Immunizations Across the LifespanHealthcare WorkersBecause of their contact with patients or infective material from patients, many healthcare workers, including physicians, nurses, emergency medical personnel, dental professionals, medical and nursing students, laboratory technicians, hospital volunteers, and administrative staff, are at risk for exposure to, and possible transmission of, vaccine-preventable diseases. Therefore, maintenance of immunity is an essential part of prevention and infection control programs for healthcare workers. Recommended immunizations safeguard the health of workers and protects patients from becoming infected through exposure to infected workers. Institutional immunization programs should substantially reduce both the number of susceptible healthcare workers in hospitals, county health departments, private physicians' offices, nursing homes, schools, laboratories, and first responders and the risks for transmission of vaccine-preventable diseases to other workers, patients, and their families. Recommended Vaccines for Healthcare Workers
Other Considerations in Vaccination Of Healthcare WorkersOther important considerations to appropriate immunoprophylaxis of healthcare workers include maintenance of complete immunization records, policies for catch-up vaccination of healthcare workers, work restrictions for susceptible employees who are exposed to vaccine-preventable diseases, and control of outbreaks of vaccine-preventable diseases in healthcare settings. Additional vaccines not routinely recommended for healthcare workers in the U.S. may be indicated for those who travel to other regions of the world to perform research or healthcare work, such as medical volunteers in humanitarian efforts. Immunization RecordsAn immunization record should be maintained for each healthcare worker. The record should reflect documented disease and vaccination histories as well as immunizing agents administered during employment. At each immunization encounter, the record should be updated and the healthcare worker encouraged to maintain the record. Florida has a statewide, computerized immunization registry, the Florida State Health Online Tracking System (Florida SHOTS™), and vaccination records for county health department clients are available (to authorized system users only) through a central database. The registry also includes the immunization records from many private physicians. Healthcare providers who are authorized immunization registry users may access the records for any previously administered immunization in the state.Catch-Up Vaccination ProgramsHealthcare facility managers should consider implementing catch-up vaccination programs for healthcare workers who are already employed, in addition to policies to ensure newly hired healthcare workers receive necessary vaccinations. This strategy will help prevent outbreaks of vaccine-preventable diseases. Because education enhances the success of many immunization programs, reference materials should be available to assist in answering questions regarding the diseases and vaccines, as well as the program or policy being implemented. Conducting educational workshops or seminars several weeks before the initiation of the program may be necessary to ensure acceptance of program goals. Work Restrictions for Susceptible Workers After ExposurePostexposure work restrictions ranging from restriction of contact with high-risk patients to complete exclusion from duty are appropriate for healthcare workers who are not immune to certain vaccine-preventable diseases. Recommendations concerning work restrictions in these circumstances have been published*. Outbreak ControlHospitals should develop comprehensive policies and protocols for management and control of outbreaks of vaccine-preventable diseases. Outbreaks of vaccine-preventable diseases may be life threatening to certain patients, costly and disruptive. Outbreak prevention, by ensuring all healthcare workers who have direct contact with patients are fully immunized, is the most effective and cost-effective control strategy. Disease-specific outbreak control measures are described in published Advisory Committee on Immunization Practices (ACIP) recommendations and infection control references. Vaccines Indicated for Foreign TravelHospital and other healthcare workers who perform research or healthcare work in foreign countries may be at increased risk for acquiring certain diseases, such as hepatitis A, poliomyelitis, Japanese encephalitis, meningococcal, rabies, typhoid, or yellow fever. Vaccinations against these diseases should be considered for foreign travel when indicated. Elevated risks for acquiring these diseases may stem from exposure to patients in healthcare settings, such as poliomyelitis and meningococcal, but may also arise from circumstances unrelated to patient care, such as high endemicity of hepatitis A or exposure to other diseases such as yellow fever. Immunization of Healthcare Workers: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC): Morbidity and Mortality Weekly Report (MMWR), December 26, 1997; 46(RR-18):1-42 *Guidelines for Infection Control in Healthcare Personnel, 1997: Recommendations of the Hospital Infection Control Practices Advisory Committee. Am J Infect Control 1998 See also: Suspected Nosocomial Influenza Cases in an Intensive Care Unit. MMWR 1988;37:3 ResourcesPublicationsLinks
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