COMMENTARY

Recommended Vaccines for All Healthcare Personnel

JoEllen Wolicki, BSN, RN

Disclosures

September 17, 2012

Editorial Collaboration

Medscape &

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Hello. My name is JoEllen Wolicki, and I am a nurse educator in the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention. I am pleased to speak with you today as part of the CDC Expert Commentary Series on Medscape. I would like to share with you some important information about the immunization recommendations for all healthcare personnel -- nurses, dental hygienists, dentists, physicians, students and trainees, and others, such as receptionists, administrative staff, and volunteers -- just about anyone who "shares air" with patients.

In November 2011, updated Advisory Committee on Immunization Practices (ACIP) immunization recommendations for healthcare personnel were published. These recommendations were also reviewed by the Healthcare (formerly Hospital) Infection Control Practices Advisory Committee.

Adults are recommended to receive vaccines based on age and risk status -- for example, pneumococcal, hepatitis A, and zoster (shingles) vaccines. Because of documented nosocomial transmission, healthcare personnel are considered to be at substantial risk of acquiring and transmitting hepatitis B, influenza, measles, mumps, rubella, pertussis, and varicella (chickenpox). Vaccines to protect against these diseases are routinely recommended for all healthcare personnel.

Influenza vaccination is recommended annually for healthcare personnel. A survey of healthcare personnel in November 2011 found that approximately 63% of respondents had been vaccinated. This estimate is an increase over the last few years but falls short of our national target of 90% coverage as defined by the Healthy People 2020 program. A strong recommendation from peers and leaders is very important to let all healthcare personnel know that they need the vaccine and that immunization will benefit not only themselves, but also their family members, friends, patients, and coworkers.

Pertussis (whooping cough) is another concern. It continues to circulate in the United States, and in some areas, rates of pertussis disease are climbing. Nosocomial spread of pertussis has been documented in various healthcare settings. Identified sources of the disease include patients, healthcare personnel, visitors, and family members. Specimens have been identified as either hospital- or community-acquired disease. So, you can see why protection against this disease is critical for healthcare personnel.

The vaccine that contains the pertussis vaccine for adults is called Tdap. All healthcare personnel, regardless of age, should be vaccinated against pertussis as soon as possible if they have not previously received Tdap vaccine. Many adults were immunized against pertussis as children and wonder why they need Tdap now. Immunity, whether from vaccine or disease, wanes over time. Tdap vaccination can reduce the risk for disease and prevent transmission.

I would like to briefly discuss measles. We saw a median number of 60 reported measles cases yearly between 2001 and 2010. However, during 2011, 222 measles cases and 17 measles outbreaks were reported to CDC from 31 different states. Measles can cause serious complications and even death. You may be surprised that 1 out of 3 of the people who contracted measles in the United States last year had to be hospitalized. Unless they have evidence of previous immunity to measles, ACIP recommends that healthcare personnel should have 2 appropriately spaced doses of the measles-mumps-rubella (MMR) vaccine.

In summary, it is critical for all healthcare personnel, including nurses, dentists, dental assistants, physicians, and allied health professionals, to be up to date with needed vaccines. Ask your healthcare provider or employee/occupational health office if you have received all necessary vaccines, including influenza vaccine. Once vaccinated, recommend vaccine to your coworkers. More information and resources on healthcare personal immunizations are available on the Centers for Disease Control and Prevention Website. Thank you very much for your attention today.

Web Resources

Advisory Committee on Immunization Practices (ACIP) Recommended Adult Immunization Schedule, United States

Immunization of Health-Care Personnel Recommendations of the Advisory Committee on Immunization Practices (ACIP)

Vaccines and Immunizations for Healthcare Workers

Disease and Vaccine Information:

Hepatitis B: http://www.cdc.gov/vaccines/vpd-vac/hepb/default.htm

Influenza: http://www.cdc.gov/flu/professionals/index.htm

Measles: http://www.cdc.gov/vaccines/vpd-vac/measles/default.htm

Mumps: http://www.cdc.gov/vaccines/vpd-vac/mumps/default.htm

Rubella: http://www.cdc.gov/vaccines/vpd-vac/rubella/default.htm

Pertussis: http://www.cdc.gov/vaccines/vpd-vac/pertussis/default.htm

Varicella: http://www.cdc.gov/vaccines/vpd-vac/varicella/default-hcp.htm

JoEllen Wolicki, BSN, RN, recently joined the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, where she serves as a nurse educator in the Education, Information, and Partnership Branch. Ms. Wolicki travels throughout the United States conducting immunization training courses and giving lectures to healthcare providers on vaccine-preventable diseases and immunization-related issues. She has published articles on immunization in nursing literature and is a contributor to the book Epidemiology and Prevention of Vaccine-Preventable Diseases, commonly known as the "Pink Book," now in its 12th edition (2012). She currently works on a variety of immunization education programs and materials and is a member of multiple working groups for the Advisory Committee on Immunization Practices (ACIP). Before joining CDC, Ms. Wolicki served as a nurse consultant for the Michigan Department of Community Health Division of Immunization for 14 years. In this role, she worked on various program components, including provider education and outreach; statewide immunization registry; Vaccines for Children (VFC); and Assessment, Feedback, Incentives, and Exchange (AFIX). She created and revised immunization education materials for healthcare providers and the general public. Ms. Wolicki earned her Bachelor of Science degree in nursing at the University of Detroit/Mercy in Detroit, Michigan.

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