Workers compensation may not cover treatment if there is no illness. Some employers opt to cover PEP through internal funding. Others may be self-insured for workers’ comp and decide internally
to accept claims for exposure without infection.
Melanie
From: MCOH-EH <mcoh-eh-bounces@mylist.net> On Behalf Of
Carr, Jennifer L.
Sent: Tuesday, April 9, 2024 4:31 PM
To: MCOH-EH <mcoh-eh@mylist.net>
Cc: Employee Health <Employee_Health@Valleymed.org>
Subject: [EXTERNAL] Re: [MCOH-EH] Re: Measles IVIG for severely immunocompromised HCWs with presumptive immunity?
If it is a work related exposure then this would be covered under your workers compensation policy and the treating provider should evaluate and determine the individuals risk for returning. If you provide your own workers compensation
evaluation then I recommend exploring this avenue. It further allows evaluation of the individual situation surrounding the employee history and context of the exposure allowing a decision to be made based on the MMWR CDC treatment guidance provided.
If a community exposure then their treating provider should determine their risk and advise accordingly. In this scenario if they were to be out for an extended period of time their other benefits such as short term disability would be
sought to provide compensation for time medically unable to work.
This is a complex question with a magnitude of approaches. Do you anticipate large scale exposure potential for your employees in your area?
Jennifer
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From: MCOH-EH <mcoh-eh-bounces+carrj=monhealthsys.org@mylist.net> on behalf of Lisa Dyrdahl <Lisa_Dyrdahl@Valleymed.org>
Sent: Tuesday, April 9, 2024 2:09:23 PM
To: MCOH-EH <mcoh-eh@mylist.net>
Cc: Employee Health <Employee_Health@Valleymed.org>
Subject: [EXTERNAL] Re: [MCOH-EH] Measles IVIG for severely immunocompromised HCWs with presumptive immunity?
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Lisa Dyrdahl, RN BSN
Employee Health Nurse
Valley Medical Center
Ph 425-690-3088
From: MCOH-EH <mcoh-eh-bounces@mylist.net>
On Behalf Of Haq, Farah via MCOH-EH
Sent: Tuesday, April 9, 2024 10:50 AM
To: mcoh-eh@mylist.net
Cc: Haq, Farah <Farah.Haq@stonybrookmedicine.edu>
Subject: [MCOH-EH] Measles IVIG for severely immunocompromised HCWs with presumptive immunity?
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In the event of a measles exposure, do any of your institutions plan to offer IVIG to severely immunocompromised healthcare workers regardless of measles vaccine/immunity
status?
Our hospital is considering offering IVIG and furloughing severely immunocompromised HCWs who are exposed to measles, even if they have documentation of presumptive
immunity to measles, which virtually all our HCWs do
The rationale is the following MMWR CDC guidance for measles-exposed immunocompromised patients (but which could presumably include exposed immunocompromised HCWs
as well):
Immunocompromised patients. Severely
immunocompromised patients who are exposed to measles should receive IGIV prophylaxis
regardless of immunologic or vaccination status
because they might not be protected by the vaccine. Severely immunocompromised patients include patients with severe primary immunodeficiency; patients who have received a bone marrow transplant until at least 12 months after finishing all immunosuppressive
treatment, or longer in patients who have developed graft-versus-host disease; patients on treatment for ALL within and until at least 6 months after completion of immunosuppressive chemotherapy; and patients with a diagnosis of AIDS or HIV-infected persons
with severe immunosuppression defined as CD4 percent <15% (all ages) or CD4 count <200 lymphocytes/mm3 (aged
>5 years) and those who have not received MMR vaccine since receiving effective ART. Some experts include HIV-infected persons who lack recent confirmation of immunologic status or measles immunity.
I am interested to know if any other hospitals are considering this?
Thank you,
Farah Haq MD, MPH
Division Head, Occupational, Environmental and Clinical Preventive Medicine
Clinical Assistant Professor
Dept. of Family, Population and Preventive Medicine
Stony Brook Medicine
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