Vaccination recommendations for specific work activities

ActivityImmunisationStatusCommentBooster doses required
Undergraduate Medical courses

Biomedical Science courses involving patient contact

Clinical work (NHS Honorary Contract or equivalent)

 Hepatitis B Mandatory Series of 3 vaccinations & blood test necessary to complete schedule. This can take up to 7 months to complete. Accelerated courses are administered to lab workers.

Annual Hepatitis B Surface Antigen (HBSAg)screening required for non-responders undertaking Exposure Prone Procedures (Medical Students and NHS Honorary Contract holders)		 Accelerated courses and “poor” responders in line with PHE guidance, DOH Green Book
MMR (Measles, Mumps Rubella) Mandatory Evidence of two vaccinations or positive serology required as proof of immunity to measles & rubella. Some clinical settings require evidence of Mumps Immunity if evidence of 2 MMR not available.  
Tuberculosis (BCG) Recommended Testing for pre-existing immunity from earlier vaccination or exposure to mycobacteria required before vaccination. No
Chickenpox Mandatory Only if no past history of infection and a negative blood test No
Other patient contact (Social) As for clinical work   Exact requirements can vary between NHS Trusts
Hepatitis B not usually required – Risk Assessment		 No
Laboratory work with human blood, serum or unfixed tissue Hepatitis B Recommended Usually recommended unless samples actively screened for hepatitis or sourced from a screened population or an individual's involvement in the work lasts for less than eight weeks.

Vaccination is not required if not directly involved in handling or for short-term use of blood in practical classes. Accelerated course is completed within a month		 No
Deliberate work with Hepatitis B cultures Hepatitis B Mandatory   No
Deliberate work with N. Meningitides cultures Meningitis Mandatory Vaccine choice (ACWY, B or C- conjugate) will be dependent on strains in use. The risk assessment for the work should specify 5 years depending on level of risk (risk assessment should specify)
Other laboratory work with human pathogens Relevant vaccine Recommended Vaccination usually recommended if available. Decision will be based on risk assessment.
Risk assessment for the work should be passed to the Occupational Health Physician for decision		  
Overseas travel Variable Variable Recommendations will be based on risk assessment which considers destination, duration of stay & activities undertaken.
Vaccination is likely for fieldwork or stays of more than a few days in countries other than Northern and Central Europe and North America.
Recommendations will be made in line with those from UK reference authorities (NATHNAC)		 Variable
Maintenance work Tetanus, Hepatitis A Recommended Only maintenance staff whose work may involve regular contact with sewage. Hepatitis A: single booster at one year
Early Years Educators As for clinical work Recommended Hepatitis B not required  
Grounds maintenance Tetanus Recommended Most adults have lasting immunity from childhood vaccinations  
Cleaning None Not applicable Risk assessment may dictate urgent Hep B vaccination if inoculation accident with discarded needle  
Welding Pneumococcus Recommended Recommended for anyone carrying out welding more than once per week.
Anyone welding for >4 hours per month, on average, may be vaccinated on request.		 No

Additional control measures for individuals who decline or do not respond to vaccinations or where individual vaccination is contra-indicated on health grounds

ImmunisationComment
Hepatitis B
  1. Restrict from direct handling of cultures or blood or tissue samples known to contain viable virus
  2. urgent OH assessment for consideration of post exposure prophylaxis after any significant exposure (inoculation or splash onto mucosa/broken skin)
  3. non-responders who undertake exposure prone procedures as part of their clinical work (NHS honorary contract holders and medical students ) will require annual hepatitis B surface antigen screening in line with the Public Health England Document :  Integrated Guidance on Health Clearance of Healthcare Workers and the Management of Healthcare Workers Infected with Bloodborne Viruses (Hepatitis B, Hepatitis C And HIV), October 2017.
MMR
  1. Non-immune students or clinical staff may need to be restricted from contact with vulnerable patient groups e.g. infants, immuno- suppressed patients each case will be considered individually in conjunction with local NHS Infection Control teams.
TB
  1. Non-immune students or staff may need to be restricted from working in clinical areas at high risk for TB exposure e.g. infectious disease wards.
  2. Non-immune individuals should be informed of the symptoms of TB and advised to report suspicious symptoms to the Occupational Health.
N. Meningitides
(research work)		  
  1. Restrict from direct handling of pathogenic cultures.

 

Revision History

August 2018: Reviewed (Claire O'Brien, Director of Occupational Health)

Vaccination policy