Doug,

Screening during onboarding is considered “TB infection testing” and CDC is no longer recommending a 4 week wait for testing as part of onboarding – or as part of exposure evaluation. The statement is brief and simply says you do not need to consider the timing of TB testing, for any reason, relative to COVID vaccination. The full text is here:

“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), 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.”

Melanie

From: MCOH-EH <mcoh-eh-bounces@mylist.net> On Behalf Of Wendland, Douglas
Sent: Tuesday, September 7, 2021 11:46 AM
To: MCOH-EH <mcoh-eh@mylist.net>
Cc: Wendy Thanassi <wendy.thanassi@gmail.com>
Subject: [EXTERNAL] Re: [MCOH-EH] TB testing and COVID-19 vaccine: update from CDC

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

From: MCOH-EH <mcoh-eh-bounces@mylist.net> On Behalf Of Thanassi, Wendy via MCOH-EH
Sent: Friday, September 03, 2021 1:07 PM
To: MCOH-EH <mcoh-eh@mylist.net>
Cc: Thanassi, Wendy <Wendy.Thanassi@va.gov>; Wendy Thanassi <wendy.thanassi@gmail.com>
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@mylist.net> On Behalf Of Rolando, Lori
Sent: Thursday, September 2, 2021 5:51 PM
To: mcoh-eh@mylist.net
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), 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

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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