February Updates:

The Michigan Update: Vaccinations for First Responders
Author: Jennifer Crooker, BSPH, CHES®, MDHHS Division of Immunization

First responders are the first line of protection for the community and therefore also at a higher risk for disease. To best protect themselves and their communities, first responders should ensure they are up to date on all their vaccines.

Infectious disease places EMS workers, law enforcement, fire fighters, and first responders at risk of becoming ill along with their families and community members. An outbreak of infectious disease among first responders can also hamper response efforts by increasing absenteeism and compounding staffing shortages. Vaccination is an important way to mitigate these risks.

Two vaccines are currently recommended for disaster responders by the Centers for Disease Control and Prevention (CDC): Tetanus is recommended for all first responders and hepatitis B is recommended for those who may come into contact with bodily fluids (CDC, 2019).  

• Tetanus (also called lockjaw) is caused by bacteria called Clostridium tetani which is found in the environment including soil, manure, and other surfaces and can be introduced into the body through wounds that break the skin. Tetanus can cause seizures, muscle spasms, and death. Tetanus vaccination is part of the routine childhood immunization schedule and is recommended for adults as well. For adults, CDC recommends that persons aged ≥19 years who have never received a dose of Tdap should receive one dose of Tdap, regardless of the interval since their last tetanus or diphtheria toxoid–containing vaccine. To ensure continued protection, booster doses of either Td or Tdap should be administered every 10 years throughout life (CDC, 2023b).
  
  
• Hepatitis B is a liver infection caused by the hepatitis B virus that can result in long-term chronic disease including life-threatening complications. It is spread through bodily fluids and is a particular risk for EMS workers who are at high risk of needle sticks (Bitely, Glauser, & Miller, 2019). The Occupational Safety and Health Administration (OSHA) “requires employers to offer the (hepatitis B) vaccination series to all workers who have occupational exposure” at no cost (OSHA, 2011). CDC now recommends hepatitis B (HepB) vaccination among all adults aged 19–59 years and adults > 60 years with risk factors for hepatitis B or without identified risk factors but seeking protection.

Healthcare workers are also strongly advised by CDC’s Advisory Committee on Immunization Practices (ACIP) to stay up to date on these vaccines: hepatitis B, influenza, tetanus/ diphtheria/pertussis (Tdap) or tetanus/diphtheria (Td), measles/mumps/rubella (MMR), varicella (chickenpox), and COVID-19 (CDC, 2011, 2023a).

Seasonal upper respiratory illnesses including influenza, respiratory syncytial virus (RSV), and COVID-19 are also risks for first responders as they work in their communities. As one EMS provider writes in EMS1 Magazine, “It’s easy to groan when the pager squawks out yet another ‘sick person, possible flu’ call, but these folks can be really ill, and they need our help. But they can also easily spread that illness to us and our families” (Fraley, 2019).

COVID-19 has hit first responders particularly hard. Data from 2020 indicate that workers in “protective service” occupations- police, firefighters, fire inspectors, correctional officers, private detectives, security guards, and probation officers- had the highest death rate from COVID-19 that year of all occupational groups (60.3 per 100,000), more than double the overall rate for all workers (28.6 per 100,000) and almost double that of healthcare workers (31.2 per 200,000) (Kekatos, 2022).

According to the Officer Down Memorial Page, 62% of officer deaths in 2020 (284 officers) and over 70% (501 officers) in 2021 were due to COVID-19 (Officer Down Memorial Page, 2024).

According to the U.S. Fire Administration, in 2021 of the 141 firefighters that died while on duty, 63 died from COVID-19 (U.S. Fire Administration, 2021).

For best protection, first responders should ensure they are up to date on flu, COVID-19, and RSV vaccines, especially as respiratory viruses are still circling. Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. Further, CDC recommends the 2023–2024 updated COVID-19 vaccines to protect against serious illness from COVID-19. 
Staying up-to-date with COVID-19 vaccines