Agree with the prior comments on this topic.  I know this is an MCOH specific mailing list but there are a lot of ACOEM members here so I just wanted to add that it is not too late in my opinion for ACOEM to take a public stand about mandating covid vaccines for certain worker populations, especially outside of healthcare.  Many other industries are considering this and our opinion may carry more weight in occupational settings where we’re the main clinical decision makers.  

Sumeet Batra MD, MPH
Medical Director of Employee Health Services
UC Davis Health
Phone) 916-734-7513
Fax) 916-734-7510
From: MCOH-EH <mcoh-eh-bounces+subatra=ucdavis.edu@mylist.net> on behalf of mcoh-eh-request@mylist.net <mcoh-eh-request@mylist.net>
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To: mcoh-eh@mylist.net <mcoh-eh@mylist.net>
Subject: MCOH-EH Digest, Vol 256, Issue 132
 
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Today's Topics:

   1. Re:  COVID Vaccine for HCWs (Rolando, Lori)
   2. Re:  COVID Vaccine for HCWs (Robert K. McLellan)
   3.  Third doses of Pfizer/Moderna (Radke, Laura L. M.D.)
   4. Re:  HCP Baseline TB Testing for Onboarding Deferral 4 Weeks
      Post completion of 2 dose COVID-19 mRNA vaccine (Wilson, Steve)


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

Message: 1
Date: Wed, 28 Jul 2021 15:52:19 +0000
From: "Rolando, Lori" <lori.rolando@vumc.org>
To: MCOH-EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] COVID Vaccine for HCWs
Message-ID:
        <DM6PR12MB55335EE069638F6E6B56E9B1E0EA9@DM6PR12MB5533.namprd12.prod.outlook.com>
       
Content-Type: text/plain; charset="us-ascii"

I agree as well ... it was a conspicuous absence.

Lori Rolando MD MPH FACOEM
Director, Vanderbilt Occupational Health Clinic
615-936-0955 (p)
615-936-0966 (f)

From: MCOH-EH <mcoh-eh-bounces@mylist.net> On Behalf Of Behrman, Amy
Sent: Tuesday, July 27, 2021 1:16 PM
To: mcoh-eh@mylist.net
Subject: Re: [MCOH-EH] COVID Vaccine for HCWs

I totally agree, Mark, on all counts.

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@mylist.net<mailto:mcoh-eh-bounces+behrman=pennmedicine.upenn.edu@mylist.net>> on behalf of Mark Upfal <mupfal@wayne.edu<mailto:mupfal@wayne.edu>>
Sent: Monday, July 26, 2021 4:07 PM
To: mcoh-eh@mylist.net<mailto:mcoh-eh@mylist.net> <mcoh-eh@mylist.net<mailto:mcoh-eh@mylist.net>>
Subject: [External] [MCOH-EH] COVID Vaccine for HCWs

Colleagues,

You may have seen the recent joint statement on worker COVID vaccination mandates for HCWs. Shouldn't ACOEM have been in the lead on this? Does anyone else find it sad that we're not even following? Where are we on this? We should at least start a conversation...

Mark
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------------------------------

Message: 2
Date: Wed, 28 Jul 2021 17:04:33 +0000
From: "Robert K. McLellan" <Robert.K.McLellan@dartmouth.edu>
To: MCOH-EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] COVID Vaccine for HCWs
Message-ID:
        <BL1PR03MB6007977B8722B57F605A4D1FB7EA9@BL1PR03MB6007.namprd03.prod.outlook.com>
       
Content-Type: text/plain; charset="us-ascii"

Me too. And that maybe we were'n approached because 1. No one in the house of medicine ever thinks of occ med 2. Our past stand with flu vaccine

Bob

From: MCOH-EH <mcoh-eh-bounces@mylist.net> On Behalf Of Behrman, Amy
Sent: Tuesday, July 27, 2021 2:16 PM
To: mcoh-eh@mylist.net
Subject: Re: [MCOH-EH] COVID Vaccine for HCWs

I totally agree, Mark, on all counts.

