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Recommended Immunizations for Emergency Workers Exposed to Flood Conditions

Download Technical Bulletin
Nevada Division of Public and Behavioral Health

Date:  May 19, 2017
Topic:  Recommended Immunizations for Emergency Workers Exposed to Flood Conditions 
Contact:  Shannon Bennett or Pam Forest, MD - Nevada State Immunization Program
To:  Northern Nevada Emergency Medical Services, Department of Public Safety, Northern Nevada Healthcare Providers

Due to the large snowpack and unpredictable spring weather patterns, state officials recently expressed concern regarding the potential for northern Nevada to experience flooding during the spring and summer of 2017. This flooding could cause emergency workers to be wounded and exposed to the bacteria that causes tetanus.

According to the Centers for Disease Control and Prevention (CDC), risks of wounds may be increased during flood cleanup. Therefore, emergency and other cleanup workers should be sure they are up-to-date with the tetanus vaccination series, ideally before starting cleanup activities. Workers should check their immunization records to determine if they have received Tdap or Td in the last 10 years. Being up-to-date with the tetanus vaccine can simplify the treatment for any wound that might occur.

Td or Tdap can be used for protection against tetanus; getting the Tdap instead of Td for one tetanus booster during adulthood is recommended to maintain protection against pertussis (whooping cough). After completing the primary tetanus vaccination series, booster doses are recommended at 10-year intervals. Management of flood-associated wounds, e.g.,a puncture wound or a wound contaminated with feces, soil,or saliva, should include appropriate evaluation of tetanus immunity and administration of Tdap or Td if indicated.

While checking the immunization record for current tetanus immunization status, please consider completing the vaccine series for the following vaccines as well,if not already completed:

• Hepatitis A & B - can be administered individually or as a combination vaccine, Twinrix®
• MMR (measles, mumps, and rubella)
• Varicella  (chickenpox)

Immunization records in Nevada WeblZ can be accessed by the individual using the online patient portal at If difficulty is encountered while trying to access immunization records, call 1-877-689-3249 for assistance from the Nevada WeblZ Help Desk.

John DiMuro, DO, MBA
Chief Medical Officer

Cody Phinney, MPH