adolescence. Each year, the occurrence of these diseases resulted in thousands of deaths and tens of thousands of cases of pneumonia, encephalitis, and the complications leading to permanent brain damage, deafness, serious birth defects and many other serious consequences. The use of measles, mumps, and rubella (MMR) vaccine during the major measles elimination effort from 1978 to 1983 effectively reduced cases of all three diseases.

During the first six months of 1989, 81% of the reported cases of measles in New York State occurred in 12 outbreaks in post-secondary institutions. These outbreaks resulted in high costs to both students and institutions for vaccine, treatment of acute illness and disease complications, lost wages and classroom time, and disruption of the learning environment. These outbreaks resulted from inadequate immunization or vaccine failure in some students coupled with the close contact in living and study quarters inherent in the college setting. The outbreaks resulted in the enactment of Public Health Law (PHL) Section 2165 (effective August 1, 1990) that mandated measles, mumps and rubella immunizations for college students and demonstrated the continuing need for effective immunization policies.

During the college measles outbreaks of 1989, the regulatory changes necessary to prevent a continuing epidemic and its attendant costs became apparent. These were enacted through changes to PHL Section 2165 mandating documentation of immunity as a prerequisite for college enrollment and attendance; and requiring a two-dose immunization schedule that adequately protects against measles vaccine failure. Implementation of these changes has curtailed outbreaks of measles, mumps and rubella on college campuses.

While anyone can get meningococcal disease, some adolescents, such as first year college students living in dormitories, are at an increased risk of meningococcal disease. On August 15, 2003, another statute, PHL Section 2167, took effect. This law requires that post-secondary institutions distribute information about meningococcal meningitis and meningitis immunization to all students. Schools must also provide students with a response form on which students indicate that they have reviewed the information and decided not to be immunized, or have received a meningitis immunization within ten years prior to the date of the response form. The institution must retain the completed response form or certificate of immunization and not permit any student to attend the institution in excess of thirty days who has not returned a response form or provided documentation of immunization against meningococcal disease.