industry & policy
implemented in combination with strict criteria for exemptions
and the wearing of surgical masks during the influenza season for
those granted these exemptions.”
Aged Care Insite spoke with Booy about the way mandatory
vaccinations would be surveilled and the difference the move
would make to infection rates.
ACI: Why has the Immunisation Coalition been advocating for
this move?
RB: We’ve been saying this now for some years, because it’s been
very clear that in hospitals and age care facilities the uptake of
flu vaccination by health staff is far from optimal. Indeed, in most
places it’s under 50 per cent. There are exceptions in Victoria, but
that’s only achieved through a lot of effort.
Why are mandatory vaccinations the way to go versus
programs that offer incentives or further education campaigns
targeting healthcare workers?
Mandatory
flu vaccine
A group of immunisation experts has again
lent its weight to the push for mandatory
healthcare worker vaccination.
Robert Booy interviewed by Dallas Bastian
T
he Immunisation Coalition, which advocates for whole-
of-life immunisation, says flu shots should be mandatory
for all care, allied health and ancillary staff members and
their employers to protect themselves and the vulnerable people
in their care.
Professor Robert Booy, director of the Immunisation Coalition,
says although some voluntary healthcare worker vaccination
programs have been effective when combined with strong
institutional leadership and robust educational campaigns, the
rates of influenza vaccination among healthcare workers in
Australia remain suboptimal, ranging from 16.3 to 58.7 per cent.
In September last year, the ministers for health and aged care
announced a move to make the flu jab compulsory for aged
care staff.
Health Minister Greg Hunt said the government will investigate
ways to make the flu vaccine compulsory for these workers
following the deaths of seven elderly residents at St John’s Village
in Wangaratta, Victoria, and reports of fatalities from flu at the
Uniting AgeWell Strathdevon aged care facility in Tasmania.
The government recently announced mandatory provision of
flu vaccines for all residential aged care providers. However, the
Immunisation Coalition would like compulsory flu vaccines for all
workers in all healthcare settings.
Booy said: “We support the development of a formal national
guideline that positions vaccination as a condition of employment
when working in patient contact roles. This condition should be
Well, for many years, in fact, decades, I thought we could
achieve good results with explanation and example, but it just
doesn’t work. Year after year we’ve seen far from good uptake
of vaccination.
What happened last year in nursing homes in Australia was that
there were probably hundreds of flu outbreaks and hundreds and
perhaps even thousands of deaths.
In order to improve the chance of controlling and preventing
flu outbreaks, having staff vaccinated at a very high rate will stop
them from being vectors, it will stop staff from catching flu and
spreading it around a nursing home.
The Immunisation Coalition also supports the development
of a national standardised system of vaccination surveillance
across all healthcare systems. What should that look like? How
do you see the change to mandatory vaccination taking place?
Well, we’ve outlined already that sometimes people can’t be
vaccinated, and for those people there should be the opportunity
to wear a mask when they come to work. But whether you’re
working in a hospital or an aged care setting, you are placing your
patients at risk if you bring an infection into your institution, so
mandatory approaches require as a matter of one’s service, one’s
job, that you either have the vaccine or you can’t work in that
position or you wear a mask.
Many people argue that aged care facilities – and hospitals
to an extent – are open communities in which family and
friends visit. What would you say to those who feel the move
won’t make a significant reduction to influenza rates?
There is evidence available already that the higher the rate of
flu immunisation, the lower the rate of breakthrough outbreaks.
Essentially, there is always uncertainty about the benefit of
any intervention, but I think there is sufficient certainty and
sufficient evidence to support the measure. It’s not based on
a large randomised control trial, but I think it is supported by
scientific evidence.
Have you received any feedback from community members or
healthcare workers about this topic?
Most people agree that we need to do something. Most
people agree that the taking of more responsibility by
healthcare workers – be they doctors, nurses or therapists – is
a good idea. ■
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