Key features of CDC guidelines
The Centers for Disease Control and Preventions new guidelines -- Immunization of Healthcare Personnel (http://1.usa.gov/ukOECq) include the following highlights and updated recommendations:
Health care personnel (HCP) are defined as all paid and unpaid persons working in health-care settings who have the potential for exposure to patients and/or to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or contaminated air.
HCP might include (but are not limited to) physicians, nurses, nursing assistants, therapists, technicians, emergency medical service personnel, dental personnel, pharmacists, laboratory personnel, autopsy personnel, students and trainees, contractual staff not employed by the health-care facility, and persons (e.g., clerical, dietary, housekeeping, laundry, security, maintenance, administrative, billing, and volunteers) not directly involved in patient care but potentially exposed to infectious agents that can be transmitted to and from HCP and patients
Hepatitis B: HCP and trainees in certain populations at high risk for chronic hepatitis B (e.g., those born in countries with high and intermediate endemicity) should be tested for HBsAg and anti-HBc/anti-HBs to determine infection status.
Influenza: Emphasis that all HCP, not just those with direct patient care duties, should receive an annual influenza vaccination. Comprehensive programs to increase vaccine coverage among HCP are needed; influenza vaccination rates among HCP within facilities should be measured and reported regularly.
Measles, mumps, and rubella (MMR): History of disease is no longer considered adequate presumptive evidence of measles or mumps immunity for HCP; laboratory confirmation of disease was added as acceptable presumptive evidence of immunity. History of disease has never been considered adequate evidence of immunity for rubella. The footnotes have been changed regarding the recommendations for personnel born before 1957 in routine and outbreak contexts. Specifically, guidance is provided for 2 doses of MMR for measles and mumps protection and 1 dose of MMR for rubella protection.
Pertussis: HCP, regardless of age, should receive a single dose of Tdap as soon as feasible if they have not previously received Tdap. The minimal interval was removed, and Tdap can now be administered regardless of interval since the last tetanus or diphtheria-containing vaccine. Hospitals and ambulatory-care facilities should provide Tdap for HCP and use approaches that maximize vaccination rates.
Varicella: Criteria for evidence of immunity to varicella were established. For HCP they include written documentation with 2 doses of vaccine, laboratory evidence of immunity or laboratory confirmation of disease, diagnosis of history of varicella disease by health-care provider, or diagnosis of history of herpes zoster by health-care provider.
Meningococcal: HCP with anatomic or functional asplenia or persistent complement component deficiencies should now receive a 2-dose series of meningococcal conjugate vaccine. HCP with HIV infection who are vaccinated should also receive a 2 dose series. Those HCP who remain in groups at high risk are recommended to be revaccinated every 5 years.
The Centers for Disease Control and Preventions new guidelines -- Immunization of Healthcare Personnel include the following highlights and updated recommendations:You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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