tuthen

talisman;
ORIGINIAL DATE:
STATE STANDARD:
POLICY NUMBER:
POLICY TITLE:

SCOPE:

PURPOSE:

POLICY:

PROCEDURE:

LUTHERAN SOCEAL MINISTRIES OE  JERSEY

LAST REVESION DATE: REVISION NUMBER:

ACCREDITATION STANDARD:
HR-4O
Employee In?uenza Immunization Policy

Lutheran Social Ministries of New Jersey Agency Wilde Employees and Contracted
Employees. 

LSWJ recognizes its responsibility to provide employees a workplace free of recognized
hazards. This policy is intended to maximize vaccination rates against in?uenza among 
employees, especially those who work in a clinical setting. The goal is to protect
residents-?participants, employees: contractors and others af?liated with and the broader
community from in?uenza infection.

Evert! employee or contracted employee of is required to receive an annual influenza
vaccination, which will be provided or possess an approved exception (see Exceptions
below).

Prior to the annual onset of in?uenza season and when the most current vaccination
recommendations are published by the Centers of Disease Control and Prevention (CDC): LSWJ
will inform employee's about the following:

i. Requirement(s) for vaccination

2.__Dates when in?uenza vaccine(s) are available

3. Procedure for receiving vaccination .

4. Procedure for submitting written documentation of vaccine obtained outside 
5. Procedure for declining due to a quali?ed exception

6. Consequences of refusing vaccination

Employees have the right to obtain the influenza vaccination horn their own healthcare
professional= at the employee? 3 expense. A record of the vamination and/or acceptable
documentation must be provided to Human Resources prior to Nov. 1st each year.

Medical Exception:

Exception to required immunization may be granted for certain medical contraindications such as:
severe allergy to the vaccine or components as de?ned by the most current recommendations of I
the Advisory Committee on Immunization Practices; Guillain-Barr? within six weeks of a
prior in?uenza vaccine.

Employee?s requesting exception must submit a declination form providing documentation of
medical contraindications to the Human Resources representative of the communityr'program.

Religious:

If an employee declines inununization because it conflicts with sincerely held religious beliefs,
they must complete a request for religious exception (see Appendix A) and submit it to the
Human Resources Representative of the community/program.

Compliance:

If an exception is granted, the individual will be required to wear a pro-approved mask, provided
by at all times while on the premises of any of buildings/programs andfor within
six (6) feet of any of residentsi'paiticipants during the in?uenza season.

 

PREPARED BY:
Nani e/T'itle:

APPROVED BY:
Nam efI?itle:

Any employee covered by this poiicy who fails to comply with the vaccination requirement will
be subject to disciplinary procedures, up to and including termination.

Vaccine Shortage:

in the event of an in?uenza vaccine shortage, will determine an appropriate distributiOn
plan for the resources available. Influonza vaccine will be offered to employees based on risk to
resident population cared for, job function, and risk of exposure to in?uenza. Priority will be
given to those who provide hands-on patient care. Those who are prioritized to receive vaccine
will be held to the mandatory standard. Those who are not prioritized to receive the vaccine will
not be held to the mandatory standard for the duration of the vaccine shortage period, and
recommendations will be provided to those who do not receive the vaccine.

Administering the Vaccine:

l.


A.

i

 

Colleen P. Franken?eid, President GEO

Kr" ta Jacobs, Erie tive?tor, HuWesourceS

The DON/Assigned Staff member will post influenza immunization availability date(s) for
employees,

An assigned Nurse will administer the in?uenza vaccine on the posted date(s) at an assigned
location.

Each employee must sign an informed consent form prior to receiving the immunization.
Continue offering in?uenza vaccine for new hires during the active flu season (October 1
and March 31m} as recommended by the CDC unless refused or contraindicated;

An employee who refuses the in?uenza immunization or for which it is contraindicated to
receive a fin shot must wear a surgical mask while in the facility and providing
residenti?participant care for the duration of the flu season.

5% 8/15?

DATE

o/re?f

DATE