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0-02: School policies consistent with laws
6-15: Universal precautions; blood-borne pathogens
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Occupational Safety and Health Administration
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8-02 - Hepatitis B immunization for staff

Recommend that all school personnel at risk for exposure to blood-borne pathogens have current hepatitis B immunization.


Many employees are at risk of having contact with someone else's blood or other body tissues and fluids. To protect those employees and the students they serve, immunization is a cost-effective measure and is required by the US Occupational Safety and Health Administration (OSHA).


Employee education on means to protect oneself and others from blood-borne pathogens and the provision of hepatitis B vaccination to those employees at risk of contact is a requirement of the Occupational Health and Safety Administration (OSHA). Those at risk for exposure to blood include school nurses, health assistants, custodians, athletic trainers, physical education and special education teachers, first responders (for first aid), coaches of contact sports, and playground aides. A worksheet has been developed to assist school district employees as they determine their level of risk and relative need for the vaccine. 29

As it is a legal requirement for the employer to provide this immunization to those at risk, employee health insurers are likely to shift the cost of vaccination programs to school districts, unless the vaccine is negotiated by the district to be covered as part of employees' health benefits. There are various ways immunization of staff can be organized. School districts may offer the vaccine on school sites, refer eligible employees to their personal physicians, arrange immunization programs with the local health department, or refer eligible employees to a contractual health care agency.


Centers for Disease Control and Prevention. Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR. 1991;40(RR-13):1-25.

Taras HL. The hepatitis B occupational risk worksheet. J Sch Health. 64(3):122, 1994.

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