Immunization and Infection Control Policy

HEALTH AND SAFETY ISSUES

Dental Hygiene is classified as a Category I level (high risk) profession for bloodborne pathogens according to OSHA Standards. Individuals who are involved in the provision of dental hygiene services may be exposed to blood borne pathogens that may result in human disease. Students and faculty members who experience an exposure to potentially infectious materials (instrument or needle stick, mucous membrane, or non-intact skin) or airborne inhalation require specific follow-up.

An accident insurance fee is assessed to courses where the likelihood of an exposure may occur and a management protocol has been developed.

Students must comply with infection control regulations as listed in the Texas State Board of Dental Examiners Rules and Regulations, Rule 108.25:

• A dental health care worker(s) who knows he/she is infected with HIV or HBV and who knows he/she is HbeAg positive shall report his/her status to an expert review panel, pursuant to provisions of THSC, §85.204, et seq, 1991, as amended.

• A dental health care worker who is infected with HIV or HBV and is HbeAg positive shall notify a prospective patient of the dental health care worker’s seropositive status and obtain the patient’s consent before the patient undergoes an exposure-prone procedure performed by the notifying dental healthcare worker.

IMMUNIZATION POLICY

To comply with the Texas Administrative Code §97.61–97.77 all students, enrolled in health-related courses and will participate in coursework or clinical activities involving the contact with direct patient care and/or exposure to blood or bodily fluids must meet compliance with state-mandated immunizations. Students must complete state-mandated and Dental Hygiene Program (DHP) requirements to engage in courses with a clinical component.

 

FOR STUDENT ENROLLED IN HEALTH RELATED FIELDS

According to Texas Administrative Code 25 rule §97.64, students who claim to have had the complete series of a required vaccination, but have not properly documented them, cannot participate in coursework or clinical activities involving the contact with direct patient care and/or exposure to blood or bodily fluids in educational, medical, or dental care facilities. Students in health sciences must comply with the requirements of the program of which they are enrolled. See program requirements for details.

  • Provisionally enrolled students may not participate in coursework activity “…which will involve direct patient contact with potential exposure to blood or bodily fluids in educational, medical, or dental care facilities” until completing all required series.

It is the students’ responsibility to make sure they are in compliance at all times with these immunizations throughout their time as a student enrolled in the DHP. Noncompliance will result in being administratively dropped from classes, which in turn may result in a withdrawal and/or dismissal from the program.

 

DEADLINES:

Students accepted into the MSU Dental Hygiene Program must be compliant with these immunizations prior to the start of their first dental hygiene clinical course. All documents demonstrating proof of vaccine for immunization and Infection Control must be submitted to Vinson Health Center. The student must then submit a copy of the Vinson Health Center Immunization History indicating compliance in ALL of the following immunizations.

 

TETANUS/DIPHTHERIA (Td)

Students can be considered compliant for Tetanus/Diphtheria only if they have documentation of the following:

  1. Tetanus-diphtheria toxoid (TD) or Tdap (tetanus-diphtheria-pertussis) documented in the last 10 years, and at least one dose of Tdap after age 20. The booster may be in the form of a Tdap (tetanus-diphtheria-pertussis) vaccine.

 

MEASLES (RUBEOLA):

Students born on or after January 1, 1957, must show, prior to patient contact, acceptable evidence of vaccination of two doses of a measles-containing vaccine administered since January 1, 1968 (preferably MMR vaccine) or documentation of at least one of the following:

  1. Born in 1957 or later must show official documentation of immunization with TWO (2) DOSES of measles containing live attenuated vaccine (preferably the MMR)
  2. Laboratory (serologic) evidence of Measles immunity.

 

MUMPS:

Students born on or after January 1, 1957, must show, prior to patient contact, acceptable evidence of vaccination of one dose of a mumps vaccine or documentation of at least one the following:

  1. Born in 1957 or later must show official documentation of immunization with live Mumps virus vaccine with at least 1 dose of mumps containing live attenuated vaccine.
  2. Laboratory (serologic)  evidence of Mumps immunity.

 

RUBELLA (GERMAN MEASLES):

Students must show, prior to patient contact, acceptable evidence of one dose of rubella vaccine documentation of at least one of the following:

  1. Born in 1957 or later must show official documentation of immunization with live Rubella virus vaccine with at least 1 dose of rubella containing live attenuated vaccine.
  2. Laboratory (serologic) evidence of Rubella immunity.

*Note that MMR is an attenuated live virus vaccine. 95-98% of individuals born before 1957 have been exposed to measles and mumps and are immune; furthermore, the development and introduction of the measles, mumps, and rubella components occurred over a span of years from 1963 to 1969, culminating with the introduction of the combination vaccine known as the MMR in 1971. Consequently, the immunization requirements are different for those born before 1957 versus those born 1957 and later, and the potential for immunization with less effective killed virus vaccines prior to 1968 requires that live virus vaccines be specified.

