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An additional level of protection for at-risk personnel
may be achieved with appropriate prophylactic immunizations. A written organizational
policy that defines at-risk personnel, specifies risks as well as benefits of specific
vaccines, and distinguishes between required and recommended vaccines is essential. In
developing such an organizational policy, these recommendations and requirements should be
specifically targeted at infectious diseases known or likely to be encountered in a
particular facility. Licensed vaccines for which the benefits
(levels of antibody considered to be protective) clearly exceed the risks (e.g., local or
systemic reactions) should be required for all clearly identified at-risk personnel.
Examples of such preparations include vaccines against hepatitis B, yellow fever, rabies,
and poliomyelitis. Recommendations for giving less efficacious vaccines, those associated
with high rates of local or systemic reactions, those that produce increasingly severe
reactions with repeated use, and unlicensed vaccines given under investigational new drug
(IND) protocols, should be carefully considered. Products with these characteristics
(e.g., cholera, anthrax, and tularemia vaccines) may be recommended but ordinarily should
not be required for employment. A complete record of vaccines received on the basis of
occupational requirements or recommendations should be maintained in each employee's
permanent medical file.
Recommendations for the use of vaccines, adapted from those of the
Public Health Service Advisory Committee on Immunization Practices, are included in the
agent summary statements in Section VII and are elaborated in the references below.(1)(2)
The reader is advised to consult the current related recommendations
of the ACIP published in the CDC Morbidity and Mortality Weekly Report (MMWR).
Particular attention must be given to individuals who are or may become immunocompromised,
as recommendations for vaccine administration may be different than for immunologically
competent adults. |
