Section V: Hepatitis B Vaccination

POST-EXPOSURE EVALUATION AND FOLLOW-UP
It is recognized that even with strict adherence to all exposure prevention practices exposure incidents can occur. As a result, procedures for post-exposure evaluation and follow-up have been established in the event that exposure to bloodborne pathogens occurs.

1. 
   
2. VACCINATION PROGRAM
   To protect employees as much as possible from the possibility of Hepatitis B infection, a vaccination program has been implemented by the school district. This program is available at no cost to all employees who may have occupational exposure to bloodborne pathogens. The vaccination program consists of a series of three inoculations over a six-month period. As part of the bloodborne pathogens training, employees receive information regarding hepatitis vaccination, including its safety and effectiveness.
   
   The Administrator or appointed designee is responsible for setting up and operating the vaccination program. Vaccinations are performed under the direction of a licensed physician or other health care professional. Lists of employees taking part in the vaccination program are available in the Employee Health Records. Informed Consent will be secured from employees. (See appendix-FORM G) The school district may require physician approval for hepatitis B vaccination. (See appendix-FORM H) Employees who have declined to take part in the vaccination program are listed and have signed the Vaccination Declination Form. (See appendix-FORM I).
   
   To ensure that all employees are aware of the vaccination program, the subject is thoroughly discussed in the bloodborne pathogens training and Hepatitis B vaccination clinic notices are posted in prominent places throughout the school district.
   
3. POST-EXPOSURE FOLLOW-UP
   
   If an employee is involved in an accident where exposure to bloodborne pathogens may occur, there are two things on which efforts need to be immediately focused.
   1. Investigation of the circumstances surrounding the exposure incident.
   2. Assurance that the employee receives medical consultation and treatment (if required) as expeditiously as possible.
   
   The Administrator or appointed designee shall investigate every reported incident that occurs within the school district. This investigation shall be initiated within 24 hours of the incident and involves gathering the following information (if at all possible):
   1. When the incident occurred--date and time.
   2. Where the incident occurred--location within the school district.
   3. What potentially infectious materials were involved in the incident--blood, body fluids, etc.
   4. Source of the potentially infectious material.
   5. Under what circumstances the incident occurred--type of work being performed.
   6. How the incident was caused--accident, unusual circumstances such as equipment failure, power outage, etc.
   7. Personal protective equipment being used at the time of the accident. Actions taken as a result of the incident--employee decontamination, cleanup, notifications made.
   
   After this information is gathered, it shall be evaluated, a written summary of the incident and its causes prepared, and recommendations made to avoid similar incidents in the future. An Exposure Incident Report will be completed. (See appendix-FORM J).
   
   If an exposure to bloodborne pathogens should occur, a comprehensive post-exposure evaluation and follow-up process shall be established to ensure that employees receive the best and most timely treatment. (See appendix-FORM K.) This process is overseen by the school nurse, a physician designated by the district, or the employee’s personal physician. The employee may refuse a post-exposure medical evaluation. (See appendix-FORM L).
   
   It is recognized that much of the information involved in this process must remain confidential and everything possible will be done to protect the privacy of the individual(s) involved. As a first step in this process, the following confidential information is provided to an exposed employee:
   1. Documentation regarding the routes of exposure and circumstances under which the incident occurred.<
   2. Identification of the source individual (unless infeasible or prohibited by law).
   
   The next step, if possible, is to test the source individual's blood to determine HBV and HIV infectivity. This is accomplished by the following tests: HBsAg and HIV antibody. This information will be made available to the exposed employee if it is obtained. At that time the employee will be made aware of any applicable laws and regulations concerning disclosure of the identity and infectious status of a source individual.
   
   The exposed employee's blood will be collected as soon as feasible after consent is obtained, and tested for HBV and HIV serological status. If the employee consents to baseline blood collection but does not give consent at that time for HIV serologic testing, the sample will be preserved for at least 90 days. If, within 90 days of the exposure incident, the employee elects to have the baseline sample tested, such testing will be done as soon as possible.
   
   Employees who have had hepatitis immunization and documented response need not be tested for hepatitis B. Once these procedures have been completed, the exposed employee will meet with a qualified healthcare professional to discuss the employee's medical status. This includes an evaluation of any reported illness as well as any recommended treatment.
   
   
   
4. THE EVALUATION AND WRITTEN REPORT
   
   After consultation, the Administrator or appointed designee shall provide a copy of the evaluating healthcare professional's written opinion within 15 days of the completion of the evaluation (See appendix-FORM M). In keeping with the emphasis on confidentiality, the written report will contain only the following information:
   1. Whether Hepatitis B vaccination is indicated for the employee.
   2. Whether the employee has received the Hepatitis B vaccination.
   3. Confirmation that the employee has been informed of the results of the evaluation.
   4. Confirmation that the employee has been told about any medical conditions resulting from the exposure incident which require further evaluation or treatment.
      
   All other finding or diagnoses will remain confidential and will not be included in the written report.
   
   
   
5. MEDICAL RECORDKEEPING
   
   Medical records pertaining to immunization for or exposure to bloodborne pathogens shall be maintained by the school district. (See appendix-FORM N) Records shall include the following information:
   1. Name of the employee.
   2. Social security number of the employee.
   3. A copy of the employee's Hepatitis B vaccination status, dates of any vaccinations, pertinent information related to the employee's ability to receive the vaccination.
   4. Copies of the results of the examinations, medical testing, and follow-up procedures which took place as a result of an employee's exposure to bloodborne pathogens. As with all information in these areas, it is recognized that it is important to keep the information in these medical records confidential. This information shall not be disclosed or reported to anyone without the employee's written consent (except as required by law).