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Immunizations for healthcare providers

Author
Patricia L Hibberd, MD, PhD
Section Editor
Peter F Weller, MD, FACP
Deputy Editor
Jennifer Mitty, MD, MPH

INTRODUCTION

Healthcare providers are at risk for exposure to and acquisition of vaccine preventable diseases. This risk can be minimized by:

Strict adherence to handwashing [1]

Rapid institution of appropriate isolation for patients with known or suspected communicable diseases [2]

Maintaining up to date immunizations in healthcare providers

Additional precautions should be taken by personnel working in the microbiology or pathology laboratory, such as no eating or drinking in areas where specimens are processed and use of protective equipment when culturing pathogens such as Mycobacterium tuberculosis [3-5].

                         

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Literature review current through: Nov 2016. | This topic last updated: Mon Jul 04 00:00:00 GMT 2016.
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References
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  1. Larson EL. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995; 23:251.
  2. Garner JS. Guideline for isolation precautions in hospitals. The Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1996; 17:53.
  3. National Committee for Clinical Laboratory Standards. Protection of laboratory workers from infectious diseases transmitted by blood, body fluids, and tissue: Tentative guideline. NCCLS Document M29-T2, 1991; 11(No. l4):l.
  4. Centers for Disease Control. Biosafety in microbiological and biomedical laboratories. HHS Publication No. 93-8595. Government Printing Office, Washington, DC, 1995.
  5. Flemming DO, Richardson JH, Tulis JJ, Vesley D. Laboratory Safety, Second Edition, ASM Press, Washington, DC 1995.
  6. Corbett EL, Muzangwa J, Chaka K, et al. Nursing and community rates of Mycobacterium tuberculosis infection among students in Harare, Zimbabwe. Clin Infect Dis 2007; 44:317.
  7. Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention (CDC). Immunization of health-care personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2011; 60:1.
  8. Centers for Disease Control (CDC). Pilot study of a household survey to determine HIV seroprevalence. MMWR Morb Mortal Wkly Rep 1991; 40:1.
  9. L'Ecuyer PB, Miller M, Winters K, Fraser VJ. Tuberculosis, hepatitis B, rubella, rubeola, and varicella infection and immunity among medical school employees. Infect Control Hosp Epidemiol 1998; 19:915.
  10. Shapiro CN, Tokars JI, Chamberland ME. Use of the hepatitis-B vaccine and infection with hepatitis B and C among orthopaedic surgeons. The American Academy of Orthopaedic Surgeons Serosurvey Study Committee. J Bone Joint Surg Am 1996; 78:1791.
  11. Panlilio AL, Shapiro CN, Schable CA, et al. Serosurvey of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus infection among hospital-based surgeons. Serosurvey Study Group. J Am Coll Surg 1995; 180:16.
  12. Agerton TB, Mahoney FJ, Polish LB, Shapiro CN. Impact of the bloodborne pathogens standard on vaccination of healthcare workers with hepatitis B vaccine. Infect Control Hosp Epidemiol 1995; 16:287.
  13. McArthur MA, Simor AE, Campbell B, McGeer A. Influenza and pneumococcal vaccination and tuberculin skin testing programs in long-term care facilities: where do we stand? Infect Control Hosp Epidemiol 1995; 16:18.
  14. Nichol KL, Hauge M. Influenza vaccination of healthcare workers. Infect Control Hosp Epidemiol 1997; 18:189.
  15. Steingart KR, Thomas AR, Dykewicz CA, Redd SC. Transmission of measles virus in healthcare settings during a communitywide outbreak. Infect Control Hosp Epidemiol 1999; 20:115.
  16. Christian MA. Influenza and hepatitis B vaccine acceptance: a survey of health care workers. Am J Infect Control 1991; 19:177.
