[MCOH-EH] [External] Re: TB testing and COVID-19 vaccine: update from CDC

[Behrman, Amy]

I'd say the essential purpose of post-offer pre-placement TB testing is to evaluate for TB infection - and of course to treat latent (or active) infection if we find it.    Amy

Amy J Behrman, MD, FACOEM, FACP

Professor, Perelman School of Medicine

Medical Director, Occupational Medicine

University of Pennsylvania

3400 Spruce Street

Philadelphia, PA  19104

________________________________
From: MCOH-EH <mcoh-eh-bounces+behrman=pennmedicine.upenn.edu at mylist.net> on behalf of wendy thanassi <wendy.thanassi at gmail.com>
Sent: Tuesday, September 7, 2021 11:35 PM
To: Wendland, Douglas <Douglas.Wendland at slhduluth.com>
Cc: MCOH-EH <mcoh-eh at mylist.net>
Subject: [External] Re: [MCOH-EH] TB testing and COVID-19 vaccine: update from CDC

Well... that would be troubling.
There's no medically logical or even imaginable reason that this vaccine- as opposed to the others (hep A/B, MMR, VZV, pneumovax, flu)- would change one's immune response to TB-specific antigens in an IGRA. And since both IGRAs have a positive control, if such a thing spuriously occurred, it would render the result indeterminate/invalid.
Further, since people need jobs, and hospitals need healthcare workers, delaying hiring is irresponsible.

My 2c!
Wendy

On Tue, Sep 7, 2021 at 10:03 AM Wendland, Douglas <Douglas.Wendland at slhduluth.com<mailto:Douglas.Wendland at slhduluth.com>> wrote:

I believe that this was for evaluation for TB infection and exposure.  I don’t believe that there has been a change in the 4 week wait for those tested as part of “onboarding”.



Douglas M Wendland, MD, MPH

St. Luke's Occupational Medicine



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Subject: Re: [MCOH-EH] TB testing and COVID-19 vaccine: update from CDC



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Yes and Hallelujah (it should never have been published). Thanks for disseminating this.



From: MCOH-EH <mcoh-eh-bounces+wendy.thanassi=va.gov at mylist.net<mailto:mcoh-eh-bounces+wendy.thanassi=va.gov at mylist.net>> On Behalf Of Rolando, Lori
Sent: Thursday, September 2, 2021 5:51 PM
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Subject: [EXTERNAL] [MCOH-EH] TB testing and COVID-19 vaccine: update from CDC



Hi all,



Just in case folks hadn’t seen this, wanted to let the list serve know that the CDC has officially updated their guidance on TB testing in the context of recent COVID-19 vaccination.

We no longer need to consider when someone has had a COVID-19 vaccine when administering a TB test as noted below:

“Use of immune-based tests for tuberculosis infection, such as the tuberculin skin test and interferon-gamma release assay

COVID-19 vaccination should not be delayed because of testing for tuberculosis (TB) infection. Testing for TB infection with one of the immune-based methods, either the tuberculin skin test (TST) or an interferon release assay (IGRA)<https://imsva91-ctp.trendmicro.com:443/wis/clicktime/v1/query?url=https%3a%2f%2fgcc02.safelinks.protection.outlook.com%2f%3furl%3dhttps%253A%252F%252Fwww.cdc.gov%252Ftb%252Ftopic%252Ftesting%252Ftbtesttypes.htm%26data%3d04%257C01%257C%257C8908a4553b024b9ad76a08d96f026247%257Ce95f1b23abaf45ee821db7ab251ab3bf%257C0%257C0%257C637662878316448805%257CUnknown%257CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%253D%257C3000%26sdata%3d73XcQ%252B6ttxQI%252F7iS28q%252BVQ%252F0Inui8qHCJO6I9%252B1R%252BHk%253D%26reserved%3d0&umid=F281550B-CB1C-5D05-A525-4362B3528C93&auth=0b393771eab4df609f0fdff83b2bfe113ffa6277-0a70fd32a4d549cd2ce5877211fcd4c7c6ae198d>, can be done before, after, or during the same encounter as COVID-19 vaccination

TSTs and IGRAs were previously recommended to be administered > 4 weeks after completion of COVID-19 vaccination to minimize potential theoretical interference between vaccination and TB testing. This was out of an abundance of caution during a period when these vaccines were new. However, given logistical challenges faced in delaying TB infection testing, the recommendation has been updated so that these tests may now be administered without regard to timing of COVID-19 vaccination.

source:

Interim Clinical Considerations for Use of COVID-19 Vaccines | CDC<https://imsva91-ctp.trendmicro.com:443/wis/clicktime/v1/query?url=https%3a%2f%2fgcc02.safelinks.protection.outlook.com%2f%3furl%3dhttps%253A%252F%252Fwww.cdc.gov%252Fvaccines%252Fcovid%2d19%252Fclinical%2dconsiderations%252Fcovid%2d19%2dvaccines%2dus.html%26data%3d04%257C01%257C%257C8908a4553b024b9ad76a08d96f026247%257Ce95f1b23abaf45ee821db7ab251ab3bf%257C0%257C0%257C637662878316448805%257CUnknown%257CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%253D%257C3000%26sdata%3drx688YMUQfsCuoOT53l1kBBfvZQiUBeBXZlkGTM89Ys%253D%26reserved%3d0&umid=F281550B-CB1C-5D05-A525-4362B3528C93&auth=0b393771eab4df609f0fdff83b2bfe113ffa6277-d457397b15e341739aec4490dc595d1a11541c55>



Thanks so much,

Lori



Lori Rolando MD MPH FACOEM

Director, Vanderbilt Occupational Health Clinic

615-936-0955 (p)

615-936-0966 (f)



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