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2.1 Vaccine Requirements Evaluation (VRE) Form

The Vaccine Requirements Evaluation (VRE) form is used to determine whether an employee is required to participate in immunization screening and tuberculosis (TB) surveillance programs. Employees must complete a VRE form upon hire and once a year thereafter.

Employees may receive vaccinations and/or TB screening by scheduling appointments through the Enterprise Health employee portal, or by calling the EHS Department at 206-667-4866.

2.2 Immunizations

The purpose of immunization screening and TB surveillance is to protect the health of patients, staff and volunteers. All required immunization screening and TB surveillance is provided free of charge to staff and volunteers. Staff and volunteers who are required to participate in the programs can submit immunization documents to the OHNs through the Enterprise Health employee portal, to mail stop J3-200, to the confidential fax number at 206.667.3467, by email to ohn@fredhutch.org.

2.2.1 Hepatitis B

Hepatitis B Virus (HBV) is the major infectious hazard for healthcare and research personnel. The Hepatitis B vaccine series and titer are made available to all staff whose work involves the potential for exposure to blood and/or other potentially infectious material.

If an employee with potential exposure declines the vaccine series, he or she must sign a Hepatitis B Declination Form. If the employee changes his or her mind in the future and requests the Hepatitis B vaccine series and titer, it is made available by Fred Hutch if the employee's work still involves the potential for exposure to blood and/or other potentially infectious material.

2.2.2 Tetanus

Tetanus, or lockjaw, is caused by a germ that enters the body through a cut or wound. Tetanus -diphtheria (Td) vaccine is made available to all Comparative Medicine Department employees who have not had a tetanus booster in the past ten years. If an employee declines the vaccine, he or she must sign a Tetanus Diptheria Declination form.

Tetanus diphtheria (Td) vaccine is also made available to employees who:

1. Have potential for exposure to live animals or animal tissues and who have not had a tetanus booster in the past ten years; and

2. Sustain a work-related laceration or puncture wound and who have not had a tetanus booster in the last five years.

2.2.3 Influenza Virus Vaccination

To reduce the spread of vaccine-preventable respiratory viruses in the workplace,  influenza vaccine is made available free of charge to staff, volunteers, and Hutch Kids employees based on CDC guidelines. (See Influenza Virus Vaccination Policy for more details.) 

  1. Enrollment in the program is based on responses from the VRE questionnaire completed through the Enterprise Health employee portal (all Fred Hutch employees within the U.S. and non-employees who are on campus a minimum of 8 hours per week, at least ten weeks per year). Non-employees can call the EHS department at 206-667-4866 to complete the VRE, or to request login access.

  2. Compliance: The Influenza Vaccination Status Form Questionnaire (located in the Enterprise Health employee portal) must be completed by all individuals enrolled in the program. One of the following requirements must be met by the last business day in October of each calendar year:

    1. Receive the seasonal respiratory virus/influenza vaccination through Occupational Health or through an outside provider (if received outside of Fred Hutch, must submit documentation*).

    2. If exemptions exist (medical/religious), complete the appropriate form and submit documentation*.

    3. If declining for personal reasons:

      1. Complete the Influenza Virus Course with 100% passing score (requested through Hutch Learning or by calling EHS at 206.667.4866 / email ohn@fredhutch.org for PDF version)

      2. Schedule a one-on-one counseling session through the Enterprise Health employee portal or by calling the EHS Department at 206.667.4866

      3. Attend session with Occupational Health via Teams meeting/phone call to review the information on the declination form.

*Documentation should be submitted through the Enterprise Health employee portal, fax to 206-667-3467, or email to ohn@fredhutch.org

2.2.4. COVID-19 Vaccination Compliance

Each member of the Fred Hutch workforce is required to participate in the COVID-19 Vaccination Program, completing the COVID-19 Vaccination Status Form Questionnaire and any related forms based on the individual’s responses [located in the Enterprise Health employee portal]. There are no exceptions to the requirement to complete the Questionnaire and related forms. New hires have within 31 days of their hiring date to comply.

