Hepatitis B vaccination series follow-up under the bloodborne pathogens standard

NOTICE: This is an OSHA Archive Document, and may no longer represent OSHA Policy. It is presented here as historical content, for research and review purposes only.

February 1, 1993

Mr. Baruch A. Fellner
Gibson, Dunn & Crutcher Lawyers
[Recipient address omitted]
Dear Mr. Fellner:

This is in response to your letter of September 25, 1992, requesting clarification of the Occupational Safety and Health Administration (OSHA) standard on Occupational Exposure to Bloodborne Pathogens Standard, 29 CFR 1910.1030. Specifically, you inquired as to the extent of the employer's obligation to follow-up with its employees to assure that the hepatitis B vaccination series is administered.

The first issue which we would like to address is the fact that your client's exposure control plan provides for written confirmation by the health care professional within 15 days "after the employee has completed the vaccinations." This is an incorrect interpretation since the standard requires in section (f)(5) that the written opinion be obtained by the employer and provided to the employee "within 15 days of the completion of the evaluation." In most cases of pre-exposure vaccination, therefore, this written opinion would follow the administration of the first shot in the series. On a related note, page 62 of OSHA instruction CPL 2-2.44C, "Enforcement procedures for the Occupational Exposure to Bloodborne Pathogens," is currently being revised to state that the written opinion includes indication for vaccine and whether such vaccination was initiated.

Your basic concern is that employer monitoring of employee compliance with the directions of the administering physician would create an "impractical and overwhelming" administrative burden. OSHA does not require that the employer make extraordinary efforts to ensure completion of the series. However, we would look for good faith efforts on the part of the employer to ensure that employees are reminded about completing the vaccination series. Documentation of written or verbal reminders to the employee would constitute a good faith effort. Since the standard allows the employee to decline the vaccination at any time, a completed declination form would also constitute documentation where an employee's failure to return for the second or third injections constitutes a refusal to complete the series.

Your letter goes on to state that your client goes beyond the requirements of the standard by arranging for the first appointment with the health care professional. Since this appointment/evaluation is included in the term "made available," your client is following the requirements of the standard by doing so; this does not constitute "an obligation beyond what is required."

You also state in your letter that the employer would have to monitor the employees' appointments in order "to assure that employees are following doctors' orders before employees are allowed to return to areas of occupational exposure." This is not accurate as the standard simply requires that the employee be evaluated and receive the first dose of the vaccine within ten days of initial assignment to a job involving occupational exposure. Employees with occupational exposure may certainly continue to work pending completion of the series.

With regard to the exposure control plan which you submitted, it is not OSHA's practice to review and approve sample plans. The final determination of compliance is made by the compliance officer and takes into account all factors pertaining to the plan at a particular worksite. However, a cursory review of the document found that paragraph #2 under "Hepatitis B Vaccination" is incorrect for the reasons stated above. The same holds true for Section I of your client's agreement with the attending health care professional. Lastly, subsections (c) through (e) of Section II are neither comprehensive nor entirely accurate.

We hope this information is responsive to your concerns. Thank you for your interest in worker safety and health.

Sincerely,
Roger A. Clark,
Director
Directorate of Compliance Programs

[Requester correspondence reproduced on OSHA page; omitted here.]