 

VARICELLA (CHICKENPOX)

Students are required to have received one dose of varicella (chickenpox) vaccine on or after the student's first birthday or, if the first dose was administered on or after the student's thirteenth birthday, two doses of varicella (chickenpox) vaccine are required. Students can be considered compliant for Varicella only if they have documentation of at least one of the following:

  1. Official documentation of one (1) dose of varicella vaccine after 1st birthday and before 13th birthday.
  2. Official documentation of two (2) doses of varicella vaccine if initiated on or after 13th birthday.
  3. Laboratory (serologic) evidence of Varicella immunity.
  4. A written, dated statement documenting the month/day/year of varicella (chickenpox) illness validated by a physician, the student's parent, or school nurse. Use form located at http://www.dshs.state.tx.us/immunize/docs/c-9.pdf 

 

HEPATITIS B

Students are required to receive a complete series of hepatitis B vaccine prior to the start of direct patient care or show serologic confirmation of immunity to Hepatitis B virus. Students can be considered compliant for Hepatitis B only if they have documentation of at least one of the following:

  1. Official documentation of immunization with THREE (3) DOSES of Hepatitis B vaccine in accordance with the CDC Advisory Committee on Immunization Practices, prior to the start of direct patient care.
  2. Laboratory (serologic) evidence of Hepatitis B immunity.
  3. If a non-responder, two (2) complete Hepatitis B series.

Official Documentation of Serologic evidence of immunity to Measles, Mumps, and Rubella (MMR) Vaccine, Varicella, & Hepatitis B is acceptable. Student must present a valid laboratory report indicating confirmation of either immunity or infection. If titers are negative, a booster along with a valid laboratory report indicating immunity is required. All boosters must be completed and official documentation provided prior enrolling in courses with a clinical component.

According to Texas Administrative Code 25 rule §97.64 Students, who claim to have had the complete series of a required vaccination, but have not properly documented them, cannot participate in coursework or activities at Midwestern State University.

 

Documentation of compliance includes: (Texas Administrative Code §97.68)

  1. Vaccines administered after September 1, 1991, shall include the month, day, and year each vaccine was administered.
  2. Documentation of vaccines administered that include the signature or stamp of the physician or his/her designee, or public health personnel, is acceptable.
  3. An official immunization record generated from a state or local health authority is acceptable.
  4. An official record received from school officials, including a record from another state, is acceptable.
  5. Exclusions from compliance with the requirements are found in the Texas Administrative Code Rule §97.62. This includes medical reasons and/or claim exclusion for reasons of conscience, including religious belief. See http://www.dshs.state.tx.us/immunize/default.shtm for more information about immunizations.

TUBERCULIN SKIN TEST (TST)

Students can be considered compliant for tuberculin testing only if they have documentation of at least one of the following (required annually):

  1. Official documentation of negative Mantoux skin test.
  2. Persons with a positive TST result must provide official documentation of a negative chest x-ray report and a complete health care evaluation verifying a negative status for tuberculosis.
  3. Active/Latent tuberculosis infection: Documentation of treatment plan, monthly documentation of compliance, and documentation of completed treatment. Failure to provide the proper documents will result in immediate loss of compliance and will be administratively removed from clinical courses.
  4. Refusal of treatment – will be administratively removed from all nursing courses and will be unable to continue in the nursing program.

 

Requirements for International Students:

Tuberculosis (TB) screening is required for all incoming international students that were born in, resided in, or traveled to (one of the high risk countries) for more than three (3) months. If you have not received the required immunizations or TB testing or do not have the necessary documentation to prove that you've had the required immunizations and TB testing you will NOT be allowed to register for classes at Midwestern State University. See http://www.cdc.gov/tb/ for more details.

TB test and/or Chest x-ray must be administered, interpreted, and reported in millimeters (mm) in the United States. Again, you must comply with these requirements before you can register for classes. Please review the recommended adult immunization http://www.immunize.org/catg.d/p2011.pdf and recommended adult immunization schedule at http://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule.pdf

See Appendix: TB Exposure Control Plan for more details.

 

INFLUENZA

  1. One dose of influenza vaccine annually is required for all students – must receive vaccine in the fall between Sept 1 and Nov 1.

All documents demonstrating proof of vaccine for immunization and Infection Control must be submitted to the MSU Vinson Health Center.

Exclusions from compliance with the requirements are found in the Texas Administrative Code Rule §97.62. This includes medical reasons, and/or claims exclusion for reasons of conscience, including religious belief. See http://www.dshs.state.tx.us/immunize/default.shtm for more information about immunizations. NOTE: Students who claim an exclusion for reasons of conscience may be excluded from school and/or clinical experiences in times of emergency or epidemic declared by the commissioner of public health and/or if a clinical site and/or institution does not accept a signed affidavit. A signed affidavit for “exclusion for reason of conscience” is valid for only two (2) years. In some instances further documentation may be required.