Workforce Immunisation for Healthcare Staff

CPD
3m

Published: 27 July 2020

Due to the nature of their work, healthcare staff are at increased risk of encountering, contracting and spreading vaccine-preventable diseases.

To protect healthcare staff and the patients in their care, particularly those who are vulnerable (e.g. young children and older adults), health service organisations are expected to maintain a workforce immunisation program and encourage all staff to be vaccinated (DoH 2019).

Workforce Immunisation in the National Safety and Quality Health Service Standards

Workforce immunisation is outlined in Action 3.13 of the National Safety and Quality Health Service Standards, under Standard 3: Preventing and Controlling Healthcare-Associated Infection.

This action aims to protect healthcare workforces and patients from vaccine-preventable diseases. Providers are required to have risk-based workforce immunisation programs that:

  • Are consistent with the Australian Immunisation Handbook;
  • Are consistent with state and territory requirements for vaccine-preventable diseases; and
  • Address specific risks to the workforce and patients.

(ACSQHC 2019)

Immunisation Policies, Procedures and Protocols

nurse receiving vaccination
Health service providers should outline the vaccination requirements for staff, students and contractors before they commence working as part of their workforce immunisation policy.

Health service providers are expected to establish comprehensive policies, procedures and protocols for workforce immunisation that outline:

  • Responsibilities for both employers and employees;
  • How the immunisation program relates to the organisation’s infection prevention and control program;
  • How risks (including high-risk areas and at-risk staff) are identified and managed;
  • How the immunisation program relates to occupational health and safety;
  • Designated staff to manage the program (who are appropriately-trained);
  • Vaccination requirements for staff, students and contractors before they commence working;
  • Workforce vaccination records and how they can be viewed;
  • How staff and patients will be appropriately informed about vaccine-preventable diseases; and
  • A management process for staff vaccination refusal.

(ACSQHC 2019)

Which Vaccinations Should Healthcare Workers Receive?

The Australian Immunisation Handbook outlines the following recommendations for healthcare staff:

Vaccine Recommended for:
Hepatitis B All healthcare workers.
Influenza All healthcare workers.
Measles-mumps-rubella (MMR) All healthcare workers who are non-immune.
Pertussis (dTpa [diphtheria-tetanus-acellular pertussis]) All healthcare workers.
Varicella All healthcare workers who are non-immune.
Hepatitis A
  • Healthcare workers who work in remote First Nations communities.
  • Healthcare workers who work with First Nations children in NT, QLD, SA or WA.
  • Other specified healthcare workers in some states or territories.
Bacille Calmette–Guérin (BCG) Healthcare workers at high risk of exposure to drug-resistant tuberculosis (depending on state or territory guidelines).

(Adapted from AIH 2018)

Note: Ideally, employees should receive these vaccines before they commence employment or within the first few weeks of employment if they have not already been immunised (VIC DoH 2014).

Workforce Immunisation Risk Matrix

Healthcare staff perform a variety of work activities, some riskier than others. The following matrix, developed by the Australian Commission on Safety and Quality in Health Care, is designed to determine the risks associated with contracting vaccine-preventable diseases for individual staff members. This tool takes into account:

  1. The staff member’s history of vaccination or disease.
  2. The staff member’s stage of employment.
  3. Whether the staff member has any opportunities to be exposed to vaccine-preventable diseases through their work activities.
  4. The consequences of the staff member being exposed to vaccine-preventable diseases.

(ACSQHC 2018)

This tool uses a scoring system. Each component of the matrix should be added together to determine the staff member’s total risk score.

1. History of vaccination/disease
2. Stage of employment Confirmed past history of vaccination or disease. Unsure of previous vaccines or disease history Unvaccinated or no known history of vaccination or disease.
Pre-employment 1 = Low 4 = Medium 6 = Medium
On commencement of work 1 = Low 6 = Medium 8 = High
Existing employee 1 = Low 8 = High 10 = Very High

3. Opportunity for exposure
No direct contact with patients or clients. Contact with patients or clients, but no contact with blood or body substances. Contact with patients or clients, and direct or indirect contact with blood or body substances.
1 = Low 4 = Medium 8 = High

4. Consequences of being exposed to a vaccine-preventable disease
Occupational acquisition. Healthcare-associated infection. Increased risk of acquisition of disease. No increased risk of disease or infection. Corporate risk.
9 = High 8 = High 6 = Medium 1 = Low 10 = Very High

Once the staff member’s score for each of these three components has been determined, add them together to determine their total risk score. The organisation can then use this information to determine what actions should be prioritised (ACSQHC 2018).

Score Risk
1 - 8 Low
9 - 16 Medium
17 - 24 High
25 - 28 Very high

(All tables adapted from ACSQHC 2018)

Encouraging Vaccine Uptake Among Staff

The following strategies may help encourage staff to participate in annual influenza vaccinations and other vaccination programs:

  • Hold a session to inform staff about the importance of vaccination and their role in preventing transmission;
  • Address any misconceptions about vaccines;
  • Utilise email, SMS or other technology to provide information to staff;
  • Promote the vaccination program verbally and through posters, flyers, newsletters and other materials;
  • Subsidise the vaccines, if possible;
  • Ensure the program is accessible to staff (time, location etc.);
  • Send reminders through email, SMS or phone; and
  • Plan vaccination programs in advance, taking into account logistics and the materials required.

(QLD DoH 2019)

nurse checking reminder on smartphone
Utilise email, SMS or other technology to provide information to staff and send reminders.

Accessing Vaccination Records

While health service organisations may keep records of vaccinations administered at work, staff should also keep personal records so that they can easily keep track of their immunisation status (Better Health Channel n.d.)

Healthcare staff may need to provide documentation proving they have received certain vaccinations (AIH 2018).

Any vaccines administered after 1996 are recorded on the Australian Immunisation Register (Better Health Channel n.d.)

Conclusion

In order to protect staff and patients from vaccine-preventable diseases, health service organisations have a responsibility to establish policies, procedures and protocols as part of a comprehensive workforce immunisation program.

Additional Resources


References

Test Your Knowledge

(Subscribers Only)

Question 1 of 3

All vaccinations administered after which year can be found on the Australian Immunisation Register?

Start an Ausmed Subscription to unlock this feature!

Author

Portrait of Ausmed Editorial Team
Ausmed Editorial Team

Ausmed’s Editorial team is committed to providing high-quality and thoroughly researched content to our readers, free of any commercial bias or conflict of interest. All articles are developed in consultation with healthcare professionals and peer reviewed where necessary, undergoing a yearly review to ensure all healthcare information is kept up to date. See Educator Profile

It’s not done until it’s documented