  17. Doebbeling BN, Edmond MB, Davis CS, et al. Influenza vaccination of health care workers: evaluation of factors that are important in acceptance. Prev Med 1997; 26:68.
  18. Lane NE, Paul RI, Bratcher DF, Stover BH. A survey of policies at children's hospitals regarding immunity of healthcare workers: are physicians protected? Infect Control Hosp Epidemiol 1997; 18:400.
  19. Adal KA, Flowers RH, Anglim AM, et al. Prevention of nosocomial influenza. Infect Control Hosp Epidemiol 1996; 17:641.
  20. Bolyard EA, Tablan OC, Williams WW, et al. Guideline for infection control in healthcare personnel, 1998. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1998; 19:407.
  21. DeCastro MG, Denys GA, Fauerbach LL, et al. APIC position paper: immunization. Association for Professionals in Infection and Epidemiology, Inc. Am J Infect Control 1999; 27:52.
  22. American College of Physicians Task Force on Adult Immunization and Infectious Disease Society of America. In: Guide for Adult Immunization, Third Edition, American College of Physicians, Philadelphia p.1994.
  23. American Academy of Pediatrics. Health care personnel. In: Red Book: 2009 Report of the Committee on Infectious Diseases, 28th Edition, Pickering LK (Ed), American Academy of Pediatrics, Elk Grove Village, IL 2009. p.94.
  24. Krause PJ, Gross PA, Barrett TL, et al. Quality standard for assurance of measles immunity among health care workers. The Infectious Diseases Society of America. Infect Control Hosp Epidemiol 1994; 15:193.
  25. Poland GA, Haiduven DJ. Adult immunizations in the health-care worker. In: APIC Infection Control and Applied Epidemiology, Olmsted R (Ed), Mosby, St. Louis 1996. p.24.
  26. Beekmann SE, Doebbeling BN. Frontiers of occupational health. New vaccines, new prophylactic regimens, and management of the HIV-infected worker. Infect Dis Clin North Am 1997; 11:313.
  27. Weber DJ, Rutala WA, Weigle K. Selection and use of vaccines for healthcare workers. Infect Control Hosp Epidemiol 1997; 18:682.
  28. Mahoney FJ, Stewart K, Hu H, et al. Progress toward the elimination of hepatitis B virus transmission among health care workers in the United States. Arch Intern Med 1997; 157:2601.
  29. Kew MC. Possible transmission of serum (Australia-antigen-positive) hepatitis via the conjunctiva. Infect Immun 1973; 7:823.
  30. Snydman DR, Hindman SH, Wineland MD, et al. Nosocomial viral hepatitis B. A cluster among staff with subsequent transmission to patients. Ann Intern Med 1976; 85:573.
  31. Ingerslev J, Mortensen E, Rasmussen K, et al. Silent hepatitis-B immunization in laboratory technicians. Scand J Clin Lab Invest 1988; 48:333.
  32. Centers for Disease Control (CDC). Hepatitis B associated with jet gun injection--California. MMWR Morb Mortal Wkly Rep 1986; 35:373.
  33. Morris IM, Cattle DS, Smits BJ. Letter: Endoscopy and transmission of hepatitis B. Lancet 1975; 2:1152.
  34. Oren I, Hershow RC, Ben-Porath E, et al. A common-source outbreak of fulminant hepatitis B in a hospital. Ann Intern Med 1989; 110:691.
  35. Centers for Disease Control (CDC). Nosocomial transmission of hepatitis B virus associated with a spring-loaded fingerstick device--California. MMWR Morb Mortal Wkly Rep 1990; 39:610.
  36. Polish LB, Shapiro CN, Bauer F, et al. Nosocomial transmission of hepatitis B virus associated with the use of a spring-loaded finger-stick device. N Engl J Med 1992; 326:721.
  37. Centers for Disease Control and Prevention (CDC). Nosocomial hepatitis B virus infection associated with reusable fingerstick blood sampling devices--Ohio and New York City, 1996. MMWR Morb Mortal Wkly Rep 1997; 46:217.
  38. Lauer JL, VanDrunen NA, Washburn JW, Balfour HH Jr. Transmission of hepatitis B virus in clinical laboratory areas. J Infect Dis 1979; 140:513.
