[MCOH-EH] MMRV

Leslie Thompson Leslie.Thompson at sharp.com
Fri Dec 12 12:47:38 PST 2014


Thanks for clarification Melanie.  The latter is my question - surgical mask year round for hypothetical asymptomatic source in absence of known exposure.  In CA many counties mandate surgical mask during flu season if vaccine declined regardless of reason.  Wondering if anyone takes that same approach year round for MMRV.  And if so, any data/studies to support.  I have seen none.
Leslie Thompson, MSN, RN, COHN-S
Manager
Employee Occupational Health Department
Sharp HealthCare
858-499-5264
leslie.thompson at sharp.com<mailto:leslie.thompson at sharp.com>

From: MCOH-EH [mailto:mcoh-eh-bounces+leslie.thompson=sharp.com at mylist.net] On Behalf Of Swift, Melanie
Sent: Friday, December 12, 2014 11:47 AM
To: MCOH/EH
Subject: [MCOH-EH] MMRV

Was not sure if you mean using N95 as PPE (yes, but if known contagious source don't knowingly assign non immune staff) or (no)

Sent from my iPhone

On Dec 12, 2014, at 12:37 PM, Leslie Thompson <Leslie.Thompson at sharp.com<mailto:Leslie.Thompson at sharp.com>> wrote:
Does anyone that mandates MMR and VZ, mask those that have medical or religious exemption?


From: MCOH-EH [mailto:mcoh-eh-bounces+leslie.thompson=sharp.com at mylist.net] On Behalf Of Swift, Melanie
Sent: Friday, December 12, 2014 9:58 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] [This might be SPAM] MCOH-EH Digest, Vol 249, Issue 7

We require vaccination, however as with any mandatory vaccine you must provide medical and religious accommodations. And with live virus vaccines such as MMR and VZ there are more medical contraindications than you'd have for flu vaccine. In pregnancy we give a one year deferral, then vaccination required unless some other contraindication.
The main benefit of the mandatory vaccine, to my mind, is that we have the vast majority immune, and we know exactly who is not immune and could not take vaccine. This is very helpful in managing an exposure and mitigating the impact to staffing.

Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic
http://occupationalhealth.vanderbilt.edu

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Hudson, T. Warner
Sent: Friday, December 12, 2014 11:37 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] [This might be SPAM] MCOH-EH Digest, Vol 249, Issue 7

If no documentation of  2 vaccines at least 28 d apart or protective titer, we do vaccinate or restrict from patient area work.  It is amazing how often after that people are able to find the documentation or accept the vaccine. Our issue is that if you are in a non patient area, later you can transfer to a patient area and we have no system to catch these.
T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health
UCLA Health System and Campus
Office 310.825.9146
Fax 310.206.4585
Pager 800.233.7231  ID 27132
E-mail twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org>

From: MCOH-EH [mailto:mcoh-eh-bounces+twhudson=mednet.ucla.edu at mylist.net] On Behalf Of Cassano Victoria
Sent: Friday, December 12, 2014 8:48 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] [This might be SPAM] MCOH-EH Digest, Vol 249, Issue 7

For those hospitals that require proof either by vaccine hx or titer, if someone is not immune do you then require the vaccine?
We follow CDC recommendations, but if someone is not immune we don't make getting vaccinated mandatory.
We do counsel that they may not be able to work with certain patients or in certain areas, such as mother/baby but we can't force someone to be vaccinated except if they work on mother/baby as Mass law requires it.
Supervisors are notified of any staff who are not immune to one of the 4.
Wondering if anyone makes them sign a declination with consequences spelled out?


Sent from my Verizon Wireless 4G LTE smartphone

-------- Original message --------
From: "Jeff Jacobs, MD"
Date:12/11/2014 2:42 PM (GMT-05:00)
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] [This might be SPAM] MCOH-EH Digest, Vol 249, Issue 7

MMR- proof of 2 vaccines or positive titer
Vz- proof of 2 vaccines or positive titer

There is no difference in our requirements between types of incoming employees. MDs, NPs, PAs, Nurses, non-clinical staff all require proof of MMRV immunity on hire. Older employees were presumably cleared when they started but we do not have that info in our EHS computer system. When we see longer-standing employees for clearance (recently Ebola teams) or surveillance we try to update their records and will offer either titers or vaccines if needed but there is no requirement that they do so.

jeff

Jeffrey A Jacobs, MD, MPH
Medical Director
Einstein LiveWell EHS
1303 Tabor Rd
Philadelphia, PA 19141
215-456-1084
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Today's Topics:

