Government moves to make flu jab compulsory for residential care staff

There is broad support for a government initiative to roll out flu vaccinations to aged care workers, but provider peaks have called on the community to also ensure best practice is followed.

There is broad support for a government initiative to roll out flu vaccinations to aged care workers, but provider peaks have called on the community to also ensure best practice is followed.

In a joint statement on Sunday, Minister for Health Greg Hunt and Minister for Aged Care Key Wyatt said Australia’s chief medical officer Professor Brendan Murphy would look at ways to boost vaccination rates among residential aged care workers including making the flu vaccination compulsory.

The federal government proposal to vaccinate all aged care workers follows an increase in deaths this winter including several residents at two facilities in Victoria and Tasmania.

Additionally Mr Wyatt has instructed the Australian Aged Care Quality Agency to conduct an urgent review into these two facilities along with an examination of infectious disease management in all aged care facilities (see related story).

While providers have a duty of care to provide the safest possible environment for residents, there is no requirement for aged care workers to be vaccinated under law.

Mr Hunt said there could not continue to be this situation where people with already low immunity were at risk from others who may be infected.

The proposal to increase vaccination rates among aged care workers has been welcomed by the full gamut of peak bodies for aged care providers, seniors and doctors, with some supporting compulsory vaccinations (see below).

Australian Medical Association president Michael Gannon told The Sydney Morning Herald that it was “utterly irresponsible” for aged care workers to work without a flu vaccination, while noting the challenge in making it mandatory as an individual could not be compelled to have one.

Pat Sparrow

The provider peaks Aged and Community Services Australia and Leading Age Services Australia did not echo calls for compulsory vaccinations but both said they would work with government to improve measures to ensure as many aged care residents and staff as possible were protected from the spread of influenza.

They also said many aged care providers already encouraged staff to be immunised through workplace immunisation programs.

ACSA CEO Pat Sparrow said vaccination alone did not prevent the spread of infectious diseases and that other prevention measures were important.

“Common sense plays a part and, in the context of a close community environment such as a residential aged care facility, the most important thing is to stay away from a facility if you are unwell – something that applies to families, visitors, staff, and indeed anyone coming into contact with older Australians particularly vulnerable to the spread of infection,” Ms Sparrow said.

ACSA is now surveying its members to understand their views on mandatory flu shots for staff.

Sean Rooney

LASA CEO Sean Rooney said mandatory influenza vaccinations for the aged care workforce may be an important tool in a mix of measures to control an outbreak or risk of infection.

“As members of the community, it is vital that we be vigilant and exercise our ongoing responsibility to ensure that if we are feeling unwell and suspect we may have the influenza virus, we do not enter an aged care facility,” he said.

Support for compulsory vaccination

COTA Australia chief executive Ian Yates said he had been concerned for some time that rates of flu vaccination among aged care staff and doctors who visit facilities were “unacceptably low and inconsistent between facilities”.

He said aged care providers had a legal obligation to ensure residents lived in a safe environment, which should include ensuring that staff were not carriers of the flu virus into nursing homes.

“In some parts of the country health authorities have worked successfully to require that all staff are vaccinated, but this is not a universal requirement and it should be,” Mr Yates said.

National Seniors chief advocate Ian Henschke said the seniors advocacy group was surprised compulsory vaccination for aged care workers didn’t already exist.

“We support this move as common sense and life-saving,” Mr Henschke said.

GP peak body The Royal Australian College of General Practitioners (RACGP) recommended aged care staff have a flu vaccination.

RACGP acting president Dr Edwin Kruys said influenza vaccinations could be less effective for older people and that along with chronic illnesses and close living conditions meant aged care residents were at high risk of developing infections and consequently dying due to influenza and pneumonia.

“It is important to prevent people introducing the influenza virus into residential aged care facilities by vaccinating staff and healthcare workers and educating visitors to stay away when unwell,” Dr Kryus said.

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Tags: acsa, ama, Australian Aged Care Quality Agency, chief-medical-officer, cota-australia, flu-vaccination, greg hunt, Ken Wyatt, lasa, racgp,

15 thoughts on “Government moves to make flu jab compulsory for residential care staff

  1. Here we go again, an isolated problem occurs in the aged care industry and there is a knee-jerk action on the part of the Government, with legislation following forcing everybody in the industry to comply to the raised bar scenario.
    Compulsory flu vaccinations for all aged care workers isn’t going to stop another influenza outbreak that may see a small number of frail aged die. Flu shots may work with some people, but unfortunately not every one can be protected.
    Does this also mean that all visitors (family & volunteers) shall have to prove that they have been vaccinated against flu before being allowed to visit ?
    Above everything else, personal hygiene and thorough hand washing is paramount to resident safety.

  2. A close friend works in an aged facility. She seldom is ill and while those about her recently were dropping like flies, she just worked away. A mature woman, she dislikes vaccinations (with appropriate exceptions) and avoids antibiotics. We had this discussion recently as I missed my flu shot this year and didn’t get the flu either. I am happy to get my shot each year, I am a bit older than she. Point is: Would she be forced to get something she does not want? Can I visit her in jail for a conjugal visit?

