The Centers for Disease Control and Prevention (CDC) has guidelines that specify which immunizations are recommended for healthcare workers, including those in dental practices. Immunizing healthcare workers against certain diseases is important because they are potentially at risk of exposure to infectious disease from a patient who may be an active carrier. Employers typically cover the costs associated with staff immunizations. Employers are required to offer and cover the cost of a Hepatitis B vaccination within 10 days of employment.
Different categories of vaccine requirements can exist in the dental practice:
- some may be required by state law
- some, while not required by state law, may be required by the employer as a matter of company policy
- some may be recommended by government agencies
For example, while the Hepatitis B vaccine is recommended by the Occupational Safety and Health Administration (OSHA), employees may opt-out of getting the vaccine unless it’s mandated by hospital policy or state law.
- Any employee who opts-out of an immunization must sign a declination form confirming that the immunization was offered and declined.
- Any employee who opts-out of an immunization can change his/her mind later.
Any employee who opts out of an immunization should be advised that certain work restrictions may be implemented in order to ensure their safety and that of patients.
The Centers for Disease Control and Prevention (CDC) strongly recommends that all healthcare workers receive the immunizations listed below. More information is available in CDC’s Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP).
- Hepatitis B - a viral infection that attacks the liver and can cause both acute and chronic disease.
- Influenza - a highly contagious viral infection of the respiratory passages causing fever, severe aching, and catarrh, and often occurring in epidemics.
- Measles - an infectious viral disease causing fever and a red rash on the skin, typically occurring in childhood.
- Mumps - a contagious and infectious viral disease causing swelling of the parotid salivary glands in the face, and the risk of sterility in adult males.
- Rubella - a contagious viral disease, with symptoms like a mild case of the measles and that can cause fetal malformation if contracted in early pregnancy.
- Varicella-zoster –a herpes virus that causes chickenpox and shingles; herpes zoster.
Current CDC immunization recommendations for dental health care personnel are detailed in the Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care.
It’s helpful to know the antibody status of the practice’s clinical personnel since that information will indicate whether an individual has been exposed to a particular disease. Practices should also maintain documentation that details staff’s post-immunization titer count to detect and measure the amount of antibodies within each person's blood; the amount and diversity of antibodies correlates to the strength of the body's immune response which should be higher after immunization if this information is available. You may want to consider requesting documentation attesting to the titers for clinical personnel who indicate they were previously vaccinated as a way to assure the safety of all personnel and patients.