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Transmittal Notice 91-01

TN 91-01


This issuance establishes the Indian Health Manual, Part 1, Chapter 12, Indian Health Service (IHS) Employee Immunization Program, and was developed for two purposes.

  • To prevent the transmission of certain vaccine preventable infectious diseases from infected employees to patients at IHS facilities.
  • To educate IHS employees about vaccine preventable infectious diseases.

The policy requires that all IHS employees working in a hospital or clinic be immune to Rubella and measles.  It will be a condition of employment. Current employees will have until October 1, 1991, to come into compliance; if they refuse, they are subject to reassignment or removal.  Exclusions because of allergy, pregnancy, etc, are included.

Each Area Office is responsible for fulfilling their labor relations responsibilities before implementing this policy.  This will require impact and implementation bargaining only, and not negotiation, over the substance of the policy.  The decision that IHS employees must receive certain immunizations is negotiable.  However, recognized unions must be given the opportunity, under 5 U.S.C. 71, to negotiate concerning the Implementation of this change in conditions of employment.  Additionally, the implementation must be carried out consistent with the terms of existing negotiated agreements.  The IHS Collective Bargaining Officials should work closely with their respective labor relations officers in implementing the employee immunization program.

The Director, Office of Personnel Management, Office of Management, Public Health Service (PHS), approved the establishment of the IHS employee immunization program in accordance with 5 CFR Part 339.301 and the Federal Personnel Chapter 339 on March 26, 1991.

/Everett R. Rhoades, M.D./
Everett R. Rhoades, M.D.
Assistant Surgeon General
Director, Indian Health Service


Part 1, Chapter 12, Indian Health Manual, pages 1 through 31 and Table of Contents.


Indian Health Service Circular No. 79-6, Rubella Screening and Immunization for Indian Health Service Employees.


This is a new chapter in the Indian Health Manual.  Insert the new chapter at Part 1, tab reading "Chapter 12 - IHS Employee Immunization Program" by placing the material behind it.  This chapter is already at the Table of Contents for Part 1.

Log and file this Transmittal Notice (TN).

Distribution:  PSD 557
Date:  April 17, 1991