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Occupational Health

Before commencing work through our agency you must provide us with a full medical report this includes Hepatitis B (Antibody), MMR, TB and Varicella.

EPP

EPP (Exposure Prone Workers) must also provide Hepatitis C, Hepatitis B (Surface Antigen) and HIV Status which must have been updated within the last 5 years.

Please see the below for a list of the acceptable Medical reports

TB

Employees new to the NHS should have completed a TB screening and have documentary evidence of such screening having taken place.

Documents evidence for TB can be presented as follows;

  • Completed BCG Scar Sighting Form (a copy of which you can find in the "Compliance Documents" list on the right hand side of this page).
  • Medical report showing Evidence of BCG or a grade II Mantoux test reading.

Hepatitis B

In order to be cleared for Hepatitis B to work within the NHS you must have had 3 Primary Courses and a booster which is then followed by a blood test the levels of the blood results should read >100mIU/mL to be considered immune. You must be able to provide documentary evidence of this.

This may not always be the case as some individuals may be considered as Non-responders. A "vaccine non-responder" is a person who does not develop protective surface antibodies after completing two full series of the hepatitis B vaccine and for whom an acute or chronic hepatitis B infection has been ruled out. Although the majority of persons vaccinated against hepatitis B successfully respond to vaccination, an estimated 5-15% of persons may not respond. It is possible that a person who does not respond to the vaccine may already be infected with hepatitis B. Therefore, testing for the presence of the virus (HBsAg) is recommended before diagnosing a person as a "vaccine non-responder".

Recommendations for Vaccine Non-responders

  • Persons who do not respond to the primary vaccine series (i.e., anti-HBs <10 mIU/mL) should complete a second 3-dose vaccine series or be evaluated to determine if they are HBsAg-positive.
  • Revaccinated persons should be retested at the completion of the second vaccine series. Persons who do not respond to an initial 3-dose vaccine series have a 30%-50% chance of responding to a second 3-dose series.
  • Persons exposed to HBsAg-positive blood or body fluids who are known not to have responded to a primary vaccine series should receive a single dose of HBIG and restart the hepatitis B vaccine series with the first dose of the hepatitis B vaccine as soon as possible after exposure. Alternatively, they should receive two doses of HBIG, one dose as soon as possible after exposure, and the second dose 1 month later.
  • The option of administering one dose of HBIG and restarting the vaccine series is preferred for non-responders who did not complete a second 3-dose vaccine series.
  • For persons who previously completed a second vaccine series but failed to respond, two doses of HBIG are preferred.
  • Non-responders to vaccination who are HBsAg-negative should be considered susceptible to HBV infection and should be counselled regarding precautions to prevent HBV infection and the need to obtain HBIG prophylaxis for any known or probable percutaneous or permucosal exposure to HBsAg-positive blood.
  • Non-responders to vaccination who prove to be HBsAg-positive should be counselled regarding how to prevent HBV transmission to others and regarding the need for medical evaluation.

Finally if you are a HB non-responder and have had your two full courses but are shown not to be a carrier will need to receive a letter from their occupational health department stating this.

MMR

The MMR vaccine is an immunisation shot against measles, mumps and rubella (also called German measles).

The vaccine is a mixture of three live attenuated viruses, administered via injection. The shot is generally administered to children around the age of one year, with a second dose before starting school (i.e. age 4/5). The second dose is not a booster; it is a dose to produce immunity in the small number of persons (2–5%) who fail to develop measles or mumps immunity after the first dose.

Documents evidence for MMR can be presented as follows;

  • Two stated MMR doses (the two doses should be dated at least 4 weeks apart)
  • Individual Virology reports stating that the antibodies have been detected.

Varicella

Varicella zoster virus (VZV) is one of eight herpes viruses known to infect humans (and other vertebrates). It commonly causes chicken-pox in children and both shingles and postherpetic neuralgia in adults.

Documents evidence for Varicella can be presented as follows;

  • Proof of previous infection
  • Proof of the two separate VZV vaccinations
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