A rubella outbreak among dental students: description of the outbreak and analysis of control measures

Vaccination policies among health professional schools: evidence of immunity and allowance of vaccination exemptions

OBJECTIVE To characterize health professional schools by their vaccination policies for acceptable forms of evidence of immunity and exemptions permitted. METHODS Data were collected between September 2011 and April 2012 using an Internet-based survey e-mailed to selected types of accredited health professional programs. Schools were identified through accrediting associations for each type of health professional program. Analysis was limited to schools requiring ≥1 vaccine recommended by the Advisory Committee on Immunization Practices (ACIP): measles, mumps, rubella, hepatitis B, varicella, pertussis, and influenza. Weighted bivariate frequencies were generated using SAS 9.3. RESULTS Of 2,775 schools surveyed, 75% (n=2,077) responded; of responding schools, 93% (1947) required ≥1 ACIP-recommended vaccination. The proportion of schools accepting ≥1 non-ACIP-recommended form of evidence of immunity varied by vaccine: 42% for pertussis, 37% for influenza, 30% for rubella, 22% for hepatitis B, 18% for varicella, and 9% for measles and mumps. Among schools with ≥1 vaccination requirement, medical exemptions were permitted for ≥1 vaccine by 75% of schools; 54% permitted religious exemptions; 35% permitted personal belief exemptions; 58% permitted any nonmedical exemption. CONCLUSIONS Many schools accept non-ACIP-recommended forms of evidence of immunity which could lead some students to believe they are protected from vaccine preventable diseases when they may be susceptible. Additional efforts are needed to better educate school officials about current ACIP recommendations for acceptable forms of evidence of immunity so school policies can be revised as needed.

Exposure Workups

Exposure workups are an important responsibility for infection control personnel. A well-designed plan for investigating exposures, which includes appropriate algorithms, will enable infection control personnel to evaluate exposures rapidly and consistently so that nosocomial transmission is minimized. Infection control personnel should use their own data to develop policies and procedures that suit the needs of their facility. After they have imple-merited the plan, infection control personnel should continue to collect data on exposures so they can continuously improve their performance.

[Are medical students sufficiently vaccinated? Results of a serological survey and of vaccine coverage]

A total of 143 medical students participated in a serological and immunization coverage survey in Geneva. Between 29 and 54% had not received the 6 injections recommended in Switzerland against tetanus, diphtheria and poliomyelitis. The vaccination rates remain low against measles (57%), rubella (46%) and mumps (11%). Satisfactory levels of antibodies against measles were detected in all students. Between 4 and 6% did not have antibodies against mumps, varicella and rubella. Only 5.4% of Swiss medical students had antibodies against hepatitis A. HBc antibodies were present in 4% of the students. Medical students are at risk of contracting and transmitting vaccine preventable diseases. Swiss medical schools should play a leading role in the development of screening programs encouraging immunization of students entering university.