Does your health dept require titers after exposure if you have full vaccination records?

There are those individuals whose immunity will just not be reflected in an IgG. I had a pediatric resident who spent an hour in the room with an infant with measles, we only had one MMR on record so we gave one post exposure but because of delayed diagnosis we were behind the 8 ball. We simultaneously did an IgG which was negative, so we furloughed her. While she was home she had time to find her old records. She found both pediatric vaccines plus the one she had to get for college, so she had documentation of 3 prior MMRs before the exposure.

 

Despite her negative IgG and her hour spent cooped up with what turned out to be a highly infectious measles case (wearing NO PPE because at her age she’d NEVER seen measles before) she did not develop the disease.

 

There are people who will never seroconvert but are immune, and I think if you have good vaccination records you can stop there. (ongoing transmission or a shaky immunization history would be the exception of course.)

 

 

 

We require titers for all, esp since few people provide vaccination records.  Most of the medical staff are also employees. 

 

This came in handy last year when we had a measles exposure incident.  Over 450 employees were potentially exposed, according to our State Dept of Health, and it mandated that only those with documented immunity could work and not be furloughed.  Because we already had the tests done, operations were less disrupted than they would have been.

 

 

 

We finally tied it to credentialing/recredentialing. Took some time to build the case, but once done compliance was virtually 100% after the first 2 year recredentialing cycle.

 

 

 

Thanks, Melanie.  This is currently a requirement for our employees, but not privileged physicians (unless they are employed by us).  I'm trying to advocate for applying the same requirement for all, but need to find out how others do it first.  Have a nice holiday!

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Swift, Melanie
Sent: Thursday, December 11, 2014 1:37 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] MMR & VZ - proof of immunity

Yes we require proof of immunity or vaccination. For MMR we provide vaccination, for VZ we provide antibody testing and then vaccination if negative.

If born prior to 1957, considered immune to measles and mumps.

Same for all. (our physicians are employees, though we have a very small number of community physicians with privileges, same requirements apply to them.)

 

 

 

For MMR & VZ, does your organization require proof of immunity for employees and staff?  Are the requirements the same or different for new employees vs. newly credentialed physicians on medical staff?

 

 

 

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