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Should staff be vaccinated?

Some occupations carry a definite risk of contracting particular diseases.
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Should staff be vaccinated?

Should staff be vaccinated?

30 July 2019

The horrors of smallpox, polio and a host of other vaccine-preventable diseases are things most of us no longer need to experience or witness, thanks to the advent of modern, community-wide vaccination programs. You’d think it would be a no-brainer, to protect people from the ravages of painful, debilitating diseases. But instead, the chorus of naysayers has made vaccination one of the most hotly-debated issues of our time. So what course should employers steer, amidst such a free-for-all?


Opponents of vaccination cite all sorts of reasons for their resistance, from worry about side effects through complacence or religious objections to simple fear of a jab in the arm.

One thing is for certain: some occupations carry a definite risk of contracting particular diseases. For example, people who have to deal with other people’s blood or body fluids or sewage face the risk of blood-borne diseases including HIV-AIDS and some forms of hepatitis.

People in regular contact with animals may be exposed to Q fever, a disease suffered by cattle, that can be passed to humans. Q fever is only one of many illnesses that can pass from animals to humans, though only some are vaccine-preventable. And laboratory workers may be exposed to heaps of nasty disease-generating organisms including rabies, typhoid and yellow fever.

Most controversial are teachers and childcare workers, who can be at real risk from children who have not been vaccinated against diseases such as varicella (chicken pox) or rubella (German measles). Unvaccinated children who contract such diseases can be highly infectious for several days before symptoms appear, so can inadvertently infect pregnant female staff with viruses that may cause birth abnormalities or disadvantages such as blindness or deafness in their unborn children.

The important point for employers to recognise, therefore, is that the risk of occupational disease should be taken very seriously.

Employers’ obligations


An employer’s duty of care means that reasonably practicable measures should be taken to manage work-related health risks, including diseases employees (or contract staff) might be exposed to in the course of their work.

Health departments advise that if workers have a significant occupational risk of acquiring a vaccine-preventable disease, the employer should implement a comprehensive occupational vaccination program. This program starts with a vaccination policy that sets out the aims of the program, the organisation’s position on managing vaccine refusal, keeping current staff vaccination records, giving staff information about relevant vaccine-preventable diseases and encouraging non-immune workers to receive the recommended vaccines.

In some sectors, other people’s health and wellbeing depends on an effective vaccination program – for example, to reduce the risk of an unvaccinated worker transmitting a disease to vulnerable people in clinics, childcare centres or aged care facilities.

Employers should take all reasonable steps to encourage non-immune workers to receive the recommended vaccines, especially if they are working with children, or in emergency and essential services, or with specific at-risk communities.

Recommendations for the various occupational groups that should be vaccinated – and the diseases from which they need protection – are listed on the Australian Department of Health’s website at https://immunisationhandbook.health.gov.au/vaccination-for-special-risk-groups/vaccination-for-people-at-occupational-risk.

Of course, vaccinations programs are not the only strategy for managing work-related health risks. Other precautions to be taken depend the nature of the risk and the circumstances of potential exposure. For example, people exposed to blood and body fluids should adopt preventive measures such as proper handling and disposal of sharps, wearing gloves when handling body fluids and using goggles or face shields if splashes are likely.

Legal requirements for vaccinations


Employers should also make sure they are aware of any particular legal requirements that apply to their workplaces in relation to vaccinations. For example, operators of childcare centres or primary schools in some jurisdictions are not legally permitted to accept children who are not fully vaccinated, even where the child’s parents refuse to vaccinate their child.

Managing vaccination refusal


If an employee’s refusal to participate in a vaccination program is believed on reasonable grounds to raise a serious health risk to anyone, employers should assess the risk according to the particular circumstances of the work situation, taking into account how diseases are spread. Decisions regarding risk control should be based on such risk assessments. All relevant options for risk control should be considered, in addition to vaccination.

Strategies that may help reduce the risk where an employee refuses vaccination (or cannot be vaccinated for medical reasons) include reviewing work practices to ensure systems of work are best practice in terms of infection control, providing extra information, instruction, training and supervision, and using personal protective equipment. In some organisations, there may be scope for adjustments to work placements (eg in a childcare centre, allocating the care of the youngest infants to workers who have received the adult pertussis – whooping cough – booster).

If an employer believes that making vaccination a condition of employment is essential for effective risk control, legal advice may help to determine the legitimacy, consistency with anti-discrimination legislation, and any risks associated with such a policy, in the particular circumstances.
 

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