Table 4. Summary of Main Changes^* from 1997 Advisory Committee on Immunization Practices/Hospital^{^†} Infection Control Practices Advisory Committee Recommendations for Immunization of Health Care Personnel

Hepatitis B	HCP and trainees in certain populations at high risk for chronic hepatitis B (eg, those born in countries with high and intermediate endemicity) should be tested for HBsAg and anti-HBc/anti-HBs to determine infection status.
Influenza	Emphasize that all HCP, not just those with direct patient care duties, should receive an annual influenza vaccination.
	Comprehensive programs to increase vaccine coverage among HCP are needed; influenza vaccination rates among HCP within facilities should be measured and reported regularly.
MMR	History of disease is no longer considered adequate presumptive evidence of measles or mumps immunity for HCP; laboratory confirmation of disease was added as acceptable presumptive evidence of immunity. History of disease has never been considered adequate evidence of immunity for rubella.
	The footnotes have been changed regarding the recommendations for personnel born before 1957 in routine and outbreak contexts. Specifically, guidance is provided for 2 doses of MMR for measles and mumps protection and 1 dose of MMR for rubella protection.
Pertussis	HCP, regardless of age, should receive a single dose of Tdap as soon as feasible if they have not previously received Tdap.
	The minimal interval was removed, and Tdap now can be administered regardless of interval since the last tetanus- or diphtheria-containing vaccine.
	Hospitals and ambulatory care facilities should provide Tdap for HCP and use approaches that maximize vaccination rates.
Varicella	Criteria for evidence of immunity to varicella were established. For HCP they include:
	Written documentation with 2 doses of vaccine;
	Laboratory evidence of immunity or laboratory confirmation of disease;
	Diagnosis of history of varicella disease by health care provider or diagnosis of history of herpes zoster by health care provider.
Meningococcal	HCP with anatomic or functional asplenia or persistent complement component deficiencies should now receive a 2-dose series of meningococcal conjugate vaccine. HCP with HIV infection who are vaccinated should also receive a 2-dose series.
	Those HCP who remain in groups at high risk are recommended to be revaccinated every 5 years.

↵* Updated recommendations made since publication of the 1997 summary of recommendations (CDC Immunization of health-care workers: recommendations of the Advisory Committee on Immunization Practices [ACIP] and the Hospital Infection Control Practices Advisory Committee [HICPAC]. MMWR 1997;46[No. RR-18]).
↵† Is now “Healthcare.”
CDC, Centers for Disease Control and Prevention; HBsAg, hepatitis B surface antigen; anti-HBc, hepatitis B core antibody; anti-HBs, hepatitis B surface antibody; HCP, health care personnel; MMR, measles, mumps, rubella; Tdap, tetanus toxoid, reduced diptheria toxoid, and acellular pertussis vaccine, adsorbed.
Reprinted with permission from: Centers for Disease Control and Prevention. Immunization of health-care personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2011;60(RR-7):1-45.