This is from a Jan 2021 email Oregon Health Authority sent based on CDC guidelines at that time.

 

Hello,

The Advisory Committee on Immunization Practices (ACIP) recently released a statement which includes information about the timing of COVID vaccine and TB screening tests (TB skin test, Quantiferon or TSPOT).

See: Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States.

As found in the above document:

 

Interpretation of tuberculosis test results in vaccinated persons

Inactive vaccines do not interfere with tuberculosis (TB) test results. There is no immunologic reason to believe either a Tuberculin Skin Test (TST) (administered by intradermal placement of 0.1 cc of purified protein derivative) or blood draw for interferon gamma release assay (IGRA) would affect the safety or effectiveness of mRNA COVID-19 vaccines. We have no data to inform the impact of the COVID-19 mRNA vaccines on either TB test for infection (i.e., TST or IGRA).

 

For healthcare personnel or patients who require baseline TB testing (at onboarding or entry into facilities) at the same time they are to receive an mRNA COVID-19 vaccine:

• Perform TB symptom screening on all healthcare personnel or patients.
• If utilizing the IGRA, draw blood for interferon gamma release assay prior to COVID-19 vaccination.
• If utilizing the TST, place prior to COVID-19 vaccination.
• If vaccination has been given and testing needs to be performed, defer TST or IGRA until 4 weeks after COVID-19 vaccine 2-dose completion.
  • All potential recipients of COVID-19 vaccination should weigh the risks and benefits of delaying TST/IGRA with their providers.

For healthcare personnel who require testing for other reasons:

• Perform TB symptom screening on all healthcare personnel
• Test for infection should be done before or at the same time as the administration of COVID-19 vaccination. If this is not possible, prioritization of test for TB infection needs to be weighed with the importance of receiving COVID-19 vaccination based on potential COVID-19 exposures and TB risk factors.
  • Healthcare personnel with high-risk conditions for TB progression should be fully evaluated as soon as possible.
  • Healthcare personnel without high-risk conditions for TB progression should proceed with contact tracing (i.e., symptom screening, chest radiograph or other imaging, specimen for microbiologic evaluation) but delay test for TB infection (TST or IGRA) if prioritized for receiving COVID-19 vaccination.
  • All potential recipients of COVID-19 vaccination should weigh the risks and benefits of delaying TST/IGRA with their providers.

Please let me know if you have any questions. Thanks!

 

Heidi Behm, RN, MPH

Tuberculosis Controller/Nurse Consultant

Public Health Division, Oregon Health Authority

Cell: 503-358-8516

Fax: 971-673-0178

 

Hopes this helps,

Steve

 

 

 

 

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