Immunization Information for Healthcare Workers

At certain healthcare facilities in Rhode Island, healthcare workers are required to be immunized against certain diseases.

Rhode Island’s immunization regulations define a healthcare worker as any person who is an employee (temporary or permanent), volunteer, student, or contractor at a healthcare facility. This includes trainees, healthcare providers with privileges at a facility, and people not directly involved in patient care (for example, clerical, dietary, housekeeping, laundry, security, maintenance, administrative, and billing staff).

Facilities in which immunization regulations apply

These regulations apply in:

  • Adult day care programs
  • CVS Minute Clinics
  • Free-standing ambulatory care surgical centers
  • Free-standing emergency care facilities
  • Home care providers
  • Home nursing care providers
  • Hospice providers
  • Hospitals
  • Kidney treatment centers
  • Nursing facilities
  • Organized ambulatory care facilities
  • Physician ambulatory surgery centers

Exemption and declination forms should be kept in employees’ personnel files. They should not be sent to the Rhode Island Department of Health.

Immunization regulations

Rhode Island's complete immunization regulations are available online. The individual vaccination requirements are summarized below.


Healthcare workers are required to either be vaccinated against the flu annually, or wear surgical masks when the Director of Health declares flu to be widespread. (more)


Healthcare workers or assisted living residence workers are required to be up to date with their COVID-19 vaccines, meaning a person has received all recommended doses of COVID-19—including a booster dose when eligible—or wear a National Institute for Occupational Safety & Health (NIOSH)-approved N95 mask while working in healthcare facilities during a period in which the COVID-19 prevalence rate in the State is greater than or equal to 50 cases per 100,000 people per week.

Hepatitis B

Workers at risk of exposure to blood-borne pathogens must be offered hepatitis B vaccine within ten days of employment. The hepatitis B vaccination series consists of three doses of vaccine given as two doses four weeks apart followed by a third dose five months after the second dose. It is recommended that testing for anti-HBs be performed one to two months after the last dose. People failing to develop a titer shall be offered a repeat three dose series with follow up titers. (Employees have the option of signing a standard OSHA declination form if they choose not to be vaccinated and should be counseled regarding risk.)

Measles, Mumps, and Rubella

For new healthcare workers, two doses of MMR are required for pre-employment. For current healthcare workers, two doses of MMR are recommended. (These individuals will be required to be vaccinated during outbreaks.)

Tetanus, Diphtheria, and Pertussis

One dose of Tdap is required for both new and current healthcare workers.


Evidence that the healthcare worker is free of active tuberculosis based upon the results of a negative two-step tuberculin skin test is required. (A negative FDA-approved blood assay for Mycobacterium tuberculosis (BAMT) may be used instead of a two-step tuberculin skin test.)

For healthcare workers who can present documentation of serial tuberculin testing with negative results in the prior two years (or more), a single baseline negative tuberculin test result is sufficient.

Varicella (Chickenpox)

Two doses of varicella vaccine are required (or laboratory evidence of immunity or laboratory confirmation of disease; or a healthcare provider diagnosis of varicella or healthcare provider verification of history of varicella; or history of herpes zoster based on healthcare provider diagnosis).