Hepatitis B Vaccination (and Declination)

Hepatitis B is a virus that can cause serious and even life threatening disease by interfering with the many functions of the liver through viral replication. It is a bloodborne pathogen as the mode of transmission is through contact with blood and bodily fluids.

Fortunately, there is a safe vaccine available to prevent infection which is administered in a series of three doses within a six month period, conferring long-term protection through immunological memory.

Occupational exposure to hepatitis B is addressed in OSHA’s Bloodborne Pathogens standard, 29 CFR 1910.1030.  As stated in the standard, “The employer shall make available the hepatitis B vaccine and vaccination series to all employees who have occupational exposure, and post-exposure evaluation and follow-up to all employees who have had an exposure incident.” The OSHA definition of occupational exposure is “reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties.”

The hepatitis B vaccination must be made available at no cost to affected employees after receiving bloodborne pathogens training and within 10 working days of initial assignment unless the employee has already received the full vaccination, antibody testing shows the employee is immune, or the vaccine is contraindicated due to medical reasons. The latter would include anyone who is severely allergic to yeast where the vaccine is produced with a certain type of yeast and the viral envelope protein, HBsAg. Common side effects of the vaccine include mild fever, headache, and soreness at the injection site.

The Bloodborne Pathogens standard allows for the employee to initially decline the vaccination and later, with a change of mind, accept it while still covered under conditions of occupational exposure. In this case, the employer is required to have the employee sign a declination statement as contained in Appendix A of the BBP standard. A hepatitis B vaccine declination form can also be found in MEMIC’s sample Bloodborne Pathogens Exposure Control Plan located in the Safety Director