a. The Questionnaire requires each member of the workforce to attest they have:

i.  Received the COVID-19 vaccination through Fred Hutch;

ii. Received the COVID-19 vaccination through an outside healthcare provider and submitted documentation;

iii. Declined the COVID-19 vaccination for medical reasons and submitted a COVID-19 Vaccination Medical Accommodation Form [COVID-19 Vaccination Program] (“medical accommodation”)

iv. Declined the COVID-19 vaccination for religious reasons (“religious accommodation”)

b.       Workforce members who have declined the COVID-19 vaccination for any of the listed reasons are required to work on campus consistent with the responsibilities and schedule of their position. Additionally, they are required to: 

i.            Wear a mask at all times while on campus; and

ii.            Complete daily COVID-19 online symptom screening for any day working on campus; and

iii.            Maintain physical distancing while on campus

c.       Managers will be provided with a list of their workforce members who have declined the COVID-19 vaccine for any reason so that managers can assist with reasonable accommodations in the workplace and ensure the workforce member is complying with the masking, symptom screening, and physical distancing requirements. Managers will not be informed of any confidential information related to the declination, only that the workforce member has declined.

d.       Workforce members, regardless of their vaccination status, may voluntarily choose to wear a mask and socially distance while on campus. Workforce members should not inquire with their coworkers as to why that coworker is wearing a mask or physical distancing, nor question the legitimacy of wearing a mask or physical distancing. Any questions about masking or physical distancing should be referred to one’s supervisor or HR Business Partner.

*Documentation should be submitted through the Enterprise Health employee portal, fax to 206-667-3467, or email to ohn@fredhutch.org

2.2.5. Vaccinia

Principal investigators who wish to use vaccinia (smallpox) must contact the Occupational Health Program at 206.667.4866 to determine whether a vaccinia vaccination is needed. If required, vaccinations are coordinated through the Occupational Health Nurse.

2.2.6 SCCA Vaccination Requirements

As a result of contact with patients, some individuals (i.e. physicians, nurses, faculty, laboratory technicians, contractors, volunteers, and administrative staff) are at risk for exposure to, and possible transmission of, vaccine-preventable diseases. To protect SCCA patients and staff from exposure to and possible transmission of Tuberculosis and vaccine-preventable diseases, the following groups are required to participate in the SCCA Immunization Program: 

  • All employees who are paid by the SCCA
  • SCCA Active Medical Staff
  • SCCA Active Volunteers
  • SCCA non-employees whose workspace is located in the SCCA Clinic or who have face-to-face interaction with patients (does not include incidental contact with SCCA patients such as entering the SCCA Clinic, riding on the elevator with patients, accessing the garage, attending meetings in the SCCA, etc)

Individuals in the SCCA Immunization Program must meet the following requirements:

Rubeola (Measles) - Acceptable evidence of immunity to rubeola includes one of the following:

  • Providing a document showing proof of having received two rubeola or MMR vaccines; or
  • Providing serological evidence of immunity to rubeola; or
  • Providing documentation of a physician-diagnosed case of rubeola.

Note: Employees and volunteers who have negative rubeola titers without documentation of prior rubeola or MMR vaccines must receive two MMR (measles, mumps, rubella) vaccines. Those who can provide documentation of prior rubeola or MMR vaccines must receive one MMR vaccine.

Mumps - Acceptable evidence of immunity to mumps includes one of the following:

  • Providing evidence of having received two doses of mumps or MMR vaccine; or
  • Providing serological proof of immunity to mumps; or
  • Providing documentation of a physician-diagnosed case of mumps.

Note: Employees and volunteers who have negative mumps titers without documentation of prior mumps or MMR vaccines must receive two MMR (measles, mumps, rubella) vaccines. Those who can provide documentation of prior mumps or MMR vaccines must receive one MMR vaccine.

Rubella - Acceptable evidence of immunity to rubella includes one of the following:

  •   Providing evidence of having received one dose of rubella or MMR vaccine; or
  •   Providing serological proof of immunity to rubella; or
  •   Providing documentation of a physician-diagnosed case of rubella.

Varicella (Chickenpox) - Acceptable evidence of immunity to varicella includes one of the following:

  • Providing evidence of serological immunity to varicella; or
  • Providing evidence of having received two varicella vaccines; or
  • Providing evidence of herpes zoster based on healthcare provider diagnosis.

