While protecting ourselves and others with masking and social distancing and move further into vaccine procurement and distribution, public health TB program staff work to continue TB care and prevention while pulled into COVID-19 vaccine delivery. Questions The CDC released guidance to answer questions about timing of TB testing and COVID-19 vaccine delivery . This guidance from is linked here https://www.cdc.gov/tb/publications/letters/covid19-mrna.html and excerpted here:
For healthcare personnel or patients who require baseline TB testing (at onboarding or entry into facilities) at the same time they are to receive a COVID-19 mRNA vaccine, CDC recommends:
- Perform TB symptom screening on all healthcare personnel or patients.
- If using IGRA, draw blood prior to COVID-19 mRNA vaccination.
- If using TST, place prior to COVID-19 mRNA vaccination.
- If COVID-19 mRNA vaccination has already occurred, defer TST or IGRA until 4 weeks after completion of 2-dose COVID-19 mRNA vaccination.
For healthcare personnel who require testing for other reasons, CDC recommends:
- Perform TB symptom screening on all healthcare personnel.
- Test for TB infection before or during the same visit as COVID-19 mRNA vaccination. If this is not possible, prioritization of testing for TB infection needs to be weighed with the importance of receiving COVID-19 mRNA vaccination based on potential COVID-19 exposures and TB risk factors.
- Healthcare personnel with high-risk conditions for TB progression should be fully evaluated as soon as possible.
- Healthcare personnel without high-risk conditions for TB progression should proceed with contact tracing (symptom screening, chest radiograph or other imaging, specimen for microbiologic evaluation) but delay being tested for TB infection (with either TST or IGRA) if prioritized for receiving COVID-19 mRNA vaccination.
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CTCA recommends that California laws and regulations move into agreement with CDC health care personnel screening guidance, assessing facility and job risk before repeating TB tests, encouraging treatment for latent TB infection (LTBI) if health care personnel have. risk for TB, test positive for TB and TB disease is ruled out to prevent TB disease from developing, treating before illness.
One out of every four people living today are infected with TB. TB kills 1.5 million people each year, according to the World Health Organization. TB is also found in the U.S. Most TB diagnosed in the U.S. was acquired years before in countries where there is a lot of TB.
Those who have lived, for more than 30 days, in a country with a lot of TB, have a risk for TB. Other TB risks include immunosuppression, current or planned, and close contact to someone who had TB disease. Anyone with a risk for TB should get tested, and consider treating their TB infection to prevent TB disease to protect family and friends from this life threatening airborne infectious disease. One out of 4 of the world’s population are infected with TB.