The selection criteria* includes the following categories at the stated percentages:
|Vaccine||Recommendations in brief|
|Hepatitis B||Give three-dose series (first dose now, second in one month, #third approximately 5 months after second dose). Give IM. Obtain anti-HBs serologic testing 1-2 months after third dose.|
|Influenza||Give one dose of TIV or LAIV annually. Give TIV intramuscularly or LAIV intranasally.|
|MMR||For healthcare personnel (HCP) born in 1957 or later without serologic evidence of immunity or prior vaccination, give two doses of MMR, 4 weeks apart. For HCP born prior to 1957, see below. Give SC.|
|Varicella (chickenpox)||For HCP who have no serologic proof of immunity, prior vaccination, or history of varicella disease, give two doses of varicella vaccine, 4 weeks apart. Give SC.|
|Tetanus, diphtheria, pertussis||Give all HCP a Td booster dose every 10 years, following the completion of the primary three-dose series. Give a one-time dose of Tdap to all HCP younger than age 65 years with direct patient contact. Give IM.|
|Meningococcal||Give one dose to microbiologists who are routinely exposed to isolates of N. meningitidis.|
Hepatitis A, typhoid, and polio vaccines are not routinely recommended for HCP who may have on-the-job exposure to fecal material.
Healthcare personnel (HCP) who perform tasks that may involve exposure to blood or body fluids should receive a three-dose series of hepatitis B vaccine at 0-, 1-, and 6-month intervals. Test for hepatitis B surface antibody (anti-HBs) to document immunity 1-2 months after third dose.
For non-responders:HCP who are non-responders should be considered susceptible to HBV and should be counseled regarding precautions to prevent HBV infection and the need to obtain HBIG prophylaxis for any known or probable parenteral exposure to hepatitis B surface antigen (HBsAg)- positive blood. It is also possible that non-responders are persons who are HBsAg positive. Testing should be considered. HCP found to be HBsAg positive should be counseled and medically evaluated.
Note: Anti-HBs testing is not recommended routinely for previously vaccinated HCP who were not tested 1-2 months after their original vaccine series. These HCP should be tested for anti-HBs when they have an exposure to blood or body fluids. If found to be anti-HBs negative, the HCP should be treated as if susceptible.*
Trivalent (Inactivated) Influenza Vaccine (TIV): May give to any HCP. Live, Attenuated Influenza Vaccine (LAIV): May give to any non-pregnant healthy HCP age 49 years and younger.
Measles, Mumps, Rubella (MMR)
HCP who work in medical facilities should be immune to measles, mumps, and rubella.
HCP born in 1957 or later can be considered immune to measles, mumps, or rubella only if they have documentation of (a) physician-diagnosed measles or mumps disease; or (b) laboratory evidence of measles, mumps, or rubella immunity (HCP who have an "indeterminate" or "equivocal" level of immunity upon testing should be considered nonimmune); or (c) appropriate vaccination against measles, mumps, and rubella (i.e., administration on or after the first birthday of two doses of live measles and mumps vaccines separated by 28 days or more, and at least one dose of live rubella vaccine).
Although birth before 1957 generally is considered acceptable evidence of measles, mumps, and rubella immunity, healthcare facilities should consider recommending a dose of MMR vaccine (two doses during a mumps outbreak) to unvaccinated HCP born before 1957 who are in either of the following categories: (a) do not have a history of physician-diagnosed measles and mumps disease or laboratory evidence of measles and mumps immunity and (b) do not have laboratory evidence of rubella immunity.
It is recommended that all HCP be immune to varicella. Evidence of immunity in HCP includes documentation of two doses of varicella vaccine given at least 28 days apart, history of varicella or herpes zoster based on physician diagnosis, laboratory evidence of immunity, or laboratory confirmation of disease.
All adults who have completed a primary series of a tetanus/diphtheria-containing product (DTP, DTaP, DT, Td) should receive Td boosters every 10 years. As soon as feasible, HCP younger than age 65 years with direct patient contact should be given a one-time dose of Tdap, with priority given to those having contact with infants younger than age 12 months
Vaccination is recommended for microbiologists who are routinely exposed to isolates of N. meningitidis. Use of MCV4 is preferred among persons ages 11-55 years; give IM. If MCV4 is unavailable, MPSV is an acceptable alternative for HCP ages 11-55 years. Use of MPSV is recommended for HCP older than age 55; give SC
*See Table 3 in "Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis," MMWR, June 29, 2001, Vol. 50, RR-11. For additional specific ACIP recommendations, refer to the official ACIP statements published in MMWR. To obtain copies, visit CDC's website at www.cdc.gov/nip/publications/ACIP-list.htm; or visit the Immunization Action Coalition (IAC) website at www.immunize.org/acip. Adapted with thanks from the Michigan Department of Community Health www.immunize.org/catg.d/p2017.pdf Item #P2017 (3/07) Immunization Action Coalition, 1 573 Selby Ave, St. Paul, MN 55104, (651)647-9009 www.immunize.org, www.vaccineinformation.org.
DH Program Info Line
Director of Dental Hygiene
Dental Hygiene Instructor
Dental Hygiene Professor
Pierce College Fort Steilacoom
Dental Hygiene Program
9401 Farwest Drive SW
Lakewood, WA 98498-1999