   1.  MMR & VZ - proof of immunity (Upfal, Mark)
   2. Re:  MMR & VZ - proof of immunity (Hudson, T. Warner)
   3. Re:  MMR & VZ - proof of immunity (Hudson, T. Warner)
   4. Re:  MMR & VZ - proof of immunity (Kent, Susan K)


----------------------------------------------------------------------

Message: 1
Date: Thu, 11 Dec 2014 13:02:26 -0500
From: "Upfal, Mark" <mupfal at dmc.org<mailto:mupfal at dmc.org>>
To: "'MCOH/EH'" <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: [MCOH-EH] MMR & VZ - proof of immunity
Message-ID:
<9EE8412E15F7E148AAA54922744E618D312D15 at MAIL03.dmcnt1.local<mailto:9EE8412E15F7E148AAA54922744E618D312D15 at MAIL03.dmcnt1.local>>
Content-Type: text/plain; charset="us-ascii"

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?



Mark Upfal, MD, MPH
Corp Medical Director, DMC Occupational Health Services
4201 Saint Antoine, UHC 4G-3
Detroit, MI 48201
(313) 993-0509
www.dmc.org/ohs<http://www.dmc.org/ohs>

__________________________________________


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This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of Tenet Healthcare Corporation.

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Message: 2
Date: Thu, 11 Dec 2014 18:05:55 +0000
From: "Hudson, T. Warner" <TWHudson at mednet.ucla.edu<mailto:TWHudson at mednet.ucla.edu>>
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] MMR & VZ - proof of immunity
Message-ID:
<2134A5387858914BBE80D079ECF6880C3C78FE1B at SOPEXMB3.ad.medctr.ucla.edu<mailto:2134A5387858914BBE80D079ECF6880C3C78FE1B at SOPEXMB3.ad.medctr.ucla.edu>>
Content-Type: text/plain; charset="us-ascii"

We require documentation of 2 MMR at least 28 days apart or protective titers for employees of the Health System.  New house staff are the same.  MDs employed by Health System are the same.  Other faculty MDs are a group we do not have our arms around yet.

Warner

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health
UCLA Health System and Campus
Office 310.825.9146
Fax 310.206.4585
Pager 800.233.7231  ID 27132
E-mail twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu%3cmailto:twhudson at mednet.ucla.edu>>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org><http://www.ohs.uclahealth.org<http://cp.mcafee.com/d/k-Kr6zqb2bParzPzVKVJd55BeZQn63qqabatXFTodFEEIFTKyU-rhKMYqenS66kjpCSQFIawEwjEzM04Sg9QhU02rtoptd7bP3_nVdZwsNRXBQSjhO_P1EVphsVqWdAklkrLYG7DR8OJMddICQmjt-hojuv78I9CzATsS02GjFPtzZ9_FYOv00jqQjd3HI9FKKu-ZVOJGAO_AOV2Hsbvg5aBzVkDMddICzAQsCzBwS2_id41Fr6N8c1sKd1sQKCy0QJwADaxEwlAh9Pd413Ph0c1og6PiWq83h0dygo2Vsq2VEw3F4vFc0Ph06qDCy1dwQsw6q80SB6_d40USUYrvpZQTRfcOmWg>>

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net]<mailto:[mailto:mcoh-eh-bounces at mylist.net]> On Behalf Of Upfal, Mark
Sent: Thursday, December 11, 2014 10:02 AM
To: 'MCOH/EH'
Subject: [MCOH-EH] MMR & VZ - proof of immunity

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?



Mark Upfal, MD, MPH
Corp Medical Director, DMC Occupational Health Services
4201 Saint Antoine, UHC 4G-3
Detroit, MI 48201
(313) 993-0509
www.dmc.org/ohs<http://www.dmc.org/ohs><http://www.dmc.org/ohs<http://cp.mcafee.com/d/2DRPoQ93hJ5x5VBdNVNYTsSCyyODuWbz1Jd55BeZQXI6QQkmkXThsvdEToud7bX33a9IPrqkS5gkg9QhU02r84W8Y01dKIcKCzBVx_HYC-MeoWZOWr9EVvVwQsIEKsJt6OaaGdT-l3PWApmU6CS3qb9K_8I9LfzAm4PhOrKr018aSU03Bit3qQjd3HI9FKKu-ZVOJGAO_AOV2Hsbvg5aBzVkDMddICzAQsCzBwS2_id41Fr6N8c1sKd1sQKCy0QJwADaxEwlAh9Pd413Ph0c1og6PiWq83h0dygo2Vsq2VEw3F4vFc0Ph06qDCy1dwQsw6q80SB6_d40USUYrxl2Vb9my>>

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This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of Tenet Healthcare Corporation.

