industry & reform
Some states have vaccine mandates and some don ’ t . Do you think we need a federal mandate like we have for aged care workers ? It ’ s important again to look at the vaccine setting pre-COVID here in Australia . We ’ ve had mandates for flu vaccination that vary across the states and territories . This includes vaccines for conditions such as the measles , mumps , rubella , diptheria , tetanus and hepatitis . We also have variation to do with flu vaccination .
If we stay in the current situation and the vaccines continue to do what they ’ re doing , and we get the vaccine rates , I think it ’ s unlikely that we will see a mandate introduced at a federal level for hospitalbased or primary care-based health workers . Instead , I think we will continue to see states and territories do their thing and implement this .
In the past , mandates have worked very well . Not surprisingly , they get vaccine coverage up very high , and certainly the research literature that has mapped the introduction of flu-based mandates in the US and elsewhere has shown that in most situations .
COVID , of course , is a very different beast , and it has thrown us a curve ball in a way that we ’ ve never seen . We acknowledge that the introduction of a mandate has to be done under a different timeframe and a different kind of setting . But still , in any kind of clinical setting , there has to be assurances that all of the other known strategies have been used to promote vaccine coverage and uptake .
So that means making sure that the access is there , that we make it as easy as possible for people to either get it onsite or offsite and to record the vaccine coverage . Making sure that there are opportunities for one-on-one conversations if people have ongoing concerns . Making sure the resources are there . Making sure all of those other elements are ticked . Then we move to this space of , are we still seeing a proportion of staff who have not received it ? Do we understand what ’ s happening amongst that group ? If we ’ ve done that , then we are moving into this mandate space .
It is really important , again , that health settings do this in conjunction with health workers . So they have the voice of the health workers on committees , they have union reps , they have people from colleges , all of the other stakeholders that will be there to communicate about the mandate , to support its introduction , and
10 | nursingreview . com . au have the potential then to really pass on information about why this mandate has now been introduced .
If we do this , based on what we know , we will lose some staff members , and that has to be acknowledged . We ’ ve got to make sure that they have been given opportunities , and all of those relevant touch points to go through before that termination occurs .
But what we ’ re seeing in the media is this kind of sentiment that we will get hundreds of staff members rushing out the door because of COVID . I don ’ t see that coming to fruition here . I think we need to be mindful of that language . We don ’ t want to lose any staff members , but we also respect that there will be some staff members who don ’ t want to receive the vaccine . And so labelling them , and the kind of sentiment I ’ ve been seeing on social media is like ‘ good riddance , they shouldn ’ t belong in health ’.
That ’ s not helpful to anyone , and we don ’ t want to get to finger-pointing at staff who decline the vaccine and move away , because in the US we ’ ve seen that many of those health workers have become the face of some of the social media campaigns to try and encourage people not to get the vaccine .
We ’ ve got to be mindful that any healthcare worker is seen as being respected and should be listened to because of their position and their background . But if they ’ re putting out messages and misinformation about the vaccine that ’ s not true , then certainly , we ’ ve got to try to avoid that . So no finger pointing , no negative comments on social media . We need to avoid all of that .
Are punitive measures against healthcare workers who post vaccine misinformation online the best way to approach this ? Stopping people and threatening them , I suppose , is the ‘ sticks ’, and we ’ ll always have sticks approaches in these public health emergencies . Instead , connecting with these people , maybe through a trusted intermediary , might be a better way to go . Instead of the hospital coming down with the stick approach , having a trusted colleague or someone within your own department or ward be the go-to person may help better with these staff members . This is , again , empowering people to do peer-to-peer education and to try and highlight that personal stories and conversations amongst colleagues
“ We don ’ t want to get to finger-pointing at staff who decline the vaccine and move away .
may have a lot of influence right now .
The patient voice is also important . What are their expectations ? I would go into a clinical setting acknowledging that the staff members there would have received the COVID vaccine . We know that when outbreaks occur in clinical settings , that it may be the staff , it may be patients , it may be family members . So again , we can ’ t point a finger that it ’ s a staff member necessarily who ’ s introduced COVID , but we want to reduce that risk as much as possible .
What are some things we need to keep in mind in the future to avoid stirring up this social divide ? I think I ’ ve spent the whole pandemic saying to the media , ‘ Please stop using photos of needles , because it doesn ’ t help ,’ and I ’ m still seeing photos of needles going into arms ; needles that are totally inappropriate . There ’ s only so much you can do . If there ’ s a lesson learned , and it ’ s around social media , say , certainly I would love to see more activity around misinformation and around how we approach misinformation .
What role do hospitals and other health facilities play in trying to reduce that risk ? I think I ’ d love to see a lot more breaking down of silos . We ’ ve had lots of action in some communities around trying to bring health workers and GPs into community forums to have conversations , and certainly I think that has proved very successful .
I think there ’ s some really important lessons to be learned about how we can support community-based immunisation . And I certainly think there are some lessons to be learned around how do we communicate and tailor our programs within clinical settings too , to enhance staff vaccination going forward ?
We ’ ve got to be careful here , because we may hit a bit of fatigue around talking about immunisation and around thinking about next year ’ s flu programs , say , where we ’ ve come off the back of a very low season . We are going to have in the next couple of years quite challenging conversations going forward about what vaccines are going to be needed and when and why . ■