Increase Hepatitis B Vaccination Compliance In Healthcare

Amanda Marten, MSN, FNP-C

The Centers for Disease Control and Prevention estimates that between 580,000 and 1 million Americans have chronic hepatitis B. However, about two-thirds of those infected are unaware they have it. Medical providers are at increased risk of occupational exposure, so, as defined in OSHA’s bloodborne pathogen standard, organizations are required to make the hepatitis B vaccine available to employees. 

The hepatitis B vaccination is so important for most healthcare workers that if employees choose not to get the vaccination, OSHA requires them to sign a declination form that is tracked by the organization’s compliance officer. This is a requirement often overlooked by organizations but spotted during OSHA inspections.

In this blog, I’ll describe what a hepatitis B infection is, why vaccination is important, and strategies for how to increase hepatitis B vaccination compliance in healthcare facilities.

What Is Hepatitis B?

Hepatitis B (HepB) is a liver infection caused by the hepatitis B virus (HBV). It’s transmitted through contact with an afflicted person’s blood or other bodily fluids. Some people are sick for a few weeks (acute infection), while others face a lifelong chronic affliction. There is no cure.

One important way to prevent an HBV infection is through vaccination. Almost all people born in the United States receive a hepatitis B vaccination series when they are children as part of their routine vaccines. For many born outside the U.S., the vaccine is not part of their routine healthcare.

Maintaining HepB Vaccination Compliance

To protect workers and curb the spread of hepatitis B, OSHA includes clear guidance in its blood-borne pathogen standard. To maintain HepB vaccine compliance, organizations must ensure that all occupationally-exposed workers:

  • Receive training on the vaccination
  • Are given the vaccination at no cost within 10 days of starting the position
  • Provide a written opinion from a licensed healthcare professional if the vaccine is contraindicated for medical reasons
  • Sign a declination form if they refuse the vaccine

The organization is required to maintain documentation of each guideline above. Generally speaking, organizations know to track the first three and most employees accept the vaccine. It’s the declination that is more often missed.

An employee has the right to refuse the vaccination. If they do, they remain at risk for acquiring the HBV infection, which is considered the most infectious bloodborne virus. The employee is required to sign a declination form with specific language that protects the organization, both from a compliance and legal perspective. It is vital to keep this declination on file.

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Four Strategies To Increase HepB Vaccination Compliance

It’s in the organization’s best interest to have as many vaccinated employees as possible since a healthcare professional has increased exposure to the HepB virus through needle sticks, failure to wear protective gloves, and improper handling of blood and bodily fluids. 

Many newly hired employees come from similar roles where the vaccine was required. Some companies request copies of immunization records, while others take blood work to screen for immunity (also known as HBV titers) during a pre-employment physical. If a newly hired employee hasn’t yet received the vaccine, offering it should be part of your organization’s onboarding process.

Don’t give up if employees initially decline the vaccine. Use these strategies to encourage HBV vaccination:

  • Create a vaccination campaign: Consider offering HBV immunizations to healthcare workers, their families, and the surrounding community. Promote free or reduced-cost vaccinations.
  • Spread awareness: Post vaccine signs in areas where employees gather or pass frequently (i.e., elevators, restrooms, break areas, conference rooms). Spread awareness by teaching about HBV transmission and prevention practices.
  • Provide incentives: Offer a small incentive to get vaccinated. Some examples include T-shirts, pens, contests, and sweepstakes entries.
  • Build dynamic education programs: Regular training on HepB risks and prevention can create awareness of risks and exposure, while also promoting vaccinations to meet compliance goals. 

Simplify Compliance With OSHA’s Bloodborne Pathogen Standard 

Full-Cycle Document & Policy Management

To comply with OSHA’s hepatitis B vaccination requirements, all employee vaccination records and declination forms must be on file. Employees likely also have to acknowledge related policies and the required exposure control plan, so having all of this in one document and policy management solution makes it easier for administrators and employees who need to access the forms.

Online Incident Reporting

The danger of hepatitis B makes it vital for exposures to immediately be reported with a properly filed incident report. Using an online incident reporting system, employees can file the report from anywhere with an internet connection, and automated escalation puts it in front of a manager immediately. A HepB exposure can be especially sensitive, so be sure your system offers an anonymous reporting option.

Compliance Training

OSHA requires bloodborne pathogen training and training on the hepatitis B vaccine. Using an online learning management system that tracks training completion and offers auto-assignment of annual courses makes it much easier to remain in compliance.

Simplify Compliance With MedTrainer

MedTrainer offers all the functions listed above in an all-in-one compliance solution. Enhance your compliance programs with digital incident reporting solutions for any size organization. Contact us to learn more.