All- We are following the
recent guidelines and drawing titers on new hires at risk who are without
Hep B titer results. You are correct in that the guidelines are vague
but we are erring on the side of caution to establish a baseline immunity
for employees at risk of exposure.
As far as the employee positive
for Hep C we use the SHEA guidelines as a reference.
Deryl
Deryl Long, RN, COHN Director of WellStar Employee
Health Services 677 Church Street Marietta, Georgia 30060 Office -770-793-7227 Fax-770-793-7952 Deryl.Long@Wellstar.org
The Flu Ends with You!
Get Vaccinated! It¡¯s the right thing
to do for our patients, our families, and our community.
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net]
On Behalf Of Barb K. Grabenbauer
Sent: Friday, January 16, 2015 3:49 PM
To: MCOH/EH
Subject: [MCOH-EH] Hep C positive HCW
Do you allow Hep C positive HCW's start
IV's?
Is that fall into: Digital
palpation of a needle tip in a body cavity
Thank you!
Barb Grabenbauer, RN
Quality Director
Marshalltown Medical & Surgical Center
Marshalltown, IA 50158
From: MCOH-EH [mcoh-eh-bounces@mylist.net]
on behalf of Brenda Kantner [bkantner@schuylkillhealth.com]
Sent: Wednesday, September 24, 2014 8:44 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] Hepatitis B and titers
It is unfortunate that even
though there were new 2013 CDC recommendations, there are still so many
individual decisions that need to be made with regard to Hep B for healthcare
workers. Nothing is ever totally clear-cut, but there are still so many
questions.
We still struggle with many
new hires not having documentation of their Hep B vaccines given in the
past. Previously, we would titer new hires
if the employee ¡°was sure¡±
they completed the series in the past. In most cases now, based on the
newest recommendations, we repeat the series or get a declination rather
than titer if there is no documentation of the three vaccines.
Brenda Kantner RN
COHN-S/CM
Employee Health Coordinator
Schuylkill Medical Center
700 East Norwegian St
Pottsville, PA 17901
Phone 570-621-4351
Fax 570-621-4257 bkantner@schuylkillhealth.com
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net]
On Behalf Of Adamo, Philip
Sent: Wednesday, September 24, 2014 8:40 AM
To: 'mcoh-eh@mylist.net'
Subject: Re: [MCOH-EH] Hepatitis B and titers
Good morning all:
I am interested in how your institution
handles Hep B titers at pre-placement
The 2013 CDC recommendations state:
¡°All HCP recently vaccinated
or recently completing HepB vaccination who are at risk for occupational
blood or body fluid exposure should undergo anti-HBs testing. Anti-HBs
testing should be performed 1¨C2 months after administration of the last
dose of the vaccine series when possible. HCP with documentation of a complete
¡İ3-dose HepB vaccine series but no documentation of anti-HBs ¡İ10 mIU/mL
who are at risk for occupational blood or body fluid exposure mightundergo anti-HBs testing upon hire or matriculation. Testing
should use a quantitative method that allows detection of the protective
concentration of anti-HBs (¡İ10 mIU/mL) (e.g., enzyme-linked immunosorbent
assay [ELISA]).¡± The word ¡°might¡± is not good
especially when mid level providers work off protocols. This is also different
then what figure 6 implies.We also know and the literature supports that
the measurement of immunity wanes over time. My recall is that after 7
years it is difficult to measure the immunity greater than 10. There is
also literature that those who receive the vaccine in infancy have undetected
immunity in adulthood; however, they are immune to Hep b.
Based on this information, I have
in previous hospitals set a standard of giving a booster for those with
documented 3 doses and more than 7 years and then checking the immunity
with a titer rather than checking a titer, getting an non immune
response, administering a booster and checking again. Any thoughts on this?
Thanks,
Phil
Philip Adamo, M.D., MPH,
FACOEM Associate Vice President
and Medical Director, Employee
Health & Occupational Injury Care
and Wellness UMass Memorial Medical
Center Hahnemann Campus Suite
201 291 Lincoln Street Worcester, MA 01605 Phone: 508-334-6179 FAX: 508-334-6433 cell 508-713-3993 philip.adamo@umassmemorial.org
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