Vaccinations are a pain in the ...

Some of the things we are asked to do in dentistry are just plain a pain in the tush. Vaccinations may be a pain in the tush but they can literally save your life, your patient's life, and impact your community.

by Noel Brandon Kelsch, RDHAP

Some of the things we are asked to do in dentistry are just plain a pain in the tush. Vaccinations may be a pain in the tush but they can literally save your life, your patient's life, and impact your community.

Every year the Advisory Committee on Immunization Practices (ACIP) gets together to look at vaccinations for health-care professionals and to ensure that the current recommendations reflect the science behind vaccinations.

As health-care providers, we have been asked to "do no harm." We have an obligation to do our part, and maintaining our vaccinations is part of the solution. In our jobs, dental health care workers (DHCW) are at risk for exposure to vaccine preventable diseases. This simple process will help us prevent the spread of disease to co-workers, patients, family, and the community.

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Other articles by Kelsch

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As an example, for many years hepatitis B (HBV) the acute disease that can lead to chronic liver disease, hepatocellular carcinoma, and cirrhosis of the liver was considered a high risk to DHCW. Simply getting the getting the vaccine and developing the immunity to the virus literally places the DHCW at no risk for the infection. If you choose to remain unvaccinated and had a single needle-stick exposure to HBV infected blood, depending on the antigens involved and virus level, you have a 6% to 30% chance of getting the disease. This disease is simply preventable through a vaccine.

In the United States, vaccination against HBV has brought this disease to an all-time low for health-care workers. Before the vaccine was available an estimated 10,000 health-care workers became infected annually in the USA. For 2002, the estimated number dropped to 400 cases. If those 400 hundred people had been vaccinated properly, the number could be zero.

Vaccinations may be a pain in the tush, but I hope you will look at your records and make sure you are up to date. Not only will this vaccination this impact your life, but the act of vaccination will stop you from spreading this life threatening disease.

Here is a list of great resources for understanding and implementing an immunization program:

NOEL BRANDON KELSCH, RDHAP, is a syndicated columnist, writer, speaker, and cartoonist. She serves on the editorial review committee for the Organization for Safety, Asepsis and Prevention newsletter and has received many national awards. Kelsch owns her dental hygiene practice that focuses on access to care for all and helps facilitate the Simi Valley Free Dental Clinic. She has devoted much of her 35 years in dentistry to educating people about the devastating effects of methamphetamines and drug use. She is a past president of the California Dental Hygienists’ Association

References

Centers for Disease Control and Prevention. Immunization of health-care workers: recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep. 1997 Dec 26;46(RR-18):1-42.

Centers for Disease Control and Prevention. Surveillance for acute viral hepatitis – United States, 2007. Surveillance Summaries, May 22, 2009. MMWR Morb Mortal Wkly Rep 2009;58:(No. SS-3).

http://www.cdc.gov/oralhealth/infectioncontrol/faq/bloodborne_exposures.htm)

Cleveland JL, Siew C, Lockwood SA, et al. Hepatitis B vaccination and infection among U.S. dentists, 1983-1992. J Am Dent Assoc 1996;127:1385-90.

Williams IT, Perz JF, Bell BP. Viral hepatitis transmission in ambulatory health care settings. Clin Infect Dis. 2004;38:1592-8.


Center for Disease Control Vaccination Recommendations for Health Care Workers:

Vaccines

Recommendations in brief

Hepatitis B

If you don't have documented evidence of a complete hepB vaccine series, or if you don't have an up-to-date blood test that shows you are immune to hepatitis B (i.e., no serologic evidence of immunity or prior vaccination) then you should

  • Get the 3-dose series (dose #1 now, #2 in 1 month, #3 approximately 5 months after #2).
  • Get anti-HBs serologic tested 1–2 months after dose #3.

Read the Vaccine Information Statement (VIS) about Hepatitis B: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hep-b.pdfto learn about this disease and potential risks associated with the vaccine. Also, visit CDC's Web page about Hepatitis B vaccination: http://www.cdc.gov/vaccines/vpd-vac/hepb/default.htm#vacc

Flu (Influenza)

Get 1 dose of influenza vaccine annually.

Read the Vaccine Information Statement (VIS) about Flu http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-flu.pdf to learn about this disease and potential risks associated with the vaccine. Also, visit CDC's Web page about Flu vaccination: http://www.cdc.gov/vaccines/vpd-vac/flu/default.htm#vacc

MMR (Measles, Mumps, & Rubella)

If you were born in 1957 or later and have not had the MMR vaccine, or if you don't have an up-to-date blood test that shows you are immune to measles, mumps, and rubella (i.e., no serologic evidence of immunity or prior vaccination), get 2 doses of MMR, 4 weeks apart.

For HCWs born before 1957, see the ACIP recommendations at bottom of this table.

Read the Vaccine Information Statement (VIS) about MMR: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-mmr.pdf to learn about this disease and potential risks associated with the vaccine.

If you also need the Varicella vaccine, see 'Vaccination Options for Preventing Measles, Mumps, Rubella and Varicella: http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/mmrv/vacopt.htm to consider reducing total number of vaccines.

Varicella (chickenpox)

If you have not had chickenpox (varicella), if you haven't had varicella vaccine, or if you don't have an up-to-date blood test that shows you are immune to varicella (i.e., no serologic evidence of immunity or prior vaccination) get 2 doses of varicella vaccine, 4 weeks apart.

Read the Vaccine Information Statement (VIS) about Varicella: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-varicella.pdf to learn about this disease and potential risks associated with the vaccine. Also, visit CDC's Web page about Varicella vaccination: http://www.cdc.gov/vaccines/vpd-vac/varicella/default-basic.htm.

If you also need the MMR vaccine, see 'Vaccination Options for Preventing Measles, Mumps, Rubella and Varicella: http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/mmrv/vacopt.htm to consider reducing total number of vaccines.

Tdap (Tetanus, Diphtheria, Pertussis)

Get a one-time dose of Tdap as soon as possible if you have not received Tdap previously.

Get Td boosters every 10 years thereafter.

Read the Vaccine Information Statement (VIS) about Tdap: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-tdap.pdfto learn about this disease and potential risks associated with the vaccine. Also, visit CDC's Web page about Tdap vaccination: http://www.cdc.gov/vaccines/vpd-vac/pertussis/recs-summary.htm.

Meningococcal

Those who are routinely exposed to isolates of N. meningitidis should get one dose.

Read the Vaccine Information Statement (VIS) about Meningococcal: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-mening.pdf to learn about this disease and potential risks associated with the vaccine. Also, visit CDC's Web page about Meningococcal vaccination: http://www.cdc.gov/vaccines/vpd-vac/mening/default.htm#vacc

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