  39. Pattison CP, Boyer DM, Maynard JE, Kelly PC. Epidemic hepatitis in a clinical laboratory. Possible association with computer card handling. JAMA 1974; 230:854.
  40. Tanaka S, Yoshiba M, Iino S, et al. A common-source outbreak of fulminant hepatitis B in hemodialysis patients induced by precore mutant. Kidney Int 1995; 48:1972.
  41. Centers for Disease Control and Prevention (CDC). Outbreaks of hepatitis B virus infection among hemodialysis patients-- California, Nebraska, and Texas, 1994. MMWR Morb Mortal Wkly Rep 1996; 45:285.
  42. Department of Labor. Bloodborne pathogens: the standard. Federal Register 1991; 60:64175.
  43. Schillie S, Murphy TV, Sawyer M, et al. CDC guidance for evaluating health-care personnel for hepatitis B virus protection and for administering postexposure management. MMWR Recomm Rep 2013; 62:1.
  44. Beltrami EM, Williams IT, Shapiro CN, Chamberland ME. Risk and management of blood-borne infections in health care workers. Clin Microbiol Rev 2000; 13:385.
  45. Cleveland JL, Cardo DM. Occupational exposures to human immunodeficiency virus, hepatitis B virus, and hepatitis C virus: risk, prevention, and management. Dent Clin North Am 2003; 47:681.
  46. Beekmann SE, Henderson DK. Protection of healthcare workers from bloodborne pathogens. Curr Opin Infect Dis 2005; 18:331.
  47. Jilg W, Schmidt M, Deinhardt F. Vaccination against hepatitis B: comparison of three different vaccination schedules. J Infect Dis 1989; 160:766.
  48. Havlichek D Jr, Rosenman K, Simms M, Guss P. Age-related hepatitis B seroconversion rates in health care workers. Am J Infect Control 1997; 25:418.
  49. Louther J, Feldman J, Rivera P, et al. Hepatitis B vaccination program at a New York City hospital: seroprevalence, seroconversion, and declination. Am J Infect Control 1998; 26:423.
  50. Lemon SM, Thomas DL. Vaccines to prevent viral hepatitis. N Engl J Med 1997; 336:196.
  51. Alimonos K, Nafziger AN, Murray J, Bertino JS Jr. Prediction of response to hepatitis B vaccine in health care workers: whose titers of antibody to hepatitis B surface antigen should be determined after a three-dose series, and what are the implications in terms of cost-effectiveness? Clin Infect Dis 1998; 26:566.
  52. Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination. Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR Recomm Rep 1991; 40:1.
  53. Gara N, Abdalla A, Rivera E, et al. Durability of antibody response against hepatitis B virus in healthcare workers vaccinated as adults. Clin Infect Dis 2015; 60:505.
  54. Hadler SC, Margolis HS. Hepatitis B immunization: vaccine types, efficacy, and indications for immunization. In: Current topics in infectious diseases, Remington JS, Swartz MN (Eds), Blackwell Science, Boston 1992. p.282.
  55. Balkovic ES, Goodman RA, Rose FB, Borel CO. Nosocomial influenza A (H1N1) infection. Am J Med Technol 1980; 46:318.
  56. Van Voris LP, Belshe RB, Shaffer JL. Nosocomial influenza B virus infection in the elderly. Ann Intern Med 1982; 96:153.
  57. Centers for Disease Control (CDC). Suspected nosocomial influenza cases in an intensive care unit. MMWR Morb Mortal Wkly Rep 1988; 37:3.
  58. Pachucki CT, Pappas SA, Fuller GF, et al. Influenza A among hospital personnel and patients. Implications for recognition, prevention, and control. Arch Intern Med 1989; 149:77.
  59. Hammond GW, Cheang M. Absenteeism among hospital staff during an influenza epidemic: implications for immunoprophylaxis. Can Med Assoc J 1984; 131:449.
  60. Patriarca PA, Weber JA, Parker RA, et al. Risk factors for outbreaks of influenza in nursing homes. A case-control study. Am J Epidemiol 1986; 124:114.
  61. Gross PA, Rodstein M, LaMontagne JR, et al. Epidemiology of acute respiratory illness during an influenza outbreak in a nursing home. A prospective study. Arch Intern Med 1988; 148:559.
