135.016D Influenza and Tdap Vaccine Recommendations for Health Care Personnel


Influenza and Tdap Vaccine Recommendations for Health Care Personnel: The Texas Medical Association: 


  • Supports 100-percent influenza vaccination among health care personnel, i.e., all employees of health care facilities with direct patient care contact. Health care personnel opting to decline influenza vaccine offered by the employer should be required to sign a declination waiver to be included in the personnel file. The waiver should include educational information about the danger of vaccine refusal and the potential spread of influenza among patients and family members. While all licensed health care facilities in Texas must have a policy on influenza and other vaccination for health care personnel, the decision to mandate influenza vaccination as a condition of employment is an individual facility decision.
  • TMA supports the Advisory Committee on Immunization Practices (ACIP) policy recommending that all health care personnel who have direct patient care contact in hospitals or clinics receive a dose of tetanus-diphtheria-pertussis vaccine (Tdap). This recommendation should be extended to long term care facilities that are experiencing an outbreak of pertussis. A two-year interval since the last tetanus-diphtheria vaccine (Td) is suggested but not required. TMA recommends that employers assess for, administer, or secure a declination waiver for Tdap during the period when they are offering the annual influenza vaccine.
  • TMA encourages physicians (and others, including advance practice nurses and midwives) practicing obstetrics quality-of-care measures in private practice to strongly encourage influenza vaccination of pregnant women, especially those during the second or third trimester of pregnancy, or upon postpartum hospital discharge. TMA supports ensuring that these women receive the tetanus-diphtheria-pertussis vaccine (Tdap) between 27-36 weeks of each pregnancy, or as recommended by the ACIP. Use of a standard delegated medical order will facilitate administration of Tdap to this population (CM-ID Rep. 2-A-08; amended CM-ID Rep 1-A-18; deleted CM-ID Rep. 2 2022).


Last Updated On

June 14, 2022

Originally Published On

October 07, 2016