Workforce Immunisation for Healthcare Staff
Published: 27 July 2020
Published: 27 July 2020
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 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:
Health service providers are expected to establish comprehensive policies, procedures and protocols for workforce immunisation that outline:
The Australian Immunisation Handbook outlines the following recommendations for healthcare staff:
|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.|
|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).
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:
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).
|1 - 8||Low|
|9 - 16||Medium|
|17 - 24||High|
|25 - 28||Very high|
(All tables adapted from ACSQHC 2018)
The following strategies may help encourage staff to participate in annual influenza vaccinations and other vaccination programs:
(QLD DoH 2019)
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.)
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.
Question 1 of 3
Mark’s employer has decided to calculate his risk score for vaccine-preventable diseases using the workforce immunisation risk matrix. Mark has a proven history of vaccinations. His role puts him into contact with patients, but he does not come into contact (direct or indirect) with any blood or body substances. If exposed to a vaccine-preventable disease, he has no increased risk of disease or infection. Based on the above information, which risk category does Mark fall into?
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