September 13, 2016

Message from Executive Sponsors: Adult pertussis booster immunization documentation due Dec. 1 for some patient care personnel

Vanderbilt University Medical Center leadership recently approved important updates to the VUMC Immunization Policy for Faculty and Staff. In addition to continuing the mandatory immunization requirements of MMR, Varicella, Hepatitis B, and annual influenza, team members working in Adult Emergency, Life Flight, Women’s Health, and the Monroe Carell Jr. Children's Hospital at Vanderbilt must document immunization compliance with an adult pertussis booster (Tdap) by Dec. 1.

Pertussis, the cause of whooping cough, is a serious disease in both children and adults and potentially fatal for babies. A severe infection may require hospitalization and can have a lasting effect on lung function, leaving people with shortness of breath or fatigue. Per the CDC, of babies hospitalized with whooping cough, about 1 out of 4 will get pneumonia, and 1 or 2 out of 100 will die. Other complications include violent, uncontrolled shaking, life-threatening pauses in breathing, and brain disease. Often called the “100-day cough,” recovery can take months. Difficulty sleeping, difficulty breathing, apnea, posttussive vomiting, and weight loss are also common. Pertussis is often unrecognized or misdiagnosed among adolescents and adults and is highly contagious for several weeks, with 80% of susceptible household contacts becoming infected.

Health care personnel (HCP) are at an elevated risk for being exposed to pertussis, especially in pediatric facilities and emergency departments. Based on 2014 data, Tdap vaccination coverage among HCP is 42 percent, and multiple outbreaks of pertussis have been reported in healthcare facilities. For example, in 2012, a community outbreak in Rochester, Minnesota, led to an outbreak at the Mayo Clinic in which 64 HCP developed pertussis.

The Hospital Infection Control Practices Advisory Committee, the CDC’s Advisory Committee on Immunization Practices (ACIP), and the American Academy of Pediatrics recommend that HCP who provide direct patient care receive the Tdap vaccine. The recommendation for administration in health care settings is based on heightened transmission risk in health care settings, the need to protect vulnerable patients, particularly infants, from pertussis, and the desire to minimize transmission risk to HCP.

We know from past experience that the overwhelming majority of team members will embrace the vaccination requirements and become compliant. However, faculty or staff members who remain non-compliant with the policy requirements after Dec. 1, may no longer be allowed to perform their normal responsibilities and may face disciplinary action. 

To check your immunization record, visit the Health and Wellness Information Portal. And remember that there are several options to comply with the mandatory Tdap immunization policy by the Dec.1 deadline:

  • Visit the Occupational Health Clinic (OHC). OHC is located in Medical Arts Building, Suite 640. Services are provided free of charge and no appointment is necessary for immunizations during standard business hours. For current VUMC team members, no appointment is necessary for immunizations during standard business hours. Future hires should schedule an appointment by calling OHC at 615-936-0955. 
  • Attend an Immunization Fair on campus or at Williamson County sites. See the OHC Comes to You for specific details.
  • Night shift or off campus? Check the OHC Comes to You calendar for a convenient option.
  • Tdap vaccine received from a VUMC clinic: Click here to give OHC permission to view your medical record for the sole purpose of documenting Tdap vaccine compliance.
  • Tdap vaccine received from an outside vaccinating entity (e.g., a local drug store): Click here to upload a signed note, receipt, vaccination card or other documentation from the outside vaccinating entity stating that you received the Tdap vaccine at that location or fax your documentation to OHC at 615-936-0966.

To request an exemption, complete the necessary forms by clicking here. All exemption requests are due by October 1. For additional questions about your immunization record, contact OHC by phone at 615-936-0955 or by email at occupational.health.clinic@vanderbilt.edu.

For more information about the Tdap vaccine, please visit the Occupational Health website.

These changes are an important step to ensuring the safety of our patients and co-workers. We thank you for everything you do to make medicine kinder and safer.

Sincerely,

Marilyn Dubree, MSN, R.N.

Executive Chief Nursing Officer

Luke Gregory

Chief Executive Officer, Children's Hospital

Paul Sternberg Jr., M.D.

Chief Medical Officer for the Vanderbilt Medical Group

Chief Patient Experience and Service Officer

Steve Webber, MBChB, MRCP

James C. Overall Professor & Chair, Department of Pediatrics

Pediatrician in Chief, MCJCHV