New employees who apply and secure jobs with durable medical equipment companies are often surprised to find out that they are being offered vaccinations to protect them against Hepatitis B.  In fact, some new employees find it unsettling to learn that their new job offers this “benefit” because of increased exposure risk to this dreaded but somewhat misunderstood disease.  Let’s dispel some myths and lay out the basic facts about the disease, its prevention, and why healthcare workers are being offered this vaccination.  

Hepatitis B is a viral liver disease. Symptoms of the disease include jaundice, fever, fatigue, nausea, vomiting, and general malaise. Acute Hepatitis B may resolve on its own, or it may develop into chronic (ongoing) Hepatitis B.  Chronic Hepatitis B can lead to cirrhosis of the liver and various forms of liver cancer.  There is no cure for the disease so, beyond treating symptoms, prevention is the key. 

A person typically contracts the disease in one of these ways: 

• Sex with an infected partner
• IV drug abuse / use of infected needles
• Accidental needlesticks (often an issue for healthcare workers)
• Contact with blood or open sores from an infected person.

Of note for all healthcare workers—including DME staff, are the needlesticks and also contact with blood and open sores.  While these are preventable and thankfully uncommon occurrences, they are a potential that warranted the Centers for Disease Control (CDC) to mandate that healthcare providers be offered vaccinations by their employers. The “mandate”, enforced by Occupational Safety and Health Administration (OSHA), calls for the following by employers who are considered healthcare providers: 

1. The employer must offer cost-free vaccinations for Hepatitis B to employees deemed to have direct patient contact with customer/patients.
2. The employer must provide education relating to the disease and the vaccination, so that the employee can make an informed decision about obtaining the vaccine.

Note that the requirement is that the employer offers the vaccine to employees!  The employee is not required to receive the vaccination.  But it is incumbent on the employer to make sure they’ve provided adequate information so that the employee makes that informed decision. 

The vaccination for Hepatitis B is a series of three simple intramuscular injections.  The first injection is given, followed with a second injection about a month later, followed by the third and final injection about six months later.  These injections will provide immunity for the vast majority of people.  The immunity lasts at least thirty years (research is premature and incomplete about “lifelong” immunity). There is a blood test to verify that the vaccine level is adequate for prevention, but the vaccine series is so successful that the verification is not generally necessary. 

It is also worth noting that there are very few and very rare dangers, contraindications, and side effects from the vaccines.  For the vast majority of healthcare workers, receiving the vaccinations is a “no-brainer.”

At your DME, most clinical employees will know about and have had the vaccines.  Anyone who worked or trained in a hospital setting has been offered the vaccinations.  Delivery staff, on the other hand, may have never heard of the disease or the vaccine.  For these employees, your company should have educational resources to help them decide.  Statistically, there are about 3000 new cases of acute Hepatitis B reported through the CDC very year.  Of course, the assumption is that the number of unreported cases would increase the total number of cases dramatically.  CDC estimates that there are about 1.5 million people walking around with chronic Hepatitis B at any given time.   These statistics present a very compelling case for vaccination. 

Providing education for employees is easy.  The CDC website and a simple Google search on the internet will help you find printable brochures, links to video lectures, podcasts, and other helpful and informative resources. 

Once an employee has been given this information, elicit a written acknowledgement from them.  If they elect to have the vaccinations, provide them through an employee health services provider in your community.  Maintain documentation of the vaccination series.  If the employee elects to not have the vaccinations, you should maintain documentation that they declined.  A very simple declination form can be signed and maintained in the human resource file for each employee.