Aged Care COP – Immunisation in aged care webinar questions

[Carrie Spinks]

1. Can you confirm were we go to find latest info for NSW on vaccination requirements, particularly for staff, can we sign up for email updates? Two links below:
Occupational assessment screening and vaccination – FAQ
Immunisation programs NSW
= Occupational Assessment, Screening and Vaccination Against Specified Infectious Diseases: https://www1.health.nsw.gov.au/pds/Pages/doc.aspx?dn=PD2026_004
2. What’s your take on Blanket Consents
Blanket or standing consent does not meet the requirements for consent
Core Legal Elements of Consent
• Capacity: The person receiving the vaccine must understand the choice and what the procedure involves.
• Voluntariness: Consent must be given freely without force, pressure, or manipulation by others.
• Informed: The individual must understand the specific procedure, expected outcomes, potential side effects, and what happens if they refuse.
• Specific: Consent applies strictly to the discussed procedure and cannot be generalized broadly
Guidelines for Immunisation practice in local governments | health.vic.gov.au

3. Are vaccines mandatory for aged care staff (in community)? Based in VIC
= no The Directions apply to:
• public health services
• public hospitals
• denominational hospitals
• private hospitals and day procedure centres
• ambulance services
• patient transport services that are employed or engaged by a health service or Ambulance Victoria
• residential aged care services operated by a public hospital, public health service or denominational hospital
• Forensicare.
Definitions of the above settings can be found within the Health Services Act 1988, Ambulance Services Act 1986 and Mental Health Act 2014.
Some examples of settings which are not subject to the Directions include general practices, community pharmacies, private allied health clinics and disability services, unless they are operated by one of the settings listed above.

4. We’re getting more and more resident’s refusing vaccinations, especially COVID vaccinations. How do you suggest accomplishing more residents to accept vaccination?
= This is a challenging area, particularly given the community backlash associated with mandated COVID-19 vaccinations. We approach each vaccine individually and focus on the specific benefits to the resident.
It is also important to listen to and acknowledge any concerns the resident may have rather than dismissing them. Often, taking the time to understand their reservations and clearly explaining the differences between COVID-19 vaccination and other vaccines can help build trust and make residents more receptive.
Where relevant, explaining the type of vaccine being offered, including whether it is mRNA-based or not, can also help address specific concerns residents may have. The key is to have an open, respectful conversation so the resident feels informed and comfortable making their own decision.

5. Do we have to take every 6 months for Covid 19?
= This is aged (older person) and immunocompromised based. Staff unless immunocompromised do not require every 6 months. https://www.health.gov.au/our-work/covid-19-vaccines/getting-your-vaccination?language=en
6. Can Aged care provider access vaccines from the department and administer by their own authorized immunizer? Example in Tasmania?
= Yes
7. I know this is about residential care, but I would be interested in how you might suggest we do this in the community-based setting for staff and associated providers (an ? clients)
= clients will be GP led. Staff: consider having a vaccination clinic at the office with vaccine provider or if it is remote and staff do not attend an office – provide pharmacy vaccination voucher at established pharmacies that will bill to the organisation or involve local GP/pharmacist and organisation reimburse.
8. Do we have to take written consent every 6 months for Covid 19 in aged care? This is very hard
= this would depend on you consent process
o if consent is provided for the year and includes two COVID -19 vaccinations, you could simply undertake annually. If not, then consent would be required each time.
10. Do private aged care facilities required to report all as well
= they don’t have to report externally – but must have records of residents’ and staff vaccine uptake internally to demonstrate to Aged Care Commission auditors. Staff information on this is voluntary – but efforts to prove attempts to retrieve this information are required.
10. What’s your experience with co-administration? i.e., making the most of the vaccination opportunity where suitable.
I think co-administration is a great strategy. The key is to clearly document which vaccine was administered at which injection site, so that if an allergic or other adverse reaction occurs, the specific vaccine involved can be identified.
11. Do you think there is a role for immunisation nurses and aged care to improve the completion of a pre-assessment action plan for aged care residents for influenza – e.g. prior agreement to have Tamiflu treatment or prophylaxis
= Yes. Aged Care organisations used to do this – especially for dementia specific wings. Consent for Tamiflu obtained at the same time as the vaccinations annually. Note: Not all GPs as prescribers agree, however, and this affected the practice.
12. Do you think it will ever change for COVID to become yearly for residents in aged care
= not at this time; it’s been proven that the older population and those with immunosuppression benefit from an additional dose to the general population. The other evidence is that, especially in RACF, there is more exposure to people that is outside the residents’ control than there is in their own home. Visitors from other residents are a source of infection, as well as staff who would not be at a private residence.

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