ERHMS

Pre-deployment Health Screening for Emergency Responders

Purpose

Pre-deployment health screening is intended to establish a baseline physical health, emotional health, and immunization 

status of emergency responders. This baseline information allows for more informed interpretation of possible postdeployment adverse health effects and can serve as an opportunity to assess whether the responder has the appropriate 

education, training, and experience to deploy in his or her assigned response capacities.

Principles of Screening

• Identification and evaluation of any pre-existing medical, physical, and/or emotional conditions that could affect 

a responder’s ability to perform safely and effectively or could place the responder at an increased risk of adverse 

health effect

Further baseline emotional health status may be derived from a review of five basic screening tools that can be found in 

the Emergency Responder Health Monitoring and Surveillance document, section 2T: Pre-deployment Health Screening 

for Emergency Responders.

Many responders will require more extensive screening based on the nature of their anticipated work and any individual 

risk factors identified in the core screening process. 

Health Screening Outcomes

• Responder may be placed into a range of fitness for deployment categories, from “Cleared for emergency response 

with no restrictions” to “Not cleared for deployment (permanent disqualification or pending medical consultation 

or workup)”.

Immunizations

• Recommended for responders to be up-to-date on certain immunizations.

• Other vaccinations to be considered if additional or out-of-the-ordinary infectious disease exposure risks are 

identified or if responders are deploying outside the United States.

Pre-deployment health screening and 

establishment of baseline health status and 

readiness of an emergency responder

Components of a Health Screening Exam

• Identifying and Contact Information

• Occupational History

• Social History

• Pre-existing Medical and Psychiatric 

Conditions

• History of Traumatic Exposures

• Special Needs
ERHMS

Emergency Responder Health Monitoring and Surveillance

The Emergency Responder Health Monitoring and Surveillance (ERHMS) system is a health monitoring and surveillance 

framework that includes recommendations and tools specific to protect emergency responders during the pre-deployment, deployment, and post-deployment phases of a disaster. The intent of ERHMS is to identify exposures and/or signs 

and symptoms early in the course of an emergency response in order to prevent or mitigate adverse physical and psychological outcomes and ensure workers maintain their ability to respond effectively and are not harmed in the course of this 

response work. Data will also help to identify during the post-deployment phase which responders would benefit from 

medical referral and possible enrollment in a long-term health surveillance program. Please refer to Chapter 2 and section 

2T for more information on Pre-deployment Health Screening for Emergency Responders.

National Institute for Occupational Safety and Health (NIOSH) ERHMS Contact:

! CDR Renée Funk, Coordinator, ERHMS at rfunk@cdc.gov or 404-498-1376

For more information on ERHMS, please visit: 

erhms.nrt.org & www.cdc.gov/niosh/topics/erhms

Vaccine Responder Group

Booster every 10 years.

After potentially contaminated wound and last booster was more than 5 years ago.

Hepatitis B vaccine Responders who will be performing direct patient care or otherwise expected to have contact with 

bodily fluids.

Seasonal influenza vaccine Annually.

Pandemic influenza vaccine During ongoing/impending pandemic activity.

Responders greater than 65 years old.

Responders 19-64 who are smokers or who have asthma.

Hepatitis A vaccine Responders at high risk (HazMat, Search and Rescue, SCUBA) and other frequent or expected 

frequent contaminated water exposures.

Measles, mumps, rubella vaccine (MMR) Responders for which there is no documentation of the MMR vaccine being previously received.

Polio vaccine Responders for which there is no documentation of a polio vaccine being previously received.

Varicella vaccine All non-immune personnel.

Rabies vaccine series Persons who are exposed to potentially rabid animals should be evaluated and receive standard 

post-exposure prophylaxis.

Anthrax vaccine Responder reasonably anticipated having repeated/ recurrent/ prolonged exposures to Bacillus 

anthracis in the event of an incident(s).

Smallpox vaccine Responders reasonably anticipated being deployed for a smallpox event and likely to have a 

particularly high risk for exposure.

Recommended for All Responders

Strongly Consider for Certain Responder Groups or Types

Linked to Identified Biological Threats

Pneumococcal vaccine

Tetanus booster

Table above shows immunizations for Emergency Responders