Infection Control: Hepatitis B Vaccination
The Hepatitis B (HBV) vaccination must be made available to employees, who are occupationally exposed to bloodborne pathogens, within ten working days of initial assignment. In addition, Cal/OSHA requires the employee to be provided with information on its efficacy, safety, method of administration, benefits and that it is provided at no cost to the employee. Exceptions to the requirement to offer the vaccination include: (1) the employee has already received the complete vaccination series; (2) antibody testing has revealed that the employee is immune; or (3) the vaccination is contraindicated for medical reasons. The employer may not require an employee to be screened for antibodies in order to receive the vaccination.
HBV vaccinations are administered in three doses, with the second and third doses administered at 1 month and 6 months after the first. Vaccinations should be received intramuscularly (in the deltoid). A December 1997 update in CDC recommendations now makes mandatory post-vaccination screenings for employees provided with the Hepatitis B vaccine. Serological conversion should be tested within one to two months of the last shot of the three-shot series. If the screening shows the vaccine did not work, the employer is required to offer to pay for a second vaccine series. The U.S. Public Health Service does not recommend routine serologic testing and booster shots.
If an employee agrees to the vaccination, the employer is to pay for the vaccination, post-vaccination screening, and, if indicated, a second vaccination series. Check with public health clinics, outpatient clinics, hospital occupational health services departments, or a physician for information where employees can receive the vaccination.
If an employee declines the vaccination, the employer must ensure the employee signs a declination form. The declination’s wording must be identical to that found in the regulation (Appendix A, Section 5193, Bloodborne Pathogens).
If an employee initially declines the vaccination then decides to have it, the employer must pay for the vaccination, post-vaccination screening, and second vaccination series, if necessary.
Summary of CDC Recommendations on Hepatitis B
Vaccinations
REFERENCES:
CDA Regulatory Compliance Manual