Are all employees who have been exposed to hepatitis B required to be vaccinated?

If an employee has an “occupational exposure” to blood or other potentially infectious materials (OPIM), the employer’s responsibilities are outlined in General Industry Safety Orders Section 5193, Bloodborne Pathogens, Subsection (f).

An “occupational exposure” is defined as a “reasonably anticipated skin, eye, mucous membrane or parenteral contact with blood or other OPIM that may result from the performance of an employee’s duties.”

24-Hour Window

The employer is to make available the hepatitis vaccine and vaccination series to the affected employees within 24 hours of the occurrence. There also shall be post-exposure and follow-up evaluations.

The key statement within subsection (f)(1)(A) is “make available,” because the regulation further states that an employee may “refuse to consent to a post-exposure evaluation and follow-up from the employer-healthcare professional.”

When consent is refused, the employer is to make available to the exposed employee, a confidential medical evaluation and follow-up from a health care professional outside of the exposed employee’s employer.

Subsection (f)(2)(A) states that the hepatitis B vaccine shall be made available after training and information criteria contained in subsection (g)(2)(G)(9) has been met and within 10 working days of initial assignment of all employees who have occupational exposure.

The employer does not have to provide the employee the vaccine when the employee has already received the complete vaccination series, antibody-testing reveals the employee is immune or the vaccine is contraindicated for medical reasons.

The employee may decline to accept the hepatitis vaccination offered by the employer. However, the employer shall make available the hepatitis B vaccination series should the employee, while still covered by this regulation, decide to accept the vaccination series.

If the employee elects to decline the vaccination series, the employee is to sign a statement acknowledging being given the opportunity to receive the vaccination series and that the employee will continue to be at risk. The employee also can be vaccinated at a future date at no charge.

Pre-Exposure Vaccine

The employer does not have to offer pre-exposure hepatitis vaccine if exceptions outlined in Section (f)(1)(A) occur:

• the first aid provider’s primary assignment is not the rendering of first aid; and
• any first aid rendered by such persons is rendered only as a collateral duty responding solely to injuries resulting from workplace incidents, generally at the location where the incident occurred.

The requirement for providing the hepatitis B vaccination is triggered by the employee’s rendering of assistance in any situation involving the presence of blood or OPIM, regardless of whether an exposure incident as defined in the standard, occurred. The exception to subsection (f)(1)(A) should be reviewed for additional conditions and requirements.

Frequently asked questions about bloodborne pathogens are answered on the Cal/OSHA website.