APPENDIX K HEPATITIS B IMMUNIZATION REQUIREMENTS

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HEPATITIS B IMMUNIZATION REQUIREMENTS

1. Per FORSCOM Regulation 700-2, Chapter 3, para. 3-2a(7), dated 15 June 1993, all AMEDD personnel are to be immunized against the Hepatitis B (HBV). The U.S. Public Health Service estimates that as many as 200,000 cases of Hepatitis B occur annually in the United States, and that 250 health care workers die annually as a result of HBV. It is a chronic, devastating, deadly disease, which is transmitted by exposure to infected blood and other body fluids. 2. This issue impacts units responsible for implementing the 91K exportable training program. Course requirements include training and testing of invasive procedures, such as initiating an intravenous infusion, drawing blood, and administering injections. Each of these activities creates a risk of exposure to infectious body fluids and transmission of Hepatitis B to both students and cadre. However, it is often the case that funds are not allocated to provide HBV immunizations for AMEDD personnel assigned to the Reserve Components. 3. In short, the 91K training requirements create a risk of exposure to Hepatitis B. It is essential that those responsible for implementation of the 91K exportable training (and other medical training courses which perform invasive procedures) develop a comprehensive program at the local level to ensure execution of both appropriate preventive measures and interventions should exposure occur. 4. The following actions are strongly recommended for each affected unit prior to instruction of the invasive procedures modules: a. b. Mandatory bloodborne pathogen training conducted during inprocessing at annual training. Coordination with local medical centers or medical department activities at the annual training site prior to departure for annual training to determine, and ensure compliance with, local policy and procedures for post-exposure follow-up. Inclusion of unit infection control plan as an annex to the annual training operations order. The annex should provide detailed guidance for each of the following areas: (1) (2) (3) By-name identification of students and cadre who are not immunized against Hepatitis B. Bloodborne pathogens educational program as described above. Procedures for exposure prevention, to include requirements for controls during training and testing, e.g., gloves, biohazard containers, and handwashing facilities. Plan for post-exposure reporting, intervention, and follow-up of any incidents in which exposure to blood or other body fluids has or may have occurred. Clear direction regarding process and resources for immediate administration of the first in the required series of three HBV immunizations for those not previously immunized will be included. Instructions for completion and routing of all required reporting forms. A copy of the local medical treatment facility policy and examples of properly-completed reporting forms will assist in this process.

c.

(4)

(5)

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(6)

Short- and long-term follow-up procedures for periodic testing and completion of immunization series for all exposed personnel.

5. Training unit commanders should review and approve the infection control annex and ensure compliance by all personnel.

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