
•	Updated subsection (3) as it is part of the requirements not the exception.


•	Updated Note 1 due to RCW 70.24.017. Law now provides for orders for testing for any bloodborne pathogen.

((EXEMPTION:

1. You are not required to provide the hepatitis B vaccination series to employees who meet any of the following:

a. The employee has previously received the complete hepatitis B vaccination series;

b. An antibody test has revealed that the employee is immune to hepatitis B;

c. There are medical reasons not to give the vaccine.

2. You are not required to provide the hepatitis B vaccination series to employees assigned to provide first aid only as a secondary duty, when you do all of the following:

a. Make hepatitis B vaccination available to all unvaccinated first-aid providers who render assistance in any situation involving the presence of blood or OPIM. Vaccination must be made available as soon as possible, but no later than twenty-four hours after the incident;

b. Provide a reporting procedure that ensures all first-aid incidents that involve the presence of blood or OPIM are reported before the end of the work shift;

c. Document first-aid incidents that involve blood or OPIM, include at least:

i. The names of all first-aid providers who rendered assistance;

ii. The time and date of the first-aid incident;

iii. A description of the first-aid incident.

3.))(1) Employers must make sure that the hepatitis B vaccination series is available to all employees who have occupational exposure and that it is:

((a.))(a) Available at no cost to the employee;

((b.))(b) Available to the employee at a reasonable time and location;

((c.))(c) Administered by or under the supervision of a licensed physician or by another licensed health care professional;

((d.))(d) Provided according to recommendations of the United States Public Health Service that are current at the time these evaluations and procedures take place;

((e.))(e) Available to any employee who initially declines the vaccination but later decides to accept it while they are still covered by this chapter;

((f.))(f) Made available after the employee has received training required by this chapter and within ten working days of initial assignment.

((Reference:

You can find more information about the United States Public Health Service recommendations for hepatitis B vaccination at http://www.cdc.gov/ncidod/diseases/hepatitis/b/index.htm.

(1)))(2) You must make sure participation in a prevaccination screening program for antibody status is not a condition for receiving hepatitis B vaccination.

(((2)))(3) You must make sure that all laboratory tests are conducted by a laboratory licensed by the state or Clinical Laboratory Improvement Amendments (act) (CLIA).

(((3)))(4) Make sure employees who decline the hepatitis B vaccination, offered by you, sign a form with this statement:

"I understand that due to my occupational exposure to blood or other potentially infectious materials I may be at risk of acquiring hepatitis B virus (HBV) infection. I have been given the opportunity to be vaccinated with hepatitis B vaccine, at no charge to myself. However, I decline hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring hepatitis B, a serious disease. If in the future I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with hepatitis B vaccine, I can receive the vaccination series at no charge to me."

(5) Exemptions:

(a) You are not required to provide the hepatitis B vaccination series to employees who meet any of the following:

(i) The employee has previously received the complete hepatitis B vaccination series;

(ii) An antibody test has revealed that the employee is immune to hepatitis B;

(iii) There are medical reasons not to give the vaccine.

(b) You are not required to provide the hepatitis B vaccination series to employees assigned to provide first aid only as a secondary duty, when you do all of the following:

(i) Make hepatitis B vaccination available to all unvaccinated first-aid providers who render assistance in any situation involving the presence of blood or OPIM. Vaccination must be made available as soon as possible, but no later than twenty-four hours after the incident;

(ii) Provide a reporting procedure that ensures all first-aid incidents that involve the presence of blood or OPIM are reported before the end of the work shift;

(iii) Document first-aid incidents that involve blood or OPIM, include at least:

(A) The names of all first-aid providers who rendered assistance;

(B) The time and date of the first-aid incident;

Reference:

You can find more information about the United States Public Health Service recommendations for hepatitis B vaccination at http://www.cdc.gov/ncidod/diseases/hepatitis/b/index.htm.

Helpful tool:

Sample declination form:

The declination form can help you document employees who have declined the hepatitis B vaccine. You can find a copy of this form in the resource section of this chapter.

((EXEMPTIONS:

When the source individual is already known to be infected with HBV or HIV, you do not need to test their status.))

You must arrange to test the source individual's blood for HBV and HIV as soon as feasible after getting their consent.

(1) If you do not get consent, you must establish that legally required consent can not be obtained.

(2) When the law does not require the source individual's consent, their blood, if available, must be tested and the results documented.

(3) Exemption: When the source individual is already known to be infected with HBV or HIV, you do not need to test their status.

Note:	1. ((Your local health authority enforces rules regarding HIV testing and consent which are found in WAC 246-100-206, Special diseases—Sexually transmitted diseases, and WAC 246-100-207, Human immunodeficiency virus (HIV) testing.
	These rules can be found at: http://www.leg.wa.gov/wac and click on Title 246 WAC.))If a source individual refuses testing, a worker may request that a local or state health officer order bloodborne pathogen testing. Authority for health officer orders is given in RCW 70.24.340.
	2. Source testing: According to the Centers for Disease Control and Prevention (CDC), hepatitis C virus (HCV) infection is the most common chronic bloodborne infection in the United States. The CDC recommends testing of the source person for the presence of anti-HCV antibody. (Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis, MMWR, June 29, 2000/50(RR11); 1-42.)