Protecting Healthcare Workers: The Impact and Implementation of the Hepatitis B Vaccine

Hepatitis is an inflammation of the liver. Hepatitis B is a virus that can be easily prevented by the Hepatitis B vaccine. There has been a 98% occupational transmission decline of Hepatitis B since the vaccine has been available. Most who receive the vaccine will develop immunity to the Hepatitis B virus. Those who do not develop immunity are non-responders and are susceptible to contracting Hepatitis B virus. Non-Responders to the vaccine should receive education about their increased risk to contract the virus.

Hepatitis B is spread by exposure to infected blood and body fluids. Exposure can happen in different ways. For Healthcare workers, the most common way of exposure is through needlesticks and sharp instruments. Another way would be poor infection control in healthcare facilities. The Hepatitis B virus can survive outside the body and on surfaces for seven days. The incubation period of Hepatitis B is 30-180 days. Symptoms of Hepatitis B include joint pain, abdominal pain, joint swelling, dark urine and yellowing of the eyes. Chronic cases can lead to liver failure, cancer, or scarring.

OSHA requires that employers offer the Hepatitis B vaccine to employees who have a reasonable expectation of being exposed to blood or body fluids on the job. Employers shall ensure that all occupationally exposed workers be educated about the vaccine series. The education shall include information on the safety, efficacy, method of administration, and benefits of the vaccine. The vaccination should be made available at no cost to the employee, after the employee has received training and within 10 working days of initial assignment unless the employee has previously received the complete Hepatitis B vaccination series, antibody testing has revealed that the employee is immune, or the vaccine is contraindicated for medical reasons. The vaccine should be administered according to the current recommendations of the US Public Health Service. To ensure immunity, the entire vaccination series should be given according to these recommendations.

Employers cannot make prescreening an employee a prerequisite for receiving the Hepatitis B vaccination. If the employee initially declines the vaccine from the employer but at a later date decides to accept the vaccination, the employer shall make available the Hepatitis B vaccination at that time. The employer shall assure that employees who decline the vaccination sign a declination statement. The purpose of the declination statement is to encourage greater participation in a vaccination program stating that an employee who declines the vaccine remains at a higher risk of acquiring Hepatitis B. If an employee declines the vaccine, education should be provided on the risk of being susceptible to the virus.

Employers are required to offer and maintain a copy of the Hepatitis B vaccinations, including the dates of the vaccines. When employees have previously received the vaccinations, that documentation should be made available to the employer. If a copy of the vaccination is not available, employers should make an effort to obtain a reliable record of the employee’s vaccinations. This could include contacting previous employers to obtain these records, having the employee provide a copy of the dates of the vaccines or contacting the facility that administered the vaccines. If a copy cannot be obtained, OSHA recommends documenting the attempts made to acquire the documentation. The employee should document the dates or approximate dates the vaccines were administered. There is no harm in repeating the vaccination series if documentation cannot be obtained and the employee consents to receiving the vaccines.

The Hepatitis B vaccine is a safe and effective way to prevent the transmission of the virus. Healthcare workers should consider getting and obtain the vaccine in order to protect themselves from a chronic and sometimes deadly virus. Additionally, May is Hepatitis Awareness month and May 19^th is National Hepatitis Testing Day.

If you are a TMC Client and would like additional information about Hepatitis as it relates to healthcare personnel, review your Exposure Control Plan in your TMC OSHA manual.