Thank you for your responses. 
I agree, it is a complex issue and shoukd involve individual risk evaluation. 

We anticipate some potential exposures due to cases in surrounding areas - hopefully not large scale but we are preparing in case.

Normally we do provide evaluation and PEP for work-related exposures (BBP, scabies, pertussis, etc) through employee health without going through workers comp, so our hospital would be providing the IVIG for the severely immunocompromised workers. The hospital would also pay workers while furloughed. 

If a HCW develops illness, then it would go through workers comp.




From: MCOH-EH <mcoh-eh-bounces@mylist.net> on behalf of Carr, Jennifer L. <Jennifer.Carr@vandaliahealth.org>
Sent: Tuesday, April 9, 2024 5:31 PM
To: MCOH-EH <mcoh-eh@mylist.net>
Cc: Employee Health <Employee_Health@Valleymed.org>
Subject: Re: [MCOH-EH] [EXTERNAL] Re: Measles IVIG for severely immunocompromised HCWs with presumptive immunity?
 
CAUTION: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.


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


Sent via the Samsung Galaxy S21 FE 5G, an AT&T 5G smartphone
Get Outlook for Android
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?
 
You don't often get email from lisa_dyrdahl@valleymed.org. Learn why this is important

We do not follow this. 

 

Lisa Dyrdahl, RN BSN

Employee Health Nurse

Valley Medical Center

Ph 425-690-3088

Lisa_Dyrdahl@Valleymed.org

 

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?

 

ATTENTION: This email originated from outside of the organization.
Do not open attachments or click on links unless you recognize the sender and know the content is safe.

 

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

 

This email is subject to the confidentiality provisions noted below

 

 



This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by e-mail and destroy all copies of the original.

CONFIDENTIALITY NOTICE: The information contained in this message may be privileged, confidential and / or proprietary and should be handled accordingly. If this message contains protected health information, any dissemination, distribution or copying is strictly prohibited, except as permitted by law. If you have received this communication in error, please promptly notify the sender and delete it and all attachments from your computer. Thank you.