  3. We all agree something needs to be done to avoid deaths from influenza etc, but again Aged Care is the headlines, knee jerk reaction, what about all the visitor’s that despite frequent requests, reminders and signs, continue to come up to visit residents when they are unwell with flu like symptoms or have looked after sick grandchildren with influenza, will they be forced to have flu injections. Nearly all aged care facilities make sure staff are aware of getting flu jabs, ensure that the cost is absorbed by the organisation.

  4. This is a horrendous idea. First, there is no conclusive evidence that vaccinating health care workers meaningfully benefits patients.

    For example:
    http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0163586

    Influenza survives on door knobs for 24-48 hours for god’s sake. Should hospitals be requiring all visitors, and patients, be vaccinated before coming? Do we really think that outbreaks in health care settings can be prevented when there is no hope of herd immunity in patient populations?

    Flu vaccine has serious problems that have (rightly) made it not part of the vaccination program. It is funded and targeted to the most vulnerable because that is when the benefits (specific to those vaccinated, and short term as they are) clearly outweigh the risks.

    1) Flu vax is pretty crap at preventing flu, protective for far less than one year (often only a few months).
    2) The choice of flu variants covered is often wrong.
    3) Getting flu vaccine regularly simply postpones susceptibility to those variants, while actually getting the flu results in 20+ years (often life) protection. In addition, getting the flu results in protection against dozens, sometimes (e.g. in the case of the swine flu) hundreds of related influenza viruses, while getting vaccinated does not confer any such cross-immunity.
    4) There is essentially no understanding of the risk of flu vaccine on influenza mutation, virility, and resistance (cf. pertussis mutation and resistance in response to acellular vaccine)

    The expected outcome of regular flu vaccination in the healthy is therefore increased morbidity later in life, when you need it most (i.e., you haven’t had the ‘common’ flus for decades, thus have no resistance to any of them or their relatives when you need it most).

    The only reason this is a hot topic now is because of the recent outbreaks in nursing homes that have killed residents. One reason for the harsh season that’s being considered is that this year’s vaccine isn’t covering the strains in the population (in which case mandated flu vax would not have helped any of these patients).

    Forced medication should have clear, and massive, expected net benefit. Flu vaccination does not fit the bill. For longterm health facilities like nursing homes, it makes far more sense to improve vaccination programs for the PATIENTS, not a forced increased risk of morbidity to healthcare workers.

  5. Also, given there is scientific papers that cast doubt into safety of the influenza vaccine, should a workplace, that wishes to abide to Health and Safety Laws, specifically for example in NSW Sect 19, be introducing into their workplace, a breach of this act? But let’s not quibble on the efficacy of the vaccine alone. Hunt, Gannon and now, Wyatt are the movers and shakers at this time, Sparrow, Rooney and Yates seem to more interested in infection control, Henschke seems to be with the minister and Kruys seems to be of the ilk of Sparrow, Rooney and Yates. OSHA, the US Work Health and safety overseer had the same thing to say a coulple of times that said the same thing. “The Occupational Safety and Health Administration (OSHA) is strongly supportive of efforts to increase influenza vaccination rates among healthcare workers in accordance with the Healthy People 2020 goals. However, at this time, OSHA believes there is insufficient scientific evidence for the federal government to promote mandatory influenza vaccination programs that do not have an option for the HCP to decline for medical, religious and/or personal philosophical reasons. While we are supportive of the Healthy People 2020 goal of a 90% vaccination rate, we have seen no evidence that demonstrates that such a high rate is in fact necessary. Furthermore, the current influenza vaccine is no magic bullet. The current state of influenza vaccine technology requires annual reformulation and revaccination and the efficacy is quite variable. Every year there are numerous circulating strains of influenza that are not included in the vaccine. In years where the antigenic match is good, the vaccine only provides protection against the 3 strains in the formulation. In years when the antigenic match is poor, the vaccine may provide no protection at all. The limits of current influenza vaccine technology are especially problematic in the context of a mandatory influenza vaccination program that results in job loss. Lastly, reliance on a mandatory influenza vaccination policy may provide healthcare workers, health care facility management and patients with an unwarranted sense of security and result in poor adherence to other infection control practices that prevent all types of infections, not just influenza. Influenza vaccination has always been just one part of a comprehensive multi-layered infection control program. While OSHA does not believe that there is sufficient evidence to meet the bar necessary to support mandatory vaccination programs, we nonetheless are convinced that influenza vaccination is generally beneficial and are supportive of efforts to promote vaccination. Influenza vaccination exemptions should be for HCP with valid medical contraindications to vaccinations, or religious and/or personal objections and a signed declination statement that indicates the HCP has been educated regarding influenza, is aware of the risk and benefits of influenza vaccination, has been given the opportunity to be vaccinated with the influenza vaccine at no charge, and can receive the influenza vaccine in the future at no charge to the HCP.” — not to mention continuous seasonal vaccinations with the vaccine can hamper CD8+ mediation. IMO I think the Minister has two things he needs to do. 1. Read the science and 2. get ready for a push back from the health care workers who understand the science and that will undermine his dogmatic attack of anyone who doesnt get a vaccine across society in General.