  62. Cartter ML, Renzullo PO, Helgerson SD, et al. Influenza outbreaks in nursing homes: how effective is influenza vaccine in the institutionalized elderly? Infect Control Hosp Epidemiol 1990; 11:473.
  63. Arroyo JC, Postic B, Brown A, et al. Influenza A/Philippines/2/82 outbreak in a nursing home: limitations of influenza vaccination in the aged. Am J Infect Control 1984; 12:329.
  64. Christie RW, Marquis LL. Immunization roulette: influenza occurrence in five nursing homes. Am J Infect Control 1985; 13:174.
  65. Atkinson WL, Arden NH, Patriarca PA, et al. Amantadine prophylaxis during an institutional outbreak of type A (H1N1) influenza. Arch Intern Med 1986; 146:1751.
  66. Centers for Disease Control (CDC). Outbreak of influenza A in a nursing home--New York, December 1991-January 1992. MMWR Morb Mortal Wkly Rep 1992; 41:129.
  67. Potter J, Stott DJ, Roberts MA, et al. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis 1997; 175:1.
  68. Tablan OC, Anderson LJ, Arden NH, et al. Guideline for prevention of nosocomial pneumonia. The Hospital Infection Control Practices Advisory Committee, Centers for Disease Control and Prevention. Infect Control Hosp Epidemiol 1994; 15:587.
  69. Gomolin IH, Leib HB, Arden NH, Sherman FT. Control of influenza outbreaks in the nursing home: guidelines for diagnosis and management. J Am Geriatr Soc 1995; 43:71.
  70. Fiore AE, Shay DK, Broder K, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. MMWR Recomm Rep 2009; 58:1.
  71. Immunization of health-care workers: recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep 1997; 46:1.
  72. Talbot TR, Babcock H, Cotton D, et al. The use of live attenuated influenza vaccine (LAIV) in healthcare personnel (HCP): guidance from the Society for Healthcare Epidemiology of America (SHEA). Infect Control Hosp Epidemiol 2012; 33:981.
  73. wonder.cdc.gov/mmwr/mmwr_reps.asp?mmwr_table=3A&mmwr_year=1999&mmwr_week=52 (Accessed on October 14, 2011).
  74. wonder.cdc.gov/mmwr/mmwr_reps.asp?mmwr_table=3B&mmwr_year=1999&mmwr_week=52 (Accessed on October 14, 2011).
  75. Williams WW, Preblud SR, Reichelderfer PS, Hadler SC. Vaccines of importance in the hospital setting. Problems and developments. Infect Dis Clin North Am 1989; 3:701.
  76. Fischer PR, Brunetti C, Welch V, Christenson JC. Nosocomial mumps: report of an outbreak and its control. Am J Infect Control 1996; 24:13.
  77. McGrath D, Swanson R, Weems S, et al. Analysis of a measles outbreak in Kent County, Michigan in 1990. Pediatr Infect Dis J 1992; 11:385.
  78. Rivera ME, Mason WH, Ross LA, Wright HT Jr. Nosocomial measles infection in a pediatric hospital during a community-wide epidemic. J Pediatr 1991; 119:183.
  79. Miranda AC, Falcão J, Dias JA, et al. Measles transmission in health facilities during outbreaks. Int J Epidemiol 1994; 23:843.
  80. Remington PL, Hall WN, Davis IH, et al. Airborne transmission of measles in a physician's office. JAMA 1985; 253:1574.
  81. Bloch AB, Orenstein WA, Ewing WM, et al. Measles outbreak in a pediatric practice: airborne transmission in an office setting. Pediatrics 1985; 75:676.
  82. Centers for Disease Control (CDC). Nosocomial rubella infection - North Dakota, Alabama, Ohio. MMWR Morb Mortal Wkly Rep 1981; 29:630.
  83. Watkins NM, Smith RP Jr, St Germain DL, MacKay DN. Measles (rubeola) infection in a hospital setting. Am J Infect Control 1987; 15:201.
  84. Braunstein H, Thomas S, Ito R. Immunity to measles in a large population of varying age. Significance with respect to vaccination. Am J Dis Child 1990; 144:296.
  85. Smith E, Wong VK. Measles susceptibility of hospital personnel. Arch Intern Med 1993; 153:1011.
  86. Mortimer EA Jr. Pertussis and its prevention: a family affair. J Infect Dis 1990; 161:473.
  87. http://www.cdc.gov/pertussis/outbreaks.html (Accessed on July 06, 2011).
  88. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/pert.pdf (Accessed on July 06, 2011).
