Why are vaccinations important for healthcare personnel? Achieving and sustaining high vaccination coverage among healthcare personnel will help to save lives, reduce disease burden and shrink health-care costs.
Who qualifies as healthcare personnel? All paid and unpaid persons working in health-care settings who have potential for exposure to patients and/or to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or contaminated air (CDC, 11/25/2011).
In which settings do vaccination recommendations apply? Recommendations apply to all HCP as defined above, including but not limited to those in hospitals, long-term care facilities, urgent care and emergency care facilities, physician's offices, outpatient clinics, rehabilitation centers, home healthcare settings, dialysis centers, surgery centers, senior housing and care communities, laboratories and health departments.
Which vaccines are recommended for healthcare personnel?
Federal regulations throughthe Occupational Safety and Health Administration (OSHA)’s Bloodborne Pathogen Standard 1910.1030(f) require employers to offer the hepatitis B vaccination to all employees who have anticipated contact with blood and other potentially infectious materials. The vaccination should be offered at no cost, after the employee has received training, and within 10 days of initial assignment to a job where there is occupational exposure, unless the worker has previously received the vaccine series, antibody testing has revealed the worker is immune or the vaccine is contraindicated for medical reasons.
The vaccination series must be provided in accordance with the recommendations of the U.S. Public Health Service current at the time of the vaccination. This includes follow-up testing one to two months after the completion of the three-dose vaccination series to test for antibody to hepatitis B surface antigen.
The Virginia Occupational Safety and Health (VOSH) Program has adopted the federal OSHA standard and has incorporated it by reference into the Virginia Administrative Code (16VAC25-90-1910). When Virginia adopts federal OSHA standards such as the 1910.1030 Bloodborne Pathogen Standard, they become state law and the VOSH Program has the authority to enforce them in public and private sector workplaces.
Besides hepatitis B vaccination as discussed above, there are no other state laws or regulations requiring vaccinations specifically for HCP in the Commonwealth of Virginia.
As a best practice, immunization coverage assessments should be performed upon hire and annually to ensure HCP are immunized appropriately.
Workers may be subject to the vaccine requirements put in place by their respective employers.
HCP without documented vaccination or immunity may be furloughed at the recommendation of the health department and/or employer in the event of an outbreak or disease exposure of public health importance.
Some State regulations provide for facilities to establish infection control policies that may include HCP vaccination. Here are some examples:
State regulations 12VAC5-410-490 provide that hospitals shall have an infection control committee to “develop, periodically evaluate, and revise as needed, infection control policies, procedures, and techniques” that “shall include, but are not limited to, appropriate employee health screening and immunization.”
State regulations 22VAC40-72-90 provides that assisted living facilities “shall establish and maintain an infection control program” that is designed to “prevent the development and transmission of disease and infection.”
The following resources are specific to influenza vaccination of healthcare personnel. The Healthy People 2020 Objective is to have 90% of healthcare personnel vaccinated against seasonal flu (Objective IID-12.9).
In January 2013, the Centers for Medicare and Medicaid Services (CMS) began requiring acute care hospitals participating in their Hospital Inpatient Quality Reporting Program to report summary-level healthcare personnel (HCP) influenza vaccination rates to the National Healthcare Safety Network (NHSN). Beginning with data from the 2013-2014 influenza season, vaccination data from acute care hospitals are publicly available on Hospital Compare.
Other types of healthcare facilities participating in other CMS Quality Reporting Programs are also required to report summary-level HCP influenza
vaccination data to NHSN. These include long-term acute care hospitals (2014/2015 influenza season to present), hospital outpatient HCP (2014/2015 season
to present), ambulatory surgery centers (2014/2015 season to present), end-stage renal disease facilities (2015/2016 season to present), inpatient
psychiatric facilities (2015/2016 season to present), and inpatient rehabilitation facilities (2014/2015 season to present).
In September 2015, the VDH healthcare-associated infection reporting regulations were updated to align state reporting requirements with the CMS Hospital
Inpatient Quality Reporting Program. Under the new regulations, hospitals are reporting HCP influenza vaccination data to VDH through NHSN for all