  6. Hey what ….I work in an aged care facility and yes Residents got the flu, but they were vaccinated! so what will be the benefit for me to be vaccinated? Only make the pharma companies a bit more richer?

  7. It is always difficult when someone passes – whether in a residential care facility or hospital, and media reports have shown influenza presentations to ED’s this year are at a record high. Yet all we seem to be hearing about is more command and control when it comes to aged care. We have recently been told not to send anyone to a hospital because they had such a high incidence of flu patients they were concerned for the elderly who might also catch it. Minister Wyatt, who talks often about consultation with consumers and the industry jumps straight to compulsory inoculation and increased pressure from the Quality [misnoma if there ever was one] Agency. The Minister might want to think about how much further this stretches the already shrinking dollar paid for the provision of what is regarded as the best quality aged care system in the world in spite of the continued reduction in real terms in funding. It is a good system not because of the uncertain Government funding but because of the dedication and heart of those who work within this industry. Minister there will be a time when the elastic band breaks. Like those who have preceded you I imagine you just want o make sure it’s not on your watch. Instead of making decisions in isolation in a knee jerk manner to be seen to be doing something, why don’t you do as you have indicated and talk to the consumers and industry and work out an approach we can all deal with. Aged care facilities do not create the virus, it is inevitably brought in and more often than not by visitors. How are your knee jerk reactions going to help with that? Could we please have a more mature conversation to find solutions that work.

  8. Hear, hear, Cap’n Dan. I too work in an aged care facility in administration so not directly with our residents on a daily basis. I am against having the flu vaccine and have not had the flu for many years. The lack of common sense by visitors who insist on entering the facility when they’re unwell, how do we police that? What about staff in direct contact persisting to work with a virus…can we direct them to go home without recrimination? Staff already have the jab fully paid for by the organisation. So many issues, yet the media focuses on anything BUT the problem at hand. How much more can we do?

  9. It seems that any and every cause of human suffering must have a perpetrator and a compulsory fix. At this rate the western civilization is going to be composed of robots who won’t do anything beneficial unless they are forced to do it. Are we going to see fines for people who don’t wash their hands on entry to hospitals and aged care facilities? I wouldn’t discount that. What about fines for jaywalkers, or people who read their emails while walking to work? Oh, wait, I think that’s happening! It’s wonderful living in a free country.

  10. And while we’re at it, why not legislate mandatory hand washing and basic infection control procedures?

    Simple precautions and fundamental hygiene practises will always be more effective than a hit and miss vax program.

    Better include every family member, visitor, GP and passer-by too…in fact, let’s just crop-dust the entire continent and implement a 24 hour curfew from May to October.

    Good luck with that

  11. I think that the idea is a bit too quick off the mark. Given that there are many visitors to residential venues and the proposed strategy seems to “blame” staff. I think a broader approach including looking at infection control — including visitors etc would be a more sensible approach.

  12. Yes, there are some points of note here.Please consider the members of our community who are immune suppressed, babies and children, our elders in care who may suffer Influenza strains.

    Yes, infection control education for the whole community is paramount.

    People who are sick with flu stay home and recover.Don’t spread these viruses by attending workplace and school.Family, friends can drop off needed supplies even grocers home deliver.

    I never used to worry re the Influenza vaccination, until I became very ill with the flu and under the care of five Physicians.I was off for 3 months.I now have my yearly vaccination and have not had Influenza since 1994.

    There are many health care workers,who are allowed to work part time at multiple hospitals and nursing homes.Once upon a time it was standard practise that that you were not allowed to do this . There needs to be changes to the Health Act to ensure better Infection control. We all need to help reduce the spread of this virus.

  13. I jave never had the flu shot nor the flu except for maybe swine flu a number of years ago. I now work in Aged care as a PCA and also do cobtract work . It is amazing how visitors and staff still insist on coming to visit and work with possible symptoms.
    Gor me, the big concerns are staff and contractors visiting multuple sites. I can visit facility A, leave and next day visit Facility B and no one reports that Facility A (after my visit) may have an infection concern and I may not have developed any symptoms yet. If I know I have possibly been exposed, I contact the next site and tell them amd they rightly ask me not to come in.
    Unfortunately it is hard for visitors to be expected to stay away under some conditions like end of life but use ppe and hyheine ( although not always effective) and at the end of the day, it is part of having someone in a facility. In short, facilities need to keep staff and contractors informed that they may have been exposed.

  14. Its a no brainer, PEOPLE ARE DYING, for goodness sake we are working in an industry where we are supposed to care but staff don’t care enough to have a vaccination to prevent deaths. If the facility doesn’t offer the injection then it is tax deductable. So the argument of cost is rubbish. People just love to create drama and play the victim when really the victims are the residents we care for.

  15. I have worked in aged care for 10 years. I have never had the flu in my life. I was forced from work to have the flu vac 7 years ago, it made me so sick. That’s the only time iv had the flu vac and the only time I was seriously sick. I enjoy my job, but if the flu vac becomes mandatory I will be forced to get up Aged Care

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