If documentation of two Varicella Vaccines cannot be provided, or if the individual was born before the varicella vaccinations were available, he/she must obtain a varicella titer through the Occupational Health Program. If the varicella titer is negative, individuals must receive two varicella vaccines, or sign the varicella waiver if declining.

In 2008, the Advisory Committee on Immunization Practices (ACIP) recommended Zostavax for use in people 60 years of age and older to prevent herpes zoster (zoster) (i.e. shingles) and its sequelae.  Zoster is a localized, generally painful cutaneous eruption that occurs most frequently among older adults and immunocompromised persons. It is caused by reactivation of latent varicella zoster virus (VZV) decades after initial VZV infection is established.

  • Occupational Health does not provide the shingles vaccine. Persons interested in receiving the vaccine should talk to their primary care provider.
  • SCCA does not require staff to receive the vaccine.
  • If a staff member is unsure of his/her varicella history, a varicella titer can be requested through Occupational Health. If the titer is negative, the staff member will be advised to receive varicella vaccine (against chickenpox) not zoster vaccine.
  • Staff members who receive the shingles vaccine can continue to work in the SCCA clinic unless a chickenpox-like rash develops following vaccination. If a rash develops, staff must contact Occupational Health immediately at 206.667.4866 and must refrain from work in the SCCA clinic until the rash has completely crusted over. 

Tetanus, Diphtheria and Pertussis (Tdap) Vaccine

A single dose booster of Tdap vaccine is required to protect against tetanus, diphtheria, and pertussis, or sign the Tdap waiver if declining.

Titers and Declinations

Individuals who do not have immunization records must have the appropriate titers drawn.  Individuals who choose not to be vaccinated against Measles (Rubeola), Mumps, Rubella, Varicella, or Tdap must sign the corresponding waiver forms.  These individuals may be furloughed off of work during the period when there is a known or suspected case of these diseases in the SCCA Clinic.  If susceptible individuals become exposed to these diseases, they may be furloughed off of work during the communicable period to prevent the possibility of infecting other staff and patients.  The decision of furlough is at the discretion of the SCCA Infection Control Physician and/or designee.  Furlough will be leave without pay (LWOP) unless the employee chooses to use accrued vacation and/or unused personal holidays during this period.

2.2.7 Tuberculosis (TB) Surveillance

Staff and volunteers whose workspace is located in the SCCA building, or who have face-to-face interaction with SCCA patients as part of their jobs, must participate in the TB Surveillance program. (Interaction with SCCA patients does not include incidental contact with patients such as entering the SCCA building, riding on the elevator with patients, accessing the garage, attending meetings in the SCCA, etc.)

TB surveillance is also required of SCCA or Fred Hutch Staff whose work activity includes:

  • Handling of tissue or organs potentially infected with TB; and
  • Contact with populations at high risk for TB infection and/or work-related travel to areas with high prevalence rates for TB.

Employees and volunteers who must participate in TB surveillance must meet the following requirements:

  • TB screening with an individual risk assessment and symptom evaluation at baseline (preplacement/new hires)

  • Baseline TB testing using interferon-gamma release assay (IGRA – QuantiFERON TB Gold Plus blood test) without documented prior TB disease or latent TB infection (LTBI); prior IGRA results are accepted provided the test has been conducted within the last 12 months;

  • No routine serial TB testing at any interval after baseline in the absence of known exposure or ongoing transmission;

  • Encouragement of treatment for all health care personnel with untreated LTBI, unless treatment is contraindicated; and

  • Annual symptom screening for health care personnel with untreated LTBI.

  • Post Exposure Screening: All personnel with known exposure to TB will receive a TB symptom evaluation at baseline and again at 8-10 weeks after the last known exposure. Personnel with a previous negative TB test result will also receive a TB test using interferon-gamma release assay (IGRA – Quantiferon blood test) at baseline and again at 8-10 weeks after the last known exposure. 

  • Staff and volunteers with a history of a positive TB skin test or IGRA must provide documentation of the positive test and report of a normal chest x-ray (performed subsequent to the test).  If documentation cannot be obtained, a TB testing with IGRA will be performed to obtain documentation and a new chest x-ray must be performed to rule-out active TB.  These individuals must also complete a TB symptom screening form at baseline and annually thereafter.