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@mylist.net<mailto:mcoh-eh-bounces+behrman=pennmedicine.upenn.edu@mylist.net>> on behalf of Mark Upfal <mupfal@wayne.edu<mailto:mupfal@wayne.edu>>
Sent: Monday, July 26, 2021 4:07 PM
To: mcoh-eh@mylist.net<mailto:mcoh-eh@mylist.net> <mcoh-eh@mylist.net<mailto:mcoh-eh@mylist.net>>
Subject: [External] [MCOH-EH] COVID Vaccine for HCWs

Colleagues,

You may have seen the recent joint statement on worker COVID vaccination mandates for HCWs. Shouldn't ACOEM have been in the lead on this? Does anyone else find it sad that we're not even following? Where are we on this? We should at least start a conversation...

Mark
---------------------------------------
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------------------------------

Message: 3
Date: Wed, 28 Jul 2021 19:59:35 +0000
From: "Radke, Laura L. M.D." <laura.radke@froedtert.com>
To: "'mcoh-eh@mylist.net'" <mcoh-eh@mylist.net>
Subject: [MCOH-EH] Third doses of Pfizer/Moderna
Message-ID: <7d770d748f714ef79ccc198400b7badc@froedtert.com>
Content-Type: text/plain; charset="us-ascii"

Wondering if any other medical centers are having providers show up with prescriptions from their personal physicians/providers requesting that they be given a third dose of COVID vaccine.  This has happened a few times this week at our facilities.  If you have experienced this, how have you handled it?

Laura L Radke, MD
Adjunct Assistant Professor of Medicine
Medical Director, F&MCW Occupational Health Services
Phone: 262-253-8197 | Fax: 262-253-5152 Cell Phone: 414-530-0723
E-mail: laura.radke@froedtert.com<mailto:laura.radke@froedtert.com>
Froedtert & the Medical College of Wisconsin Workforce Health / North Hills Health Center Building B First Floor
W129 N7055 Northfield Dr.
Menomonee Falls, WI 53051


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

Message: 4
Date: Wed, 28 Jul 2021 16:02:59 +0000
From: "Wilson, Steve" <Steve.Wilson@bayareahospital.org>
To: MCOH-EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] HCP Baseline TB Testing for Onboarding Deferral
        4 Weeks Post completion of 2 dose COVID-19 mRNA vaccine
Message-ID: <6278b76f4f124369b509fc412ef8d772@EXCH1.bahad.local>
Content-Type: text/plain; charset="us-ascii"

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<https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fcovid-19%2Finfo-by-product%2Fclinical-considerations.html%3FCDC_AA_refVal%3Dhttps%253A%252F%252Fwww.cdc.gov%252Fvaccines%252Fcovid-19%252Finfo-by-product%252Fpfizer%252Fclinical-considerations.html&amp;data=04%7C01%7Csubatra%40ucdavis.edu%7C64d3a1394f13462d9c5008d952d46c5a%7Ca8046f6466c04f009046c8daf92ff62b%7C0%7C0%7C637631894573988030%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&amp;sdata=XKFVkKAls%2FFc1oQS5WHqIrTT573RofwEs0HYFmpCPX0%3D&amp;reserved=0>.
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


From: MCOH-EH <mcoh-eh-bounces+steve.wilson=bayareahospital.org@mylist.net> On Behalf Of Fiorella, Kristie
Sent: Wednesday, July 28, 2021 02:05
To: 'mcoh-eh@mylist.net' <mcoh-eh@mylist.net>
Subject: [MCOH-EH] HCP Baseline TB Testing for Onboarding Deferral 4 Weeks Post completion of 2 dose COVID-19 mRNA vaccine

CAUTION: This email originated outside of Bay Area Hospital. Do not click links or open attachments unless you recognize the sender and know the content is safe.

Hello~
If you are using IGRA for baseline TB testing, are you deferring at onboarding or entry into your facility until the HCP is 4 weeks post completion of a two dose mRNA?
If you are not delaying, do you feel the COVID-19 mRNA vaccine could have had a potential effect on any HCP IGRA test results during the first 4 weeks after COVID-19 vaccination?
Thank you!


Kristie K. Fiorella, RN, M.S., COHN-S
Manager, Employee Health
700 Children's Drive Room  A1026
Columbus, OH 43205-2664
Office Phone: 614-355-4140
Office Fax: 614-355-4142
Clinic Hours: M, W, F: 7:30 A - 4:00 P and T, Th: 8:00 A - 4:30 P
[cid:image001.jpg@01D7838E.C5C70C30]

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Subject: Digest Footer

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End of MCOH-EH Digest, Vol 256, Issue 132
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