Giving Employee and Patient Safety a Shot: Healthcare Personnel Immune Status at an Urban Acute Care Hospital

Abstract

<h3>Background</h3> Healthcare personnel (HCP) and hospitalized patients are at risk for exposure to communicable diseases. The Advisory Committee on Immunization Practices (ACIP) publishes vaccination and post-exposure work restriction recommendations for HCP. With a rise in community vaccine-preventable disease (VPD) cases, we assessed HCP immune status to determine the level of protection for HCP and patients against certain VPDs. <h3>Methods</h3> We conducted a cross-sectional analysis of immune status of HCP working at an urban, 420-bed acute care hospital. HCP vaccination and titer records were obtained from Employee Health. The percent of HCP vaccinated against varicella, measles, mumps, rubella, hepatitis B, tetanus, diphtheria, pertussis, and meningococcal disease was calculated based on documented vaccination date. The percent of HCP with presumptive immunity was calculated using vaccination date and/or titer data based on ACIP recommendations. <h3>Results</h3> Vaccination and titer records for 2,898 HCP were analyzed. Prevalence of presumptive immunity was highest for rubella (85.3%), measles (79.3%), and mumps (76.1%), followed by varicella (72.8%), meningococcal disease (66.7%), and hepatitis B (48.4%). A vast minority of HCP had presumptive immunity against tetanus (14.3%), diphtheria (14.3%), and pertussis (15.1%). Clinical HCP had a higher prevalence of presumptive immunity than non-clinical HCP across all VPDs. In a subset of HCP with documented titers after vaccination, only 61.5% of HCP demonstrated positive titers against hepatitis B, 74.3% demonstrated positive titers against varicella, 74.1% demonstrated positive titers against measles, and 82.5% demonstrated positive titers against mumps. In 2019, Employee Health and Infection Prevention responded to 21 communicable disease exposures, including exposures to varicella, pertussis, and bloodborne pathogens. <h3>Conclusions</h3> These data identify an opportunity for collaboration between Employee Health and Infection Prevention to increase documentation of presumptive immunity among HCP and enhance employee and patient safety. Future work will include a risk assessment for clinical areas, followed by HCP education and vaccination campaigns.