Documenting Immunization Compliance

An immunization record should be established for each OHCP at the time of initial employment.^4,6,53 The most reliable way to determine immunity is to obtain documentation of:

1. physician-diagnosed infection or

2. laboratory evidence of immunity, or

3. age-appropriate vaccination.

If there is any doubt as to the immune status of an OHCP, it is best to assume that the person is non-immunized. Following each subsequent immunization encounter, the record should be updated. The information recorded should include the type of vaccine; the dose, route, and site of administration; the name of the person who gave the vaccine; the date the vaccine was given; the manufacturer and lot number; and the date the next dose is due.

A Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care was published by the CDC in 2016. This guide is based on elements of Standard Precautions and represents a summary of basic infection prevention expectations for safe care in oral healthcare setting as recommended in the Guidelines for Infection Control in Dental Health-Care Setting – 2003.^48,49 The guide includes an Infection Prevention Checklist for Dental Settings (Appendix A). The Infection Prevention Checklist, Section I: Policies and Practices provides a tool to monitor and document institutional compliance with Dental Health Care Personnel Safety (Section I.3), i.e., compliance with current CDC recommendations for immunizations.