________________________________

IMPORTANT WARNING: This email (and any attachments) is only intended for the use of the person or entity to which it is addressed, and may contain information that is privileged and confidential. You, the recipient, are obligated to maintain it in a safe, secure and confidential manner. Unauthorized redisclosure or failure to maintain confidentiality may subject you to federal and state penalties. If you are not the intended recipient, please immediately notify us by return email, and delete this message from your computer.
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------------------------------

Message: 3
Date: Thu, 11 Dec 2014 18:06:24 +0000
From: "Hudson, T. Warner" <TWHudson at mednet.ucla.edu<mailto:TWHudson at mednet.ucla.edu>>
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] MMR & VZ - proof of immunity
Message-ID:
<2134A5387858914BBE80D079ECF6880C3C78FE53 at SOPEXMB3.ad.medctr.ucla.edu<mailto:2134A5387858914BBE80D079ECF6880C3C78FE53 at SOPEXMB3.ad.medctr.ucla.edu>>
Content-Type: text/plain; charset="us-ascii"

I meant to say same for VZ

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health
UCLA Health System and Campus
Office 310.825.9146
Fax 310.206.4585
Pager 800.233.7231  ID 27132
E-mail twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu%3cmailto:twhudson at mednet.ucla.edu>>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org><http://www.ohs.uclahealth.org<http://cp.mcafee.com/d/FZsScz9J5x5VBdNVNYTsSCyyODuWbz1Jd55BeZQXI6QQkmkXThsvdEToud7bX33a9IPrqkS5gkg9QhU02r84W8Y01dKIcKCzBVx_HYC-MeoWZOWr9EVvVwQsIEKsJt6OaaGdT-l3PWApmU6CT3qb9K_8I9LfzAm4PhOrKr01l9QVKN-A_Q-pfw09Jq9CxRS4QTnfvuYVmRipvOpsxlK5LE2BiNYGjU6CSjhOqejhOMr1vF6y0QJzoA60Kn6wKqnjh0qmMijBgQgaO8AVCy0xVEw60I83pFtd41Ew6N8c1sKd1sQg1QyfQC0pEw3djPh0CMqeg3d40rizvCy0srsudRADH>>

From: Hudson, T. Warner
Sent: Thursday, December 11, 2014 10:06 AM
To: 'MCOH/EH'
Subject: RE: MMR & VZ - proof of immunity

We require documentation of 2 MMR at least 28 days apart or protective titers for employees of the Health System.  New house staff are the same.  MDs employed by Health System are the same.  Other faculty MDs are a group we do not have our arms around yet.

Warner

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health
UCLA Health System and Campus
Office 310.825.9146
Fax 310.206.4585
Pager 800.233.7231  ID 27132
E-mail twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu%3cmailto:twhudson at mednet.ucla.edu>>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org><http://www.ohs.uclahealth.org<http://cp.mcafee.com/d/FZsS76Qm4nCkT7D7PtPqqabatXEKc6QQkmkXTjKMrjhhpjLt5NYSztxUQsLIccECPdJFjol1h0Dh7w09IwjEzM04SWMOWqenC7-LOrX0VzHTbFICzB_C3hOOyVORQr8EGETvVkffGhBrwqr76Qmjt-hojuv78I9CzATsS02GjFPtzZ9_FYOv00jqQjd3HI9FKKu-ZVOJGAO_AOV2Hsbvg5aBzVkDMddICzAQsCzBwS2_id41Fr6N8c1sKd1sQKCy0QJwADaxEwlAh9Pd413Ph0c1og6PiWq83h0dygo2Vsq2VEw3F4vFc0Ph06qDCy1dwQsw6q80SB6_d40USUYr_lGTifm>>

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net]<mailto:[mailto:mcoh-eh-bounces at mylist.net]> On Behalf Of Upfal, Mark
Sent: Thursday, December 11, 2014 10:02 AM
To: 'MCOH/EH'
Subject: [MCOH-EH] MMR & VZ - proof of immunity

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?



