Due to the nature of their work, healthcare workers are at increased risk of encountering, contracting and spreading vaccine-preventable diseases.
To protect their staff and the patients in their care, particularly those who are vulnerable (e.g. young children, pregnant patients and older adults), health service organisations are expected to maintain a workforce immunisation program and encourage all staff to be vaccinated (DoHaAC 2022).
Workforce Immunisation in the National Safety and Quality Health Service Standards
Workforce immunisation is outlined in Action 3.15 of the National Safety and Quality Health Service Standards, under Standard 3: Preventing and Controlling Infections.
This action aims to protect healthcare workforces and patients from vaccine-preventable diseases. Providers are required to have a risk-based workforce screening and immunisation program that:
- Is consistent with the Australian Immunisation Handbook
- Is consistent with state and territory requirements for vaccine-preventable diseases
- Addresses specific risks to the workforce and patients.
(ACSQHC 2019)
Workforce Immunisation Under the Strengthened Aged Care Quality Standards
Standard 4: The Environment - Outcome 4.2: Infection prevention and control under the strengthened Aged Care Quality Standards (Action 4.2.1) requires aged care providers to establish an infection prevention and control system that:
- Is informed by staff immunisation and infection rates
- Includes risk-based vaccine-preventable disease screening and vaccination for staff.
(ACQSC 2024)
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 |
|
Bacille Calmette–Guérin (BCG) | Healthcare workers at high risk of exposure to drug-resistant tuberculosis (depending on state or territory guidelines) |
(AIH 2021)
Note: While the Australian Immunisation Handbook provides recommendations, individual states and territories may have mandated vaccination requirements that healthcare workers need to follow. Make sure you refer to your jurisdiction’s guidelines (AIH 2021).
For example, in Victoria, healthcare workers who are employed in certain healthcare settings are required to be fully vaccinated against COVID-19 (Health.vic 2023).
Workforce Immunisation Risk Matrix
The following matrix, developed by the Australian Commission on Safety and Quality in Health Care, is designed to determine the risk posed to an individual healthcare organisation by vaccine-preventable diseases (ACSQHC 2023).
Workforce vaccination status and access to workforce screening | ||||
Risk of disease exposure |
|
|
|
|
No increased risk of exposure to disease or infection | Low | Medium | High | |
Staff have a risk of exposure to vaccine-preventable disease due to the nature of their role | Medium | High | Very high | |
Hospital-based outbreak of vaccine-preventable disease (no evidence of community transmission) | Medium | High | Very high | |
Community-wide outbreak of a vaccine-preventable disease | High | Very high | Very high | |
Disease with no available vaccine | Very high | Very high | Very high |
Low | The risk can be managed by routine procedures and there is minimal risk of harm or injury from the risk. |
Medium | The risk can be managed by specific monitoring or audit procedures. There is potential for harm or injury from the risk. |
High | There is a serious risk that must be managed immediately. Consequences to individuals and the organisation are high due to a high potential for harm or injury. |
Very high | There is a serious risk that must be addressed immediately. The magnitude of the consequences to the individual and organisation of an event, should it occur, are considered very high with potentially significant harm or injury. |
(All tables adapted from ACSQHC 2023)
Once the risk level has been assessed, the organisation is expected to establish an action plan to address these identified risks (ACSQHC 2023).
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
- Plan vaccination programs in advance, taking into account logistics and the materials required.
(Queensland Health 2019)
Accessing Staff 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 2022).
Healthcare staff may need to provide documentation proving they have received certain vaccinations (AIH 2021).
Any vaccines administered after 1996 are recorded on the Australian Immunisation Register (Better Health Channel 2022).
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.
Topics
References
- Aged Care Quality and Safety Commission 2024, Draft Provider Guidance Standard 4, Australian Government, viewed 14 May 2024, https://www.agedcarequality.gov.au/resource-library/draft-provider-guidance-standard-4
- Australian Commission on Safety and Quality in Health Care 2019, Action 3.15 Workforce Screening and Immunisation, Australian Government, viewed 20 July 2023, https://www.safetyandquality.gov.au/standards/nsqhs-standards/preventing-and-controlling-infections-standard/infection-prevention-and-control-systems/action-315
- Australian Commission on Safety and Quality in Health Care 2023, Workforce Immunisation Risk Matrix, Australian Government, viewed 20 July 2020, https://www.safetyandquality.gov.au/sites/default/files/migrated/Workforce-immunisation-risk-matrix1.pdf
- Australian Immunisation Handbook 2021, Vaccination for People at Occupational Risk, Australian Government, viewed 20 July 2020, https://immunisationhandbook.health.gov.au/vaccination-for-special-risk-groups/vaccination-for-people-at-occupational-risk
- Better Health Channel 2022, Immunisations for Work, Victoria State Government, viewed 21 July 2022, https://www.betterhealth.vic.gov.au/health/HealthyLiving/immunisations-at-work?viewAsPdf=true
- Department of Health and Aged Care 2022, Immunisations for Health Care Workers, Australian Government, viewed 20 July 2023, https://www.health.gov.au/health-topics/immunisation/health-professionals/immunisations-for-health-care-workers
- Health.vic 2023, Vaccination for Healthcare Workers, Victoria State Government, viewed 21 July 2020, https://www.health.vic.gov.au/immunisation/vaccination-for-healthcare-workers
- Queensland Health 2019, Staff Vaccination Programs, Queensland Government, viewed 21 July 2023, https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/immunisation/healthcare-workers/staff-vaccination-programs
Test Your Knowledge
Question 1 of 3
A healthcare organisation does not have access to up-to-date vaccination records for all its staff members, but does have a workforce screening/ vaccination program in place. What is the organisation’s risk level in the event of an organisation-based outbreak of a vaccine-preventable disease?