Immunisation of Educators within the early learning centre is an effective way to protect not only themselves but also the children within the service who may be vulnerable to vaccine preventable diseases.
Recommended Vaccinations For Educators
The National Health and Medical Research Council (NHMRC) recommends that all educators and other staff are immunised against:
Pertussis (Whooping Cough)
Whooping cough is a highly contagious infection caused by bacteria. It is spread through an infected person coughing or sneezing or through direct contact with secretions from the mouth or nose of an infectious person.
Unvaccinated staff should be excluded for up to twenty one days after the last exposure to the infection.
This is especially important for educators and other staff caring for the youngest children who are not fully vaccinated. Even if the adult was vaccinated in childhood, booster vaccination may be necessary because immunity to pertussis decreases over time.
Measles
An acute, highly infectious viral illness caused by a morbillivirus. Measles are spread through respiratory droplets from an infectious person during coughing, sneezing or direct contact with secretions from the nose or mouth of an infected person.
Unimmunised staff should be excluded until fourteen days after the first day of the appearance of rash in the last case. If unimmunised staff are vaccinated within 72 hours of their first contact with the case they may return to the service.
Mumps
Mumps are an infection of the salivary glands and are caused by a virus. They are spread through direct contact with droplets from a sneeze or cough of an infectious person.
Unvaccinated staff should be excluded for between twelve and twenty five days after exposure to the virus.
Rubella
Rubella is a mild illness caused by the rubella virus. It is highly contagious and is spread by droplets from the nose and throat through coughing or sneezing or by direct contact with an infectious person.
It is not mandatory for unvaccinated staff to be excluded however four days exclusion after first contact with the virus is recommended for the safety of staff.
For Educators born during or since 1966 who do not have vaccination records of two doses of MMR, or do not have antibodies against rubella varicella, for Educators who have not previously had varicella (a blood test is required to prove previous infection).
Hepatitis A
Hepatitis A is caused by infection of the liver with the hepatitis A virus. It is spread through the faeces of an infected person contaminating something which is transferred to another person’s mouth.
Unvaccinated staff should be excluded for up to two weeks after last exposure the virus.
Young children can be infectious even if they are not showing any symptoms.
Varicella (Chickenpox)
Varicella is an acute infection caused by a virus known as the Varicella Zoster Virus. It is spread through coughing, sneezing and direct contact with fluid inside blisters.
Exclusion of unvaccinated staff isn’t mandatory, however it is recommended for safety of staff.
Influenza
Influenza is very infectious and can spread through the air by coughing and sneezing, as well as by hands, cups and other objects that have been in contact with an infected person’s mouth or nose.
All staff should also consider having yearly influenza vaccinations.
Additional vaccinations are recommended for special categories of educators and other staff:
Hepatitis B
For Educators who care for children with intellectual disabilities. Although the risk is low, seek advice about hepatitis B immunisation if the children are not immunised.
Japanese Encephalitis
For educators and other staff who work in the outer Torres Strait islands for one month or more during the wet season.
- Educators who are pregnant or immunocompromised (i.e. have a weakened immune system) should seek advice from their doctor about vaccinations. Some vaccinations are not recommended during pregnancy, or if a person has a disease or is undergoing treatment that affects their immune system.
- Students who undertake vocational placements at early childhood education and care services are also at risk of exposure to diseases that are vaccine preventable.
- Tertiary and vocational education institutions that offer early childhood education and care courses should implement a student immunisation program for the relevant vaccinations (as listed above). Early childhood education and
care services should ensure that students undergoing vocational placements are
immunised.
Managing Vaccination Refusal
Educators who are not immunised place children - especially younger ones - at a greater risk of being susceptible to preventable diseases that are preventable by vaccinations.
Where workers refuse vaccination, are unable to be vaccinated for medical reasons, or do not respond to vaccination, management should undertake a risk assessment to determine the most appropriate way to protect Educators against infection, giving consideration to the way in which the infectious disease is spread.
Control measures may include:
- appropriate work placement and adjustment (e.g. consider placing workers who have received the adult pertussis booster to care for the youngest infants).
- review of work practices to ensure safe systems of work for infection prevention and control
- additional information, instruction, training and supervision
- personal protective equipment
In the event of an outbreak of a vaccine - preventable disease, it may be necessary to implement work exclusions, restrictions or adjustments to protect non-immune workers and prevent further spread of the disease.
Potential Consequences Of Vaccination Refusal
Educators should be advised of the potential consequences if they refuse reasonable requests for immunisation. These include:
- being restricted to working with children over 12 months old
- potentially having to take antibiotics during outbreaks of bacterial diseases that are vaccine preventable,
- even if the educator is not ill
- being excluded from work during outbreaks of vaccine-preventable diseases.
Employers should:
- develop a staff immunisation policy that states the immunisation requirements for educators and other staff
- develop a staff immunisation record that documents each staff member’s previous infection or immunisation for the diseases
- require all new and current staff to complete the staff immunisation record
- regularly update staff immunisation records as staff become vaccinated
- provide staff with information about vaccine-preventable diseases—for example, through in-service training and written material, such as fact sheets
- take all reasonable steps to encourage non-immune staff to be vaccinated.
Advice given to educators and any refusal to comply with vaccination requests, should be documented.
Who Pays For Vaccination
Vaccination costs should be negotiated between management and the Educators.
Vaccine uptake by workers is generally higher where management provides vaccination at no cost or at a subsidised cost.
Educators in early childhood services are more likely to be exposed to vaccine preventable diseases through contact with infectious children and their blood and body substances. Vaccination helps to protect Educators, their families and the children they care for.
References:
- Immunisation In Early Childhood Education and Care Services, Work Safe QLD
- Staying Healthy, Preventing Infectious Diseases In Early Childhood Education and Care Services, FIFTH EDITION 2012, © Commonwealth of Australia 2012
- Occupational Immunisations - Child Care Staff, Willoughby City Council