Mark Upfal, MD, MPH
Corp Medical Director, DMC Occupational Health Services
4201 Saint Antoine, UHC 4G-3
Detroit, MI 48201
(313) 993-0509
www.dmc.org/ohs<http://www.dmc.org/ohs><http://www.dmc.org/ohs<http://cp.mcafee.com/d/1jWVIp4zqb2bParzPzVKVJd55BeZQn63qqabatXFTodFEEIFTKyU-rhKMYqenS66kjpCSQFIawEwjEzM04Sg9QhU02rtoptd7bP3_nVdZwsNRXBQSjhO_P1EVphsVqWdAklkrLYG7DR8OJMddL6Qmjt-hojuv78I9CzATsS02glJM07aAW6RECq7nojjtsZZXPBrl9B_9BO5mUm-walb7OFfwqrpd79EVd7b1I5-Aq83iSdygo2Vsq2VFtd41Fr19el3h0H8yjCq827Cy0o2MwdCBQQg6y0r4wM5OUQ5Ph07i8_io1Cy0cRfd42r1EV0cQg1Jad-q81NJNUSkc9tnlp3sRj>>

__________________________________________

This e-mail message and any attachments may be privileged and confidential and protected information. If you are not the intended recipient, or an employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any review, use, disclosure, dissemination, distribution or copying of this communication may be a violation of the law. Please contact the sender immediately by replying to the message and delete it from your computer. Thank You.



This message (including any attachments) is confidential and intended solely for the use of the individual or entity to whom it is addressed, and is protected by law. If you are not the intended recipient, please delete the message (including any attachments) and notify the originator that you received the message in error. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of Tenet Healthcare Corporation.

________________________________

IMPORTANT WARNING: This email (and any attachments) is only intended for the use of the person or entity to which it is addressed, and may contain information that is privileged and confidential. You, the recipient, are obligated to maintain it in a safe, secure and confidential manner. Unauthorized redisclosure or failure to maintain confidentiality may subject you to federal and state penalties. If you are not the intended recipient, please immediately notify us by return email, and delete this message from your computer.
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Message: 4
Date: Thu, 11 Dec 2014 18:05:16 +0000
From: "Kent, Susan K" <KentS at empirehealth.org<mailto:KentS at empirehealth.org>>
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] MMR & VZ - proof of immunity
Message-ID:
<08F2F12E9D65C2438125A428E999AB3C010B682311 at TN001WEXMBX006.US.chs.net<mailto:08F2F12E9D65C2438125A428E999AB3C010B682311 at TN001WEXMBX006.US.chs.net>>
Content-Type: text/plain; charset="us-ascii"

Proof if immunity to MMR and VZ required for employees - not required for medical staff

Susan Kent, RN, BSN | Employee Health | Worker Compensation | Leave of Absence | VALLEY HOSPITAL | ROCKWOOD HEALTH SYSTEM | 12606 East Mission Ave. | Spokane Valley, WA 99216 | Tel: 509.473.5744 | Fax: 509.473.5886 | kents at empirehealth.org<mailto:kents at empirehealth.org>

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net]<mailto:[mailto:mcoh-eh-bounces at mylist.net]> On Behalf Of Upfal, Mark
Sent: Thursday, December 11, 2014 10:02 AM
To: 'MCOH/EH'
Subject: [MCOH-EH] MMR & VZ - proof of immunity

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?



Mark Upfal, MD, MPH
Corp Medical Director, DMC Occupational Health Services
4201 Saint Antoine, UHC 4G-3
Detroit, MI 48201
(313) 993-0509
www.dmc.org/ohs<http://www.dmc.org/ohs><http://www.dmc.org/ohs<http://cp.mcafee.com/d/k-Kr3xAg6wUSyMyYOCUYU-rKrjhhpjLt5NwSCyyODuWtS3qqabatXEKfCQrIf6zBZxxB4SpJJar2Ea84W8Y01dA2t4u00CTm6njhOYM_R-jvo7ctuVtdAQsLYMqemknemKzp55l6X_axVZicHs3jqdPqb9K_8I9LfzAm4PhOrKr018aSU03Bit3qQjd3HI9FKKu-ZVOJGAO_AOV2Hsbvg5aBzVkDMddICzAQsCzBwS2_id41Fr6N8c1sKd1sQKCy0QJwADaxEwlAh9Pd413Ph0c1og6PiWq83h0dygo2Vsq2VEw3F4vFc0Ph06qDCy1dwQsw6q80SB6_d40USUYrlI-Ku-hC>>

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Subject: Digest Footer

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End of MCOH-EH Digest, Vol 249, Issue 7
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