Occupational Health Requirements
Students must provide evidence they are in compliance with Tripler Army Medical Center (TAMC) health requirements. During inprocessing, students must report to the TAMC Occupational Health Clinic with their immunization records or signed documentation from their physicians or school health officials showing that they are in compliance with TAMC’s health requirements.
Students will not be allowed to start any rotation until compliance with TAMC's health requirements has been properly verified.
Except where otherwise indicated, the following are considered the minimum essential requirements.
- Tuberculosis (TB) screening requirement for:
- Individuals without History of Latent or Active Tuberculosis.
- Documentation of two (2) consecutive annual negative Tuberculin Skin Tests with the most recent negative test within the past 365 days. In the absence of the above, then 2-step testing will be required; OR
- Documentation of a negative Interferon Gamma Release Assay result within 365 days of the start of the rotation.
- Individuals with a Known History of Latent Tuberculosis Infection (LTBI).
- Documentation of the most recent Chest X-ray result. Date of Chest X-ray must be on or after the date of positive Tuberculin Skin Test or Interferon Gamma Release Assay result, AND
- Documentation of completion of a negative annual screening questionnaire for sign and symptoms of active tuberculosis disease.
- Individuals with Previously Treated Active Tuberculosis (TB Disease).
- Documentation of completion of an approved treatment regimen for active tuberculosis disease, AND
- Documentation of clearance from a specialist in Infectious Diseases or Pulmonology, AND
- Documentation of completion of a negative screening questionnaire for signs and symptoms of active tuberculosis disease performed in-person with a member of the Occupational Health Staff at Tripler prior to the start of the rotation.
- Documentation of two (2) doses of MMR vaccine at least 28 days apart with the first dose received on or after the first birthday; OR
- Positive antibody titer.
- Tetanus-Diphtheria-Pertussis (Tdap): Documentation of one dose of Tdap regardless of time interval since last Td only vaccine.
- Hepatitis B:
- Documentation of completed three (3) dose vaccine series with positive Hepatitis B surface antibody titer post vaccination; OR
- Positive Hepatitis B surface antibody titer after reported history of vaccination.
- Note: Student health care workers frequently rotate in areas of the hospital at highest risk of blood/body fluid exposures. Therefore, documentation of a positive Hepatitis B surface antibody titer before rotation is preferred. If documentation of three (3) doses of Hepatitis B vaccine (in compliance with current CDC guidelines for minimum dosing intervals) has been received by Occupational Health, but an antibody titer performed before rotation is negative, the student shall be allowed to rotate. The home educational institution will be notified that the applicable student should see a provider to receive booster vaccination and repeat Hepatitis B surface antibody testing. Individuals with a continued negative antibody titer after 6 total doses of vaccine (two (2) completed series) should be tested for evidence of Hepatitis B infection before assuming there is solely a lack of vaccine response.
- Influenza: Documentation of annual influenza vaccine.
- Documentation of two (2) doses of varicella vaccine at least 28 days apart; OR
- Positive antibody titer; OR
- Diagnosis or verification of a history of varicella disease by laboratory results or documentation from a health-care provider; OR
- Diagnosis of a history of herpes zoster (varicella zoster) by a health-care provider.
- Required only if 1) known anatomic of functional asplenia, OR 2) known persistent completed component deficiencies in individuals younger than 55 years old. (May be offered as an off-label use to those with the above conditions who are older than 55.)
- Documentation of completed 2-dose series with doses administered 8 to 12 weeks apart.