Workforce screening and immunisation | Australian Commission on Safety and Quality in Health Care

Action 3.11
The healthcare service has a risk-based workforce vaccine-preventable diseases screening and immunisation process that: Is consistent with the current edition of the Australian Immunisation Handbook Is consistent with jurisdictional requirements for vaccine-preventable diseases Identifies and addresses specific risks to the workforce, consumers and patients.

Action 3.11

The healthcare service has a risk-based workforce vaccine-preventable diseases screening and immunisation process that:

Is consistent with the current edition of the Australian Immunisation Handbook
Is consistent with jurisdictional requirements for vaccine-preventable diseases
Identifies and addresses specific risks to the workforce, consumers and patients.

This action protects the workforce from vaccine-preventable infections and minimises the transmission of vaccine-preventable infections in a healthcare service. It requires a documented screening and immunisation process for the workforce, including those who refuse vaccination.

A Workforce Immunisation Risk Matrix (see Table 4) may be used to support healthcare services identify, evaluate and address risks that are relevant to the scope of the role and function of the members of the workforce. The risks for vaccine-preventable diseases may differ between healthcare services.

Table 4: Workforce Immunisation Risk Matrix

Risk of disease exposure	Workforce immunity/vaccination status and access to workforce screening
Risk of disease exposure	All members of the workforce have up-to-date records of their immune status/ vaccination history available AND A workforce screening/ vaccination program is in place	Up-to-date immune status/vaccination records are NOT available for all members of the workforce AND A workforce screening/ vaccination program is in place	Up-to-date immune status/vaccination records are NOT available for all members of the workforce AND A workforce screening/ vaccination program is NOT in place
No increased risk of exposure to disease or infection associated with working in the health service organisation	Low	Medium	High
Members of the workforce 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 risk	Risk is managed by routine procedures. There is minimal risk of harm or injury from the risk.
Medium risk	Risk is managed by specific monitoring or audit procedures. There is potential for harm or injury from the risk.
High risk	There is a serious risk that must be addressed immediately. Consequences to individuals and the organisation are high due to a high potential for harm or injury.
Very high risk	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.

Note: Vaccination programs should include catch-up vaccination, such as annual influenza vaccination.

Source: NSQHS Standards Workforce Immunisation Risk Matrix (ACSQHC, 2021).

Reflective questions

Key tasks

Develop a process to facilitate workforce immunisation for vaccine-preventable diseases. This process should
- identify specific risks to the workforce, consumers and patients, including prevalence of certain vaccine-preventable diseases and occupational risks
- specify recommended and/or mandated vaccinations for the workforce based on identified risks. Ensure requirements are consistent with the current edition of the Australian Immunisation Handbook and state or territory requirements for vaccination
- specify employer and employee responsibilities regarding immunisation
- outline additional risk mitigation strategies required where members of the workforce refuse, or have medical exemptions for specified vaccinations
- ensure employment agreements, policies, procedures or protocols specify recommended and/or mandated vaccinations.

Examples of evidence

The type and comprehensiveness of evidence used is dependent on each healthcare service context. The content and complexity of the policies and processes will likely depend on the size of the healthcare service, but could include:

List of recommended and/or required workforce vaccinations, including the rationale for inclusion
Evidence of employment agreements, policies, procedures or protocols that outline to both the employer and employee the responsibilities for managing occupational risks for vaccine-preventable diseases or immunisation requirements
Audit results or records of workforce vaccination compliance
Evidence of communication with prospective employees or the existing workforce about vaccination requirements
Workforce vaccination records.

Where to go for more information

Commission resources

NSQHS Standards Workforce Immunisation Risk Matrix – used by healthcare service organisations to assess their workforce for risks associated with vaccine-preventable disease transmission and develop actions to mitigate these risks.
The Commission: Infection Prevention and Control eLearning Module: Health workforce screening and immunisation for vaccine-preventable diseases.

Other resource

Australian Government Department of Health: Australian Immunisation Handbook – provides clinical guidelines for healthcare professionals and others about using vaccines safely and effectively.