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Home My WebLink About106.007 - EMS-22, Hepatitus B Vaccination Program Fresno City Fire Department 100 Administrative Manual SECTION 106.007 HEPATITIS B VACCINATION PROGRAM (EMS-22) PURPOSE The EMS-22 form is used to inform members of the risks and benefits of receiving a Hepatitis B Vaccination / Hepatitis B Titer and the risks of acquiring Hepatitis B from a work exposure. APPLICATION In order to meet the requirements of our annual Hepatitis B rogram, all members must sign indicating either cceptance or eclination of the Hepatitis B vaccination / Hepatitis B iter test (accination as needed, ter once a year as needed.) OPERATIONAL POLICY This section intentionally left blank. OPERATIONAL GUIDELINE This section intentionally left blank. PROCESS Members will submit completed form in a sealed envelope to the Training Division, EMS Coordinator. A licensed health care provider will discuss appropriate plans for each member who chooses testing. INFORMATION Employees have the right to refuse the Hepatitis B vaccine and/or any post- exposure evaluation and follow-up. OSHA regulations require employers to keep a record of a vaccine refusal by having the employee sign a Hepatitis B accination and/or Hepatitis B Titer eclination orm. The employer is to keep signed forms on file in the Department Learning Management System. Kevin Reynolds, Captain Section 106.007 Effective Date: October 2007 Current Revision Date: 07/1/2022 Next Revision () Date: 07/1/202 Page 1 of 5 If an employee changes his/her mind at a later date, OSHA regulations still require the employer to make the vaccine available at no cost. DEFINITIONS This section intentionally left blank. CROSS-REFERENCES This section intentionally left blank. Kevin Reynolds, Captain Section 106.007 Effective Date: October 2007 Current Revision Date: 07/1/2022 Next Revision () Date: 07/1/202 Page 2 of 5 EMS-22 Hepatitis B Vaccination / Hepatitis B Titer Program Hepatitis B (Can be prevented by Hepatitis B vaccine.) Hepatitis B is a liver infection caused by Hepatitis B virus. Hepatitis B is transmitted when infected blood or other body fluids are exchanged. This can happen from sharing personal items, such as razors, diabetes blood sugar monitors, or through sexual contact. Hepatitis B causes flu-like symptoms, which include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, joint pain, dark urine, clay-colored bowel movements, and jaundice. The virus can remain in the liver of some people for the rest of their lives and can result in severe liver diseases, including fatal cancer. Employees can get vaccinated for FREE! Employers are required by Occupational Safety and Health Administration (OSHA) regulations to make the Hepatitis B vaccine available at no cost to employees who may be exposed to blood while at work. What are the risks from Hepatitis B vaccine? Hepatitis B is a very safe vaccine. Most people do not have any problems with it. The vaccine contains non-infectious material and cannot cause Hepatitis B infection. Some mild problems have been reported: Soreness where the shot was given (approximately 1 in 4 people). Temperature of 99.9°F or higher (approximately 1 in 15 people). How Hepatitis B Vaccine is administered: The vaccination schedule most often used for adults and children has been three intramuscular injections, with the second and third administered one and six months after the first injection. How long does protection from Hepatitis B vaccine last? Studies indicate immunologic memory remains intact for at least 20 years among healthy vaccinated individuals who initiated Hepatitis B vaccination >6 months of age. The vaccine confers long-term protection against clinical illness and chronic Hepatitis B virus infection. Section 106.007 Page 3 of 5 Hepatitis B Vaccination / Hepatitis B Titer Program Hepatitis B Titer Hepatitis B surface antibody (anti-HBs): The presence of anti-HBs is generally interpreted as indicating recovery and immunity from Hepatitis B infection. Anti-HB also develops in a person who has been successfully vaccinated against Hepatitis B. How Hepatitis B Titer is administered: The titer is done with a few cc’s of blood from a simple blood draw. Results: Anti-HBs level of greater than or equal to 10 mIU/mL is recommended by the Center for Disease Control as the standard for demonstrating post vaccination protection against Hepatitis B. If anti-HBs levels are low, the medical provider may suggest a booster or a new series depending on levels. Employees who turn down the Hepatitis B vaccination and/or the Hepatitis B Titer must sign a declination for. Employees have the right to refuse the Hepatitis B vaccine and/or any post-exposure evaluation and follow-up. OSHA regulations require employers to keep a record of a vaccine refusal by having the employee sign a Hepatitis B vaccination and/or Hepatitis B Titer declination form. The employer must keep signed forms on file. If an employee changes his/her mind at a later date, OSHA regulations still require the employer to make the vaccine available at no cost. Please submit the attached form completed and sealed in an envelope to the Training Division, EMS Coordinator. SUBMIT COMPLETED FORM IN A SEALED ENVELOPE TO THE EMS COORDINATOR Section 106.007 Page 4 of 5 EMS 22 Hepatitis B Vaccination / Hepatitis B Titer Program NAME: Employee ID# Hepatitis B Vaccination and/or Hepatitis B Titer Testing Acceptance The risks and benefits of receiving Hepatitis B vaccination/titer test and the risks of acquiring Hepatitis B from a work exposure have been explained to me. I acknowledge no guarantees have been made to me regarding the effectiveness of this testing or the absence of adverse reactions to the testing. I understand this information and have had all my questions answered to my satisfaction. I understand that I will receive these services free of charge. I voluntarily give my consent to receive the Hepatitis B vaccination/titer testing. Signature Date Hepatitis B Vaccination and/or Hepatitis B Titer Testing (REFUSAL) I decline Hepatitis B vaccination and/or Hepatitis B Titer at this time. I understand by declining this vaccine/test, I continue to be at risk of acquiring Hepatitis B, a serious disease. In the future, if I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with Hepatitis B vaccine, I can receive the vaccination series at no charge to me. Signature Date SUBMIT COMPLETED FORM IN A SEALED ENVELOPE TO THE EMS COORDINATOR Section 106.007 Page 5 of 5