Our company has decided to provide our employees with an MMR booster.

 

KIM

 

Kim Alvis, RN, COHN, COHC

Senior Medical Specialist

CTEH, LLC

Office: 501-801-8478 | Mobile: 501-766-1515

Emergency Response 24-Hour Hotline: +1(866) 869-2834

kalvis@cteh.com |www.cteh.com

 

 

From: MCOH-EH <mcoh-eh-bounces@mylist.net> On Behalf Of Tara Dockery
Sent: Tuesday, May 14, 2019 10:43 AM
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] [EXTERNAL] Re: MCOH-EH Digest, Vol 254, Issue 125. Measles Prevention in Non-immune Appropriately Vaccinated

 

That’s the problem, we don’t have the documentation of the vaccines or a positive titer given to us, so we test. Inadvertently find people who are immune to 2 components but not a third, so we then booster.

I have been really happy with my diligence in finding who is immune and not  once we had the Measles outbreak close to home, and I have all the documentation I need. In one of my APIC meetings they said that only 20 % of the providers who are treating the patients with Measles had proof of immunity in their files….  I am just thankful I have what I need by hook or by crook!

 

Tara

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Swift, Melanie D., M.D. via MCOH-EH
Sent: Monday, May 6, 2019 3:40 PM
To: mcoh-eh@mylist.net
Cc: Swift, Melanie D., M.D. <Swift.Melanie@mayo.edu>
Subject: Re: [MCOH-EH] [EXTERNAL] Re: MCOH-EH Digest, Vol 254, Issue 125. Measles Prevention in Non-immune Appropriately Vaccinated

 

Thank you Kathleen!

I hope everyone on the list pays attention – there is far too much post vaccination measles (and mumps) antibody testing being done. Please y’all – restrain yourselves and spend your energy getting vaccine documentation, or just vaccinating if there is no documentation available!

 

Melanie

 

Melanie Swift, MD
Medical Director, Mayo Clinic Physician Health Center

Senior Associate Consultant

Assistant Professor of Medicine

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+swift.melanie=mayo.edu@mylist.net] On Behalf Of Harriman, Kathleen@CDPH
Sent: Monday, May 06, 2019 1:36 PM
To: mcoh-eh@mylist.net
Subject: [EXTERNAL] Re: [MCOH-EH] MCOH-EH Digest, Vol 254, Issue 125. Measles Prevention in Non-immune Appropriately Vaccinated

 

CDC does not recommend serologic testing for measles, mumps or rubella for employees with two documented doses of MMR vaccine (past or present). If such employees are  inadvertently tested and found to be measles IgG negative or equivocal, CDC recommends trusting the vaccine history rather than the serologic results, and considering such employees presumptively immune to measles. See: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6204a1.htm.

 

What is important to know, and I don't think is well known, is that commercial measles IgG testing is often not sensitive enough to identify people who would mount an adequate immune response to measles if they were exposed.

 

In California, if a HCW (or any other person) is exposed to measles and it is likely that they have received MMR vaccine but they are measles IgG negative or equivocal at a commercial lab, we ask that the blood specimen be sent for retesting at our state laboratory where it is almost always IgG positive.

 

If a HCW is actually exposed to measles, we do not consider birth before 1957 adequate proof of immunity, and would want such HCWs tested for measles IgG. Similarly, we would want to retest exposed HCWs with a history of being measles IgG negative or equivocal after a history of two doses of MMR vaccine. If either category of HCW was then tested at a commercial lab and found to be measles IgG negative or equivocal, we would request retesting at our state lab to determine their true measles immune status.

 

In our experience, falsely measles IgG negative or equivocal results are not uncommon, and we don't want to furlough or quarantine people unnecessarily.

 

Kathleen Harriman

California Department of Public Health

Richmond CA

kathleen.harriman@cdph.ca.gov

 

Today's Topics:

 

1.      Measles Prevention in Non-immune Appropriately Vaccinated Healthcare Employees (Leibu, Rachel)

2.      Re:  Measles Prevention in Non-immune Appropriately Vaccinated Healthcare Employees (Lawrence Budnick)

 

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

 

Message: 1

Date: Mon, 6 May 2019 01:28:20 +0000

From: "Leibu, Rachel" <Rachel.Leibu@atlantichealth.org>

To: MCOH/EH <mcoh-eh@mylist.net>

Cc: "Cuoco, Lisa" <Lisa.Cuoco@atlantichealth.org>

Subject: [MCOH-EH] Measles Prevention in Non-immune Appropriately Vaccinated Healthcare Employees

Message-ID:BN6PR16MB14264476103AA6C9E49CB476F2300@BN6PR16MB1426.namprd16.prod.outlook.com

       

HI Everyone,

 

With the ever growing measles outbreak, how are you handling those employees who have appropriate proof of vaccination for measles but have a negative measles titer post vaccination.  What are you doing for this cohort of employees both prophylactically and in the event of an actual measles  exposure?

 

Rachel Leibu, MD, MBA, MS, FACOEM

Medical Director Occupational Medicine Services Atlantic Health System

973-829-4277

 

Message: 2

Date: Mon, 6 May 2019 12:37:08 +0000

From: Lawrence Budnick <budnicla@njms.rutgers.edu>

To: MCOH/EH <mcoh-eh@mylist.net>

Cc: "Cuoco, Lisa" <Lisa.Cuoco@atlantichealth.org>

Subject: Re: [MCOH-EH] Measles Prevention in Non-immune Appropriately Vaccinated Healthcare Employees

Message-ID:BN6PR1401MB1969959930C1AEA3A5DE8B50FE300@BN6PR1401MB1969.namprd14.prod.outlook.com

       

Attached is the guidance document from our state health department. Based on it and measles exposure incidents on our campus in 2013 and 2014, we would give a third dose of vaccine and retiter in 6-8 weeks, to help guide future potential exposures. It is possible that the negative titer the person had was taken long after the 2nd measles vaccination. In addition, as the state guidance notes several times, "Extra doses of MMR are not harmful" as long as there are no contraindications.

 

Lawrence D. Budnick, MD, MPH

Professor of Medicine

Director, Occupational Medicine Service

Rutgers University - New Jersey Medical School

65 Bergen Street, Suite GA-167, Newark, NJ 07107 tel 973.972.2900 fax 973.972.2904 lawrence.budnick@rutgers.edu<mailto:lawrence.budnick@rutgers.edu>