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Vaccines for which benefits (levels of antibody considered to be protective) clearlyexceed the risks (local or systemic reactions) should be required for all clearly identifiedat-risk personnel. Examples of such preparations include vaccines against yellow fever,rabies and poliomyelitis. This type of vaccination should be made a prerequisite toemployment.

If necessary, pre-employment physicals are provided to new employees at the request ofthe prospective employer. The lab supervisor or lab manager should make this request toEH&S and Human Resources.

Recommendations for giving less efficacious vaccines (i.e. those associated with highrates of local or systemic reactions or those that produce increasingly severe reactionswith repeated use) should be carefully considered. Products with these characteristics(e.g. cholera vaccine, tularemia vaccine, typhoid vaccine) should be recommended butmay not ordinarily be required for employment. A complete record of vaccines receivedon the basis of occupational requirements or recommendations should be maintained inthe employee's permanent medical file.

The following table summarizes vaccination practices at the U.S. Government Centersfor Disease Control. These practices were adapted from the Recommendations of thePublic Health Service Advisory Committee on Immunization Practices for specificapplication to at-risk personnel working in or entering laboratory areas. Additionalvaccination recommendations may be found in the agent listings, section V, D.