We do allow an unvaccinated (or those without appropriate titers) healthcare worker to work. It is too high a risk for a population of primarily women of childbearing age. This risk that is being mitigated is both the employee's risk and the patient's risk. Hepatitis B is the only voluntary vaccination for a HCW.

Nancy Rodway MD MPH FACOEM

Sent from Outlook

From: MCOH-EH <mcoh-eh-bounces+nrodway=hotmail.com@mylist.net> on behalf of Morelli, Karen J <kmorelli@emhs.org>
Sent: Monday, February 27, 2017 12:29 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] MMR vaccine requirements

If the employee has no record of vaccine, we recommend getting 2 vaccines spaced by one month. We allow them to work after they have received the first vaccine. We also allow for declination, so if a person doesn't want to receive the vaccine, they need to sign the declination before we can clear them to work. We advise them that if there is an outbreak, they will not be able to work and this is unpaid time.

Thank you,
Karen Morelli RN, BSN, CEAS, Clinical Supervisor
WorkHealth~Bangor Region

-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Jayme Kasman
Sent: Monday, February 27, 2017 12:09 PM
To: 'mcoh-eh@mylist.net'
Subject: Re: [MCOH-EH] MMR vaccine requirements

*********************************************************************************************************************************************
The e-mail below is from an external source. Please do not open attachments or click links from an unknown or suspicious source.
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We use the following guidance from the CDPH (California Department of Public Health) https://www.cdph.ca.gov/programs/immunize/Documents/CDPH_IZ_Recs_CA_HCP.pdf
Entitled:
California Department of Public Health - August 2015 Immunization and Immunity Testing Recommendations for California Healthcare Personnel and Health Science Students

We allow staff to work if they have started the vaccination process for MMR

Jayme Kasman, RN, MSN
Employee Health Nurse
Barton Occupational Health
P: 775-589-8935 F:775-589-8979
jkasman@bartonhealth.org
www.bartonhealth.org

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-----Original Message-----
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Sent: Wednesday, February 22, 2017 9:46 AM
To: mcoh-eh@mylist.net
Subject: MCOH-EH Digest, Vol 252, Issue 75

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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@glensfallshosp.org>
To: "mcoh-eh@mylist.net" <mcoh-eh@mylist.net>
Subject: [MCOH-EH] MMR vaccine requirements
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        <DM5PR10MB1321DE24F3FD9350D3E97444B0500@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@Vanderbilt.Edu>
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] MMR vaccine requirements
Message-ID:
        <984BE23843F0DE4EBE652D6EE07600BE65CB5903@ITS-HCWNEM104.ds.vanderbilt.edu>

Content-Type: text/plain; charset="us-ascii"

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.<http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6007a1.htm>

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@mylist.net] On Behalf Of Reichen, Catherine
Sent: Wednesday, February 22, 2017 11:36 AM
To: mcoh-eh@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

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The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
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The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh@mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   http://www.mcoh-eh.net
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
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List archives (public): http://mylist.net/archives/mcoh-eh/
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Send administrative requests to: drjoe@meditrax.com
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