[MCOH-EH] MCOH-EH Digest, Vol 252, Issue 75

[Harriman, Kathleen (CDPH-CID-DCDC-IMM)]

Here is the information we put together for California HCWs: http://www.cdph.ca.gov/programs/immunize/Documents/CDPH_IZ_Recs_CA_HCP.pdf

With regards to your specific question: If an employee doesn't have any documentation of MMR vaccine doses, then serologic testing is appropriate (if the employee can document one MMR dose, then give the second dose and do not test). If testing indicates that the worker is not immune to rubeola (measles) or mumps, he/she would need two MMR doses. If the worker is not immune to (only) rubella, then only one dose of MMR vaccine would be needed. 

Kathleen Harriman, PhD, MPH, RN
Immunization Branch
California Department of Public Health
kathleen.harriman at cdph.ca.gov


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Today's Topics:

   1.  MMR vaccine requirements (Reichen, Catherine)
   2. Re:  MMR vaccine requirements (Swift, Melanie)


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Message: 1
Date: Wed, 22 Feb 2017 17:36:18 +0000
From: "Reichen, Catherine" <creichen at glensfallshosp.org>
To: "mcoh-eh at mylist.net" <mcoh-eh at mylist.net>
Subject: [MCOH-EH] MMR vaccine requirements
Message-ID:
	<DM5PR10MB1321DE24F3FD9350D3E97444B0500 at DM5PR10MB1321.namprd10.prod.outlook.com>
	
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Can anyone help me out?  If a new hire does not have vaccine records to prove MMR vaccination - we run titers.  If the titer for rubeola shows no immunity but rubella shows immunity - should the employee receive one or two MMR's?  Do you run repeat titers after a period of time?  Do you allow them to start working with only one vaccine? Can you also provide a resource of how to determine this requirement?  Thank you in advance!

Cathy

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Message: 2
Date: Wed, 22 Feb 2017 17:45:27 +0000
From: "Swift, Melanie" <melanie.swift at Vanderbilt.Edu>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] MMR vaccine requirements
Message-ID:
	<984BE23843F0DE4EBE652D6EE07600BE65CB5903 at ITS-HCWNEM104.ds.vanderbilt.edu>
	
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Hi Cathy,

The CDC does not recommend that you run titers for these diseases in the absence of vaccination records. If someone does not have a record of vaccination, the appropriate thing to do is vaccinate them. Antibody testing is not very informative or helpful for MMR. No, you should not check titers after vaccinating. One in 5 appropriately vaccinated individuals will have a negative IgG for mumps!

We do accept a positive antibody test if someone presents us with one, and we have checked IgG on someone who has a contraindication to vaccination, just to guide an accommodation decision.

Guidance may be found at Immunization of health-care workers: recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR 2011;60(RR07);1-45.<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.cdc.gov_mmwr_preview_mmwrhtml_rr6007a1.htm&d=DwICAg&c=Lr0a7ed3egkbwePCNW4ROg&r=hTSNVGl_lH1D3dMZRBGXOXL32T66SSgFMVt6rTw8dYc&m=yDaBlCvzB7E6tQSoTnTXd2k7pbblnf_7HDPcUmqKP7s&s=FyOrK9SCDOGC80Xu9y8EccoINrdslhPM2L3NrePcK_w&e= >

Attached is a statement we provide to people whose school, or next employer, is asking them to have labs drawn despite appropriate vaccination.

Melanie

Melanie Swift, MD
Associate Professor of Clinical Medicine Director, Vanderbilt Occupational Health Clinic Vanderbilt University Medical Center

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Reichen, Catherine
Sent: Wednesday, February 22, 2017 11:36 AM
To: mcoh-eh at mylist.net
Subject: [MCOH-EH] MMR vaccine requirements

Can anyone help me out?  If a new hire does not have vaccine records to prove MMR vaccination - we run titers.  If the titer for rubeola shows no immunity but rubella shows immunity - should the employee receive one or two MMR's?  Do you run repeat titers after a period of time?  Do you allow them to start working with only one vaccine? Can you also provide a resource of how to determine this requirement?  Thank you in advance!

Cathy