  89. Centers for Disease Control and Prevention (CDC). National, state, and local area vaccination coverage among adolescents aged 13-17 years --- United States, 2009. MMWR Morb Mortal Wkly Rep 2010; 59:1018.
  90. Centers for Disease Control and Prevention (CDC). Tetanus and pertussis vaccination coverage among adults aged ≥ 18 years --- United States, 1999 and 2008. MMWR Morb Mortal Wkly Rep 2010; 59:1302.
  91. Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in adults aged 65 years and older - Advisory Committee on Immunization Practices (ACIP), 2012. MMWR Morb Mortal Wkly Rep 2012; 61:468.
  92. Josephson A, Karanfil L, Gombert ME. Strategies for the management of varicella-susceptible healthcare workers after a known exposure. Infect Control Hosp Epidemiol 1990; 11:309.
  93. Weber DJ, Rutala WA, Parham C. Impact and costs of varicella prevention in a university hospital. Am J Public Health 1988; 78:19.
  94. Josephson A, Gombert ME. Airborne transmission of nosocomial varicella from localized zoster. J Infect Dis 1988; 158:238.
  95. Varicella and zoster in hospitals. Lancet 1990; 335:1460.
  96. Friedman CA, Temple DM, Robbins KK, et al. Outbreak and control of varicella in a neonatal intensive care unit. Pediatr Infect Dis J 1994; 13:152.
  97. Faoagali JL, Darcy D. Chickenpox outbreak among the staff of a large, urban adult hospital: costs of monitoring and control. Am J Infect Control 1995; 23:247.
  98. Krasinski K, Holzman RS, LaCouture R, Florman A. Hospital experience with varicella-zoster virus. Infect Control 1986; 7:312.
  99. Nettleman MD, Schmid M. Controlling varicella in the healthcare setting: the cost effectiveness of using varicella vaccine in healthcare workers. Infect Control Hosp Epidemiol 1997; 18:504.
  100. Prevention of varicella. Update recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 1999; 48:1.
  101. wonder.cdc.gov/mmwr/mmwr_reps.asp?mmwr_table=3A&mmwr_year=2001&mmwr_week=52 (Accessed on October 14, 2011).
  102. Centers for Disease Control. Hepatitis Surveillance Report No. 56. Public Health Service, Centers for Disease Control. Atlanta, US Department of Health and Human Services, 1996.
  103. Papaevangelou GJ, Roumeliotou-Karayannis AJ, Contoyannis PC. The risk of nosocomial hepatitis A and B virus infections from patients under care without isolation precaution. J Med Virol 1981; 7:143.
  104. Rosenblum LS, Villarino ME, Nainan OV, et al. Hepatitis A outbreak in a neonatal intensive care unit: risk factors for transmission and evidence of prolonged viral excretion among preterm infants. J Infect Dis 1991; 164:476.
  105. Lee KK, Vargo LR, Lê CT, Fernando L. Transfusion-acquired hepatitis A outbreak from fresh frozen plasma in a neonatal intensive care unit. Pediatr Infect Dis J 1992; 11:122.
  106. EISENSTEIN AB, AACH RD, JACOBSOHN W, GOLDMAN A. AN EPIDEMIC OF INFECTIOUS HEPATITIS IN A GENERAL HOSPITAL. PROBABLE TRANSMISSION BY CONTAMINATED ORANGE JUICE. JAMA 1963; 185:171.
  107. Meyers JD, Romm FJ, Tihen WS, Bryan JA. Food-borne hepatitis A in a general hospital. Epidemiologic study of an outbreak attributed to sandwiches. JAMA 1975; 231:1049.
  108. Watson JC, Fleming DW, Borella AJ, et al. Vertical transmission of hepatitis A resulting in an outbreak in a neonatal intensive care unit. J Infect Dis 1993; 167:567.
  109. Doebbeling BN, Li N, Wenzel RP. An outbreak of hepatitis A among health care workers: risk factors for transmission. Am J Public Health 1993; 83:1679.
  110. Burkholder BT, Coronado VG, Brown J, et al. Nosocomial transmission of hepatitis A in a pediatric hospital traced to an anti-hepatitis A virus-negative patient with immunodeficiency. Pediatr Infect Dis J 1995; 14:261.
  111. Hanna JN, Loewenthal MR, Negel P, Wenck DJ. An outbreak of hepatitis A in an intensive care unit. Anaesth Intensive Care 1996; 24:440.