I wanted to give everyone an update. Several large institutions are offering it to ENT specialists for prevention purposes. From my investigations with CDC vaccination experts, there is simply a lack of data regarding efficacy in individuals over 26 years of age. Recently an ENT specialist received funds from Merck to study this exact question. More to come.

Regards,

Mary

Take 3 minutes to watch this doodle on sharps safety. https://www.youtube.com/watch?v=mpm_7pNn5GM&feature=youtu.be

Mary Spangler, M.S., N.P., COHN-S

Administrative Director, Occupational Health Services

Stanford Health Care & Stanford Children’s Health Care

300 Pasteur Drive, M/C 5205, Stanford, CA 94305-5513

Office: (650) 725-9583 Fax: (650) 498-7748 (fax)

mspangler@stanfordhealthcare.org

Administrative Assistant Michelle Fitch 650-725-2529 mfitch@stanfordhealthcare.org

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From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Swift, Melanie, M.D.
Sent: Tuesday, June 20, 2017 3:07 PM
To: mcoh-eh@mylist.net
Subject: Re: [MCOH-EH] papilloma vaccine for physicians working with lasers

Ugh – that is a tough one. There is a paucity of data on efficacy in groups over age 26, and what is there suggests that it’s less effective. Probably there is some benefit for someone age 29, unless they are previously infected, but probably there is not much benefit for someone who is 60. It just only can protect against the 9 strains in the vaccine, and duration of protection is unknown for this type of occupational setting. How often would you boost them? Never? So much is undefined. But no reason to think it’s unsafe. Given all the unknowns I think it would be hard to say that it’s something employers should be expected to provide.

However, all other protections should be provided, such as a vacuum to evacuate the laser plume, and respirators to protect the user from airborne particles. If you are doing all of that then I really believe that you’ve satisfied the employer’s obligation. If you wanted to start a program to provide vaccination off label over age 26 there is nothing wrong with doing that, but administering it will be problematic as the data on efficacy, schedule, boostering, and durability in older age groups are just not there to guide you.

Wish I knew an easier answer! Has anyone else explored this data more?

Melanie

Melanie Swift, MD
Senior Associate Consultant

Division of Preventive, Occupational, and Aerospace Medicine

Phone 507.284.2560

_______________________________
Mayo Clinic
200 First Street SW
Rochester, MN 55905
www.mayoclinic.org

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Spangler, Mary
Sent: Tuesday, June 20, 2017 1:36 PM
To: mcoh-eh@mylist.net
Subject: [MCOH-EH] papilloma vaccine for physicians working with lasers

Have any of you given Gardasil (Papilloma vaccine) to physicians working with lasers? We just had one ENT resident report that her institution provided it and one of her colleagues is requesting it. He is 29 so outside the guidelines. Would like to hear from others.

Thank you,