nurse and doctor

Recommended Immunizations and Immunity Testing for ESWs

Workers in a variety of settings may be at risk of exposure to communicable disease because of their contact with patients/clients (diagnosed or undiagnosed) or their environment. There is also a risk that workers could transmit an undiagnosed vaccine-preventable disease to others. Immunization is one of the most important steps Emergency Service Workers (ESWs) can take to protect themselves and reduce transmission to others.

ESWs should be immunized as per the recommendations for healthcare workers in the Canadian Immunization Guide. Recommended vaccines include:

  • Measles, mumps, rubella (MMR)
  • Tetanus, diphtheria (Td)
  • Pertussis (Tdap)
  • Chickenpox (varicella)
  • Hepatitis B
  • Annual influenza and COVID-19 is highly recommended

It is also important that ESWs be screened for tuberculosis (TB) and have a documented history of a 2-step TB skin test. This serves as a comparison for a future skin test should an ESW have a significant exposure to a person with active tuberculosis disease. See the table below for more details.

 

Vaccine/TestsESW Recommendations

Tetanus, diphtheria - Td

Pertussis (whooping cough) - Tdap

  • Following a complete primary series (minimum of 3 doses), ESWs should receive a Td booster every 10 years. One of the doses during adulthood should be Tdap vaccine (for protection against pertussis).
  • Women should receive a dose of Tdap during every pregnancy to protect their newborn.
  • ESWs with an unknown history or no record of immunization should have 2 doses of Td, 4-8 weeks apart and a third dose 6-12 months later (one of these doses should be given as Tdap for protection against pertussis).
Measles, mumps, rubella - MMR
  • ESWs regardless of their year of birth, should have one of the following:
    • Documented evidence of 2 doses of MMR vaccine on or after the first birthday OR
    • Documented laboratory evidence of immunity (from previous vaccination and/or disease).

Hepatitis B

This vaccine is not publicly funded (free) for adults

  • ESWs should receive 3 doses of vaccine given at 0, 1, and 6 months or the alternate schedule of 2 doses given in elementary school (2 X 1.0mL dose series, given 4-6 months apart)
  • AND have documented laboratory evidence of immunity following receipt of vaccine (1-6 months after last dose of vaccine)

Note: ESWs who show no immunity to hepatitis B may require additional doses of vaccine for complete protection.

Varicella (chickenpox)

This vaccine is not publicly funded for adults.

  • ESWs should have one of the following:
    • Documented evidence of 2 doses of varicella-containing vaccine OR
    • Laboratory evidence of immunity with an unknown history of chickenpox disease.
  • ESWs with an unknown history of chickenpox disease should receive 2 doses of vaccine given 4-8 weeks apart.
InfluenzaStrongly recommended that ESWs have 1 dose annually for protection against circulating strains.

Tuberculosis Skin Test (TB)

Testing required for employment is not publicly funded.

  • ESWs with an unknown TB status should have a baseline 2-step TB skin test (two tests are completed 1-4 weeks apart).
  • ESWs with a previously documented positive TB skin test should have a baseline chest x-ray.

Visit the Public Health Agency of Canada: Canadian Immunization Guide for more information.

Immunization Records

Staying up to date on your vaccinations is important throughout your life. It is the responsibility of each ESW to know their immunization history and keep a personal record. It is strongly recommended that each ESW retain a copy of their immunization record and/or any immunity testing completed in their personal health records, and if required with their employer. The CANImmunize app is a free tool to track your immunizations on your smartphone and help you get vaccinated on time.

ESWs who are unsure of their vaccination status are advised to consult with their health care provider or the local public health department. This is especially pertinent for ESWs who were not born or raised in Canada and who may have had different vaccine schedules, as they may not be fully protected.

If the ESW cannot locate a record of immunization or is unsure of their immunization status, their doctor may order a blood test that will determine their immunity to vaccine-preventable diseases. Depending on the results, the ESW may show immunity (protection) against vaccine preventable diseases either through prior exposure or immunization, or it may be necessary for the ESW to repeat some immunizations to ensure that they are fully protected.

 

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