Posted By Ron Hunter And what of analphylactic reaction? Of contra-indicator symptoms and hypersensitivity? Innoculation itself is not without risk. Are your people aware of these risks? There are occupational health providers who would view innoculation as a very last resort. What are the significant findings of your Risk Assessment?

Posted By Fred Pratley Definitely not my area of expertise, but assuming the person declining the inoculation develops one of the various infections, does the person then present as a significant infection risk to work colleagues, bearing in minding your internal protocols and incubation periods etc? If yes, a significant risk, then surely the inoculation programme needs to be mandatory? Also, if the risk proves not to be significantly different, adopting an "exclusion from labs" policy could have potential lead to later claims of discrimination.

Posted By jclamb I would agree with your approach re not making it mandatory. There are many reasons why someone might refuse an immunisation, not least because they have an undisclosed underlying health reason (that may not have any effect on their ability to work) which makes them unable to have it, for example they may be immnosuppressed. A point worth considering re potential discrimination issues.

Posted By Tanya Boyce Are the tissue samples screened, partly screened or completley untested when they arrive with you? this information will likely change the risk assessment outcome. All our human tissue workers are given HepB vaccines by occ health. If there is an issue with someone not wanting to have the vaccine or not being able to have it then it is reffered to occ health to find out why and advise us. If someone cant have it due to immunosuppression then it raises a good question over how safe it is to work in lab with potentail pathogen containing samples. Further assessment is then needed.

Posted By Jim Tassell (2) Phil see the ACDP paper on this at: http://www.hse.gov.uk/biosafety/diseases/bbv.pdf It's hard going but thorough.

Posted By Phil Kitcher Thank you all so far for the responses. Ron Hunter correctly gives a reason for why the HBV immunisation may be refused. (for example: The individual has previously had an allergic reaction to this vaccine or has a severe allergic reaction to yeast(used in the manufacturing process for the vaccine).) Thus it is possible to countenance valid reasons not to vaccinate. Some of the tissue samples we have in the laboratories are HBV positive. They are contained and and handled in a manner consistent with HSE guidance on blood borne pathogens (see Jim Tassell link). The Employer does offer the vaccination from a reputable supplier, (pre-screen, then a course of 3 injections followed by post screening) together with periodic boosters as given to health care workers in much higher risk environments. (blood transfusion units). For Ian Blenkham: I am reasonably confident the laboratory safety standards are sufficiently robust to prevent infection. However probability for these events is not zero. I side benefit of the voluntary policy is that Staff gain an immunity with only slight discomfort to themselves and the employer is indirectly protected from claims should the disease be caught elsewhere. Re-reading http://www.hse.gov.uk/biosafety/diseases/bbv.pdf I notice para 119. “ Employees are at liberty to refuse vaccination, but any refusal should be considered as part of the risk assessment – since additional controls may be necessary - and considered with regards to the type of work assigned to the individual." Currently there is a policy of excluding immuno-suppressed individuals from working in these Labs. From the discussion I think I am on the right track. It is appropriate for the vaccination to be voluntary since our work is not of high(est) risk for the pathogen. Phil