Employee Immunization Program

POLICY: An employee immunization evaluation will be conducted as part of the pre-employment physical examination and pre/post-exposure to infectious disease in the facility. An optional immunization program will be available to all staff.

GUIDELINES:

1. All employees will be evaluated for protection from the following diseases upon hire. Protection can occur through physician certified clinical disease or documented record of vaccination.

• Chickenpox
• Hepatitis B
• Measles
• Mumps
• Rubella
• Tetanus-Diphtheria
• Tuberculosis
• Polio

2. Employees who are HIV-positive may be exempt from some or all routine immunization mandates as their condition dictates.
   
3. Inquiries concerning Employee Assessment/Immunization should be referred to the Infection Control Surveillance Officer.
   
4. The facility’s Infection Control Surveillance Officer/designee will administer Hepatitis B, influenza vaccines, and tetanus-diphtheria prophylaxis only.
   
   
5. Immunization required for pre- and post-exposure to infectious diseases in the facility will be determined by the facility’s Medical Director and provided by the employee’s personal physician.
   
6. The Administrator and Medical Director reserve the right to evaluate the appropriateness of immunizations offered, based on:

• The employee’s risk of exposure in a given geographical area
• The duties and direct resident contact the employee will experience
• The resident population and level of care provided

7. HEPATITIS B VIRUS (HBV)

1. All personnel will have documented training in: epidemiology, modes of transmission, prevention, and availability of an effective vaccine to prevent HBV.
   
2. Employees at substantial risk of exposure to direct contact with blood or body fluids containing blood in the course of their duties must be offered the opportunity to be immunized with HBV vaccine, as required by OSHA’s Occupational Exposure to Bloodborne Pathogens Standard.

8.INFLUENZA

1. Annual, optional immunization with a vaccine based on currently circulating viral strains, as identified by the Centers for Disease Control and Prevention, should be offered to employees. The vaccine is particularly recommended for those with histories of chronic cardiac, pulmonary, renal or metabolic diseases.
   
2. Influenza immunization is recommended for all personnel. Studies indicate that this reduces the introduction of or helps limit spread of influenza within the facility. It will also decrease staff absenteeism during an influenza outbreak.

In case of a confirmed Influenza A epidemic, the Medical Director may consider amantadine or rimantadine prophylaxis, not to exceed 2 weeks duration, for nonvaccinated or newly vaccinated personnel, unless medically contraindicated.

9. TETANUS-DIPHTHERIA TOXOID

1. Routine Immunization. An employee who has never completed the primary series will be encouraged to do so. A booster Td dose every 10 years is recommended for employees with a history of primary immunization.
2. Prophylaxis is based on assessment of an occupationally-related wound/injury (clean or contaminated) and the immunization status of the injured individual. Evidence shows protective levels of antibodies persist for at least five (5) years after the primary series of four (4) doses of tetanus toxoid.

INJURY	IMMUNIZATION HX	RECOMMENDATION
Minor, uncontaminated wound	> 10 years since primary series/booster	Booster dose Td
Contaminated, open or Penetrating wound	> 5 years since primary series/booster	Booster dose Td