Occupational Assessment, Screening and Vaccination Against Specified Infectious Diseases – NSW Health Policy Directive update
The Ministry of Health has revised its policy directive on Occupational Assessment, Screening and Vaccination Against Specified Infectious Diseases, with the primary changes relating to the inclusion of COVID-19 vaccination requirements and amending its approach to influenza vaccination.
This amendment was in large part due to the previous COVID-19 vaccination requirement for health care workers, which was set out in the Public Health (COVID-19 Vaccination of Health Care Workers) Order 2022, ceasing on 19 June 2022. On that basis, vaccination requirements in health workplaces would now generally fall to organisational policies, as they have for other infectious diseases.
However, the underpinning requirement for all public health workers to have a minimum two COVID-19 vaccinations to be able to work in the NSW Health Service remains in place and legally enforceable via Determination No 33 of 2021 issued by the Secretary, NSW Health on 12 November 2021. This remains in place and will complement the revised PD.
The key points of the changes to COVID-19 and influenza vaccinations include the following:
- The previous Category A high risk has been removed. As a result, almost all nurses and midwives will now simply fall into Category A.
- All Category A workers will be required to have a third COVID-19 vaccination and a yearly influenza vaccination (remembering that having two COVID-19 vaccinations is a mandatory requirement for employment).
- Medical contraindications for either vaccination will continue to be managed as has been the case previously.
- Category A workers however who choose not to have the third COVID-19 vaccination and / or influenza vaccination can continue to work but they must comply with all risk reduction strategies identified whilst working in a Category A position and confirm that they are willing to do so.
- The exception to the above will be those Category A workers located in facilities with Commonwealth funded aged care beds or services. These workers will need to comply with the Public Health (COVID-19 Care Services) Order (No 2) 2022 which remains in place and legally requires staff to have had three doses of a COVID-19 vaccine.
Whilst the Ministry has provided an updated FAQ document on the revised PD, the Association has additionally prepared a specific set of FAQs on the changes relating to your COVID-19 and influenza vaccination requirements.
Why is the Ministry of Health changing its policy about vaccinations?
The previous COVID-19 vaccination requirement for health care workers was set out in the Public Health (COVID-19 Vaccination of Health Care Workers) Order 2022, but this ceased on 19 June 2022. On that basis, vaccination requirements in health workplaces (public or private) now falls to organisational policies.
Didn’t the Ministry issue something last year that required two COVID-19 vaccinations to be employed?
That is correct. The Secretary, NSW Health, issued Determination No 33 of 2021 on 12 November 2021, which required as a condition of employment two COVID-19 vaccinations. This remains in place, is legally enforceable, and will underpin any policy framework.
I work in a Category A high risk position. Will this continue?
No, the Ministry has removed this classification. This now leaves all health workers to be placed in either Category A or B roles. In short, Category A will likely encompass almost all nurses and midwives employed in public health.
What will be the Category A requirements for COVID-19 and influenza vaccinations?
Category A requires three doses of a TGA approved / recognised COVID-19 vaccine or two doses, with the third to occur within 8 weeks of the new PD being published if more than 13 weeks since the second dose or within six weeks from the due date of a third dose, whichever is the later. These workers will also be required to receive an annual influenza vaccination.
What about students on clinical placements?
Category A students will need to comply with the above requirements. However, in a clinical placement early in their first year, they may be granted temporary compliance if they have evidence of two COVID-19 doses, and submitted an undertaking to have a third COVID-19 dose within six weeks of the dose being due.
For Category A students, the influenza vaccination is mandatory if undertaking a placement between 1 June to 30 September each year (or other dates as set by the Chief Health Officer).
I work in an MPS with aged care beds. What are my obligations?
You must comply with the new PD and with all other legal requirements. This would currently include the Public Health (COVID-19 Care Services) Order (No 2) 2022 which is still in place. This requires staff to have had three doses of a COVID-19 vaccine.
What if I can’t have the vaccination due to a medical issue?
A health worker is compliant with the above requirements if they have a medical contraindication to all available approved or recognised vaccines, COVID-19 or influenza. Evidence is required to be submitted using the relevant Form and criteria, completed by your treating doctor / specialist.
Whilst I do not have a medical contraindication, I am not inclined to have either the third COVID-19 vaccination or influenza vaccination. What happens to me?
Category A workers who are non-complaint with the third COVID-19 dose or influenza vaccination requirements can continue to work but they must comply with all risk reduction strategies while working in a Category A position. Redeployment to a Category B position can be considered but will be by exception only.
As part of this process, you will be required to submit a Non-Participation Form acknowledging that you will comply with specified risk reduction strategies; and the use of designated PPE. If such an assurance is not provided, then you may be subject to disciplinary action, including possible termination of employment.
If that Public Health Order has expired, what about private hospitals and other health settings previously covered?
The organisation will need to establish its vaccination requirements within its own policies and procedures via the WHS framework. If opting to include vaccination, it will need to be able to demonstrate that it is necessary for the health and safety of the workplace, and all reasonable alternatives or other risk mitigation factors would not be sufficient or reasonable.
Does this apply in aged care as well?
As noted above, the Public Health (COVID-19 Care Services) Order (No 2) 2022 remains in place. All aged care staff, health practitioners and students entering a residential aged care facility must have had three doses of a COVID-19 vaccine. The third dose is due 13 weeks after a person’s second dose.