Please provide the following information to Occupational Health and Safety Services no later than 7 business days prior to your start date. INCOMPLETE FORMS AND LATE SUBMISSIONS WILL DELAY YOUR START DATE

The information below provides the list of all immunization/testing requirements.

1. Red Measles

You require 2 doses of measles vaccine with the first dose being given on or after your 1st birthday and the second dose given at least 4 weeks from the first dose OR provide laboratory evidence of your immunity. Immunization is required for those without immunity.

2. Rubella

You require 1 dose of rubella vaccine, given on or after your 1st birthday OR provide laboratory evidence of your immunity. Immunization is required for those without immunity.

3. Mumps

You require 2 doses of mumps vaccine with the first dose being given on or after your 1st birthday and the second dose given at least 4 weeks from the first dose OR provide laboratory evidence of your immunity. Immunization is required for those without immunity.

4. Varicella (Chicken pox)

You require 2 doses of varicella vaccine (e.g. physician's certificate or vaccination record) OR provide laboratory evidence of your immunity or laboratory confirmation of disease. Immunization is required for those without immunity.

5. Tuberculosis (TB) Surveillance

You are required to have a baseline two-step TST regardless of BGC unless you have: documented results of a prior two-step test which can include: 2 individual skin tests done at least one week apart *. A single step is required if the last of the 2nd step was more than 12 months ago, or if there are indications of travel to an area known for high levels of TB or an exposure to someone known or suspected of having TB or symptoms of TB. (*The two-step TB skin test is normally given as a series of two single TB skin tests repeated between 1-4 weeks apart. However, two individual TB skin tests performed 4-52 weeks apart are also considered an acceptable "two-step TB skin test" - Canadian Thoracic Society & the Public Health Agency of Canada, 2013).

Tuberculin skin testing should be administered and read before immunization or delayed for at least 4 weeks after vaccination. Vaccination with COVID-19 vaccines may take place at any time after all steps of tuberculin skin testing have been completed.

PLEASE NOTE: If you have had a live vaccine (Measles, Mumps, Rubella, Chickenpox, Shingles) within 4 weeks prior to needing a TB skin test, you will not be eligible. A TB skin test may be given on the same day as a live vaccine, but otherwise may not be administered until at least 4 weeks have elapsed. A delay in administration of the test will delay your start date.

Tuberculosis Testing Schedule:

Contact your doctor or Occupational Health at St Joseph's to discuss your TB skin test requirements at least 2 weeks before your start date. You must be available to come back for the follow-up read or test.

Individuals with Positive TB Skin Tests

You must provide Occupational Health with documentation of chest X-ray taken after the positive TB skin test. If you have a history of a confirmed positive TB test and you have already received counseling or advice concerning prophylactic treatment (Isoniazid), you should provide a copy of your consult note. Another chest X-ray may be taken if clinically indicated.

6. COVID-19

Vaccination for COVID-19 is mandatory for all new hospital employees, volunteers and students. The vaccine is offered via local COVID-19 Vaccination Clinic Sites.

• As of September 28, 2021, NACI recommends that: COVID-19 vaccines may be given at the same time as, or any time before or after, other vaccines, including live, non-live, adjuvanted or unadjuvanted vaccines.
• TST should be delayed for at least 4 weeks after COVID vaccine or live vaccines such as MMR, Varicella, and Yellow Fever. NOTE: Aside from COVID vaccine a TB skin test may be administered on the same day as all other vaccines or within 4 weeks of a previous non-live vaccine.

7. Hepatitis B

It is recommended that all health care workers to receive a course of Hepatitis B vaccine. For your protection, it is important to obtain a Hepatitis B titre test following immunization to ensure that you are adequately protected. If you have been vaccinated, please provide laboratory evidence of immunity.

8. Tetanus/Diphtheria or Tetanus/Diphtheria/Pertussis (Tdap)

It is recommended that you receive a primary series of Tetanus/Diphtheria vaccine in childhood followed by a routine booster every ten (10) years. You can also receive a one-time dose of Tdap, especially if you are providing care to pregnant women and/or children. If you have not already received a primary Tetanus/Diphtheria series, then you require three doses as part of adult primary immunizations. Contact your family physician or Public Health Unit in order to complete your primary series.

9. Influenza

It is strongly advised that you receive the vaccination yearly. If you have not received your influenza vaccination, and your start date is occurring during the times of the year when influenza vaccine is offered, (approximately October to March), you can receive influenza vaccination while at work. If you received influenza vaccination in the community during the months of October to March, you must submit proof of influenza vaccination to Occupational Health and Safety.

To update any/all vaccinations and get blood work done:

• Visit your family doctor or local walk-in clinic with the health review form to be completed. A list of walk-in clinics in the London and Middlesex County is available on this link: London and Middlesex County
• Public Health Units can provide vaccinations/ Immunizations (MMR and Varicella). To contact Public Health Unit closest to you, please access the link and ask for the Immunization Clinic: https://www.phdapps.health.gov.on.ca/PHULocator/
• As blood tests are required if you are unable to confirm vaccination dates and test results may take 2-4 weeks. You may want to discuss revaccination as an option with your doctor.

Where to get Record of Immunization or Vaccinations/ Immunizations and Blood Titers

• Current or past employer - request a copy of your record from the Occupational Health Department.
• Health care training school program - request a copy of your immunization record from Student Health Services.
  Facilities where you performed volunteer work - request copies of your record.
• Public Health Department in the school district that you attended - ask for a copy of your vaccination record.
• Childhood record (often a yellow card or form) from your family doctor or other health care professionals you have received care from i.e., obstetricians, midwives or family physicians.
• Immigration records provided they are signed by a physician or nurse
• View your immunization records online by going to Immunization Connect Ontario (ICON) Online System

In the London Area you can get TB skin test through the following:

1. Some family doctors' offices or walk-in clinics may provide this service.
2. Western Student Health Services (Western students by appointment) Room UCC 11, Tel. (519) 661-3030
3. Fanshawe Student Health Services (Fanshawe students only, walk-in) Room SC 1001, Tel. (519) 452-4230
4. Hyde Park Medical Walk-In Clinic (walk-in) 640 Hyde Park Rd., (519) 641-3627
5. Oxford Medical Walk-In Clinic (walk-in) 140 Oxford St East, Unit 102, (519) 433-4999
6. Bayshore Home Health (by appointment) 595 Bradley Avenue, 2nd Floor, (519) 680-0849
7. Care Partners:

Perth / Stratford	Oxford / Woodstock	St. Thomas
61 Lorne Avenue East	65 Springbank Drive North	107 Edward Street
Unit 4	Unit 5	St. Thomas, ON
Stratford, ON	Woodstock, ON	1-800-443-4615
1-800-668-4326	1-800-443-4615	Ext. 3200
Tillsonburg
25 Townline Road
Tillsonburg, ON
1-519-688-1853