To the Editor.
—The article by Mr McRae and Dr Stephens1 in JAMA advocated that medical schools provide and pay for their students' hepatitis B virus (HBV) vaccinations. The article cited the 1992 Occupational Safety and Health Administration (OSHA) blood-borne pathogens standard promulgated to limit occupational transmission of infectious agents.2 The authors believed that medical students are "noticeably missing" from the scope of the standard, and they concluded that OSHA standards should be extended to require medical schools to cover their students.All medical students need to be protected from blood-borne pathogens. However, OSHA standards can be applied only to employees because the Occupational Safety and Health Act, which provides the legal authority under which OSHA sets workplace standards, is limited to employers and employees.3 Since medical students are not employed by their medical schools, OSHA cannot legally extend its standards to cover them.Medical schools need
Wallin MT, McDiarmid M, Montopoli M, Presson A, Holland V. Hepatitis B Vaccine for Medical Students. JAMA. 1996;275(6):444. doi:10.1001/jama.1996.03530300028024