Vaccine-preventable diseases

The first step is to identify if your workers could acquire a vaccine-preventable disease at work.

Inspect your business

Think about your place of work and make a note of where work processes and your work environment create a risk of vaccine-preventable diseases.

Talk to your workers

Talk to your workers to find out if they have any health and safety concerns. You could ask workers to complete a confidential survey. This allows workers who are less likely to speak out in public to provide feedback.

Review available information

Make sure that you have read all relevant legislation and codes of practice. Stay up to date with information about risks and hazards in the workplace. Read the Queensland Health occupational immunisation pages to stay up to date with the recommended vaccinations for your industry or occupation.

The How to manage work health and safety risks Code of Practice 2021 (PDF, 0.65 MB) outlines when you should do a risk assessment. You can use this risk assessment template (DOCX, 0.02 MB) to guide you and record your assessments.

To assess the risk, you should consider the following risk factors:

• if there are workers with no or unknown immunity to the relevant vaccine-preventable diseases at work
• if there are workers who are especially vulnerable to vaccine-preventable diseases at work, for example, workers who are pregnant, have a chronic medical condition or a weakened immune system
• if there are other people who are at risk from the spread of vaccine-preventable diseases at work, for example, patients, residents and infants.

Occupational immunisation programs

If workers are at risk of acquiring a vaccine-preventable disease at work, you should implement an occupational immunisation program.

An occupational immunisation program should:

• include an immunisation policy stating:
  • your workplace’s vaccination requirements
  • how you’ll manage workers who refuse vaccination or have a medical condition that makes vaccination inadvisable and those who fail to respond to vaccination
  • how you’ll protect workers in the period between vaccination and developing immunity to the infectious disease
  • how you’ll manage the risks to contract and labour-hire workers, students, volunteers, and others
• require at-risk workers to complete an immunisation record when starting work or seek medical advice to confirm their immunity or vaccination history if a record isn’t available, if it is lawful and reasonable to do so
• identify workers who don’t have immunity and encourage them to be vaccinated in line with the company’s immunisation policy
• provide workers with information about relevant vaccine-preventable diseases at work and the availability of vaccination.

If workers are responsible for arranging their own vaccinations:

• make sure they get vaccinated as directed
• maintain each worker’s immunisation record
• update the records after the worker has been vaccinated.

Up-to-date records can help minimise disruption to your business if there’s an outbreak of a vaccine-preventable disease. They’ll help you to quickly identify workers who have immunity and avoid unnecessary work exclusions or restrictions.

What do you do if a worker refuses to be vaccinated?

If a worker refuses vaccination, is unable to be vaccinated for medical reasons, or doesn’t develop adequate immunity following vaccination, you need to determine how you will protect these workers and others against infection.

This first step is to engage with the worker to understand their reasons for not wanting to be vaccinated. You should also talk about the options available to keep them safe.

The control measures you choose will depend on the specific vaccine-preventable disease and how it spreads. This may include:

• providing appropriate work placement and adjustment—for example, in early childhood education and care, place workers who have received the adult pertussis (whooping cough) booster to care for the youngest infants
• implementing work restrictions or adjustments where this is reasonably necessary to protect the health and safety of people at work—for example, restrict workers who don’t have immunity to a specific vaccine-preventable disease from:
  • performing at-risk activities
  • working in at-risk environments
  • having contact with vulnerable people or contact with people or animals infected with the disease

Seek medical advice as needed about work restrictions or adjustments for workers with no immunity to a vaccine-preventable disease

• reviewing work practices to ensure safe systems of work
• providing additional information, instruction, training and supervision
• providing personal protective equipment.

If a non-immune worker is potentially exposed to a vaccine-preventable disease at work, for example from a needlestick injury, make sure they receive appropriate first aid and medical advice about any treatment they may need.

If there is an outbreak of a vaccine-preventable disease at your place of work, you may need to exclude a non-immune worker, or implement appropriate work placement, adjustment, or work restrictions to protect the worker and prevent further spread of disease. Contact Queensland Health for advice about how to manage the outbreak.

Confirming immunity

Most vaccines provide a high level of protection, so confirming immunity after vaccination is usually not necessary. However, workers at significant occupational risk for hepatitis B should make sure they’re properly protected by having a blood test to confirm their immunity four to eight weeks after completing the course of vaccination. If the vaccination hasn’t been effective, seek medical advice—some people may respond to additional doses of the vaccine. Anyone who continues to not respond to hepatitis-B vaccination (a persistent non-responder) is not protected against hepatitis B and you will need to manage their risk of exposure.

Booster doses

Workers may require ongoing booster doses of vaccine to stay protected from some vaccine-preventable diseases. For example, people who work with bats or live lyssaviruses in laboratories should follow current guidelines for booster doses of the rabies vaccine. You should find out if booster doses of vaccine are required for any vaccine-preventable diseases at your place of work and seek medical advice as needed.

Animal vaccines

Some infectious diseases that spread from animals to people (zoonoses) can be prevented by vaccinating animals, for example, Hendra virus infection of horses and leptospirosis in cattle and pigs. Vaccinating animals against these diseases not only helps protect the animal but may stop the spread of infection from animals to people. If you work with animals, speak to your veterinarian about the recommended vaccines for your animals.

Infection prevention and control

Vaccination is one of the most effective ways to prevent infectious diseases. However, no vaccine is 100 per cent effective. A small percentage of people are not protected after vaccination. Also, not all infectious diseases can be prevented by vaccination. Putting a number of controls in place to prevent the spread of infectious diseases is also important to protect workers at work. The control measures you choose will depend on the specific infectious disease and how it spreads but may include hand hygiene, covering cuts and abrasions, keeping the workplace clean, waste management, safe handling and disposal of needles and syringes, and personal protective equipment.

Risk management should be an ongoing process in your business, and you should review your control measures regularly. You can read more about the circumstances when work health and safety laws require you to review your risk controls.