Because of your contact with vulnerable patients and/or infective material from patients, you are at risk for exposing patients and being exposed to and possible transmission of vaccine-preventable diseases. Maintenance of immunity is therefore an essential part of prevention for healthcare workers. It is important to recognize that most infectious diseases are contagious before a person is symptomatic. It is your professional responsibility to know and keep current with your immunizations and health requirements.
- If any of your immunizations will expire in the middle of a semester, you will be required to have up-to-date immunizations before beginning the next term.
Please familiarize yourself with the information provided on the Clinical Passport Northwest website at www.CPNW.org. It is also recommended that you retain a copy of your Clinical Passport for your personal records. See Clinical Passport login directions for help creating your CPNW account.
This information is subject to change. Please see the CPNW website link above for the most current requirements.
- All live vaccines (MMR, Varicella, LAIV (nasal flu) have to be administered on the same day or separated by 28 days.
- The TST (Tuberculin Skin Test) and a live vaccine must be done on the same day or separated by 30 days. If done sooner, there is potential for a false positive, resulting in increased cost and unnecessary treatment (chest-x-rays).
- MMR - You are required to have 2 MMR’s or proof of titer (3 titers, one each of Measles (Rubeola), Mumps and Rubella). NOTE: In most cases getting the MMR is far less expensive than having blood titers drawn. Revaccination with MMR vaccine is safe.
- Varicella - If you have had the first Varicella vaccine and then have the disease you have two options: 1) Do the 2nd Varicella or 2) Have a titer drawn. NOTE: Titer is only recommended if you have had chicken pox disease. Titer after Varicella vaccine is not recommended by the CDC as most Varicella tests are not sensitive enough to detect antibody level for immunity post vaccination.
- Tetanus- If you need the tetanus immunization, it is important for you to inform your health care provider to administer Tdap and NOT Td. This protects you from pertussis outbreaks when working with patients in OB/Peds, Hem/Onc or any other area where there are susceptible patients. You are required to show proof of one dose of Tdap.
- TST skin test: - There are two types of tests that are done to measure for TB exposure. The first is the tuberculin skin test. When you first have a TST you are required to get a 2 step. If the first TST is negative then you will need to obtain a 2nd TST within 1-3 weeks, then yearly after that. If your yearly TST lapses, you will then need to complete the 2 step process. Tests must be read in mm and include date of each test, date of each reading, signature of person reading test and facility where read.
There is also a TB blood test called QuantiFERON (TB Gold Test). Unlike the TB skin test, QuantiFERON is not affected by prior BCG vaccination. Results can be available within 24 hours. QuantiFERON should be administered on the same day as live-virus vaccines or 4-6 weeks after administration of live virus vaccine.
- Hepatitis B Info:
- The series of three vaccines at 0, 1, and 6 months plus immunity confirmed by (anti-HBs) titer is recommended.
- The titer should be drawn 4-8 weeks after completion of the series.
- If you have a negative (anti-HBs) titer, you will need to repeat the series and titer. If negative, you are considered a non-responder.
- If you have received the primary series of three vaccines and did not have a titer drawn:
- If the primary series of three vaccines is > 5 years old, it is recommended that you receive a 4th dose of Hep B then test for antibodies (titer) 1-2 months later. A positive titer indicates immunity. If your titer is negative, you must receive two additional does of Hep B and have another titer drawn. If negative, you are considered a nonresponder.
- If the primary series of three vaccines is < 5 years old, you require a titer only. A positive titer indicates immunity. However, if your titer is negative, you must receive a second series of three vaccines and have another titer drawn. If negative, you are considered a nonresponder.
- Nonresponder: Persons who do not have a protective concentration of anti-HBs (> 10mlU/mL) after revaccination (i.e., after receiving a total of 6 doses) should be tested for HBsAg and anti-HBc to determine infection status. Those determined not to be infected but who have anti-HBs <10mlU/mL (nonresponders) should be considered susceptible to HBV infection and should be counseled about precautions to prevent HBV infection and the need to obtain hepatitis B immune globulin (HBIG) postexposure prophylaxis for any known or likely exposure to HBsAg-positive blood.
Please be aware that there are healthcare settings that may have a health requirement specific to their organization. Requirements such as these can be found within the “Optional Requirements" area on the bottom right of the Passport. Your Nursing Program will inform you if any of these requirements will be necessary.