Vaccination Needed in Australia for Health Care Workers and Students

Courtesy of NSW Health

I haven't got the chance to write anything new lately as I was contemplating on the topic to share. As my husband was preparing his paper works for his bridging program, the topic (vaccinations) just seemed to be the right thing to write about. So let's explore the vaccination needed before undergoing clinical placement. (I am a certified nurse immunizer in Australia, so I deal with a lot of these). 

First thing that you need to understand is, vaccination in Australia is important before being employed in a health care setting. Even if you are just applying as a receptionist, or any position in admin or a student, vaccination history record is of utmost importance. New South Wales (NSW) is the strictest among the states and territories in Australia regarding this. Since I currently live in Western Sydney and there are a lot of students coming in the practice to have their vaccines sorted out, I seemed to have memorized the process. 

Here in Australia, the person that you have to see to have your vaccination stuff sorted out is a General Practitioner (GP), usually they liaise with a nurse immuniser or PHU if they need clarification. Unlike in the Philippines where in you see a specialist (Paediatrician) to have your vaccines administered when you were younger, here in Oz, you actually see a GP for all the medically related issues you have, that encompasses vaccinations. If they need to refer you to a specialist, they will do so. Only then, will you be able to see a specialist if they write a referral letter to your chosen specialist. So going back, the best thing to do is to actually bring your vaccination records, even if they were overseas vaccinations. It would give the GP a clear picture of what you have had in the past and where to go from there. 

The picture above depicts the vaccines needed before being employed in a healthcare setting or undergoing clinical placement. All of the vaccines recommended in the said picture is based on the Australian Immunisation Handbook 10th Edition. If you had vaccinations when you were younger, the first thing a GP orders is a blood test. The blood test includes serology testing for measles, mumps, rubella (MMR), varicella and hepatitis b. The results normally come back in 2 days. You need to go back and see your GP to get the results. The GP would then fill out the form, and determine if you need further vaccinations. 

For the Diptheria, Tetanus and Pertusis category, there is no serology testing for this. You will automatically need a vaccine if your last vaccination was 10 years ago. Some schools though would require you to have a booster shot of Polio (like my husband's school). You just then need to tell your GP about this. The GP would instead write you a script for Boostrix IPV or an Adacel Polio vaccine instead of the normal Boostrix and Adacel as the first two have the Polio component that you need. There is a shortage of the said vaccines at the moment in NSW and the Minister of Health is well aware of the problem. Just keep calling the chemists if they have the vaccine already. It's just a matter of waiting for the vaccines to be available.

For Hepatitis B, if your serology turns out to be zero, then you would need three doses of the Hepatitis B vaccines. You need to follow the vaccination schedule which is 0, 1, 6. This means you would have the vaccination now, then after a month then 6 months from the first dose. Another option is to go for the fast track method, which is 0, 1, 4, which means you would get the vaccine now, one month after and then 4 months from the first dose. Both methods require you to have a serology test a month after the final dose. The results would determine if you need further doses. The GPs normally write a script for Engerix B adult vaccine.

For MMR, sometimes the results turn out that you do not have any immunity to all of them and sometimes there is only one of the three you do not have immunity to. So for the first scenario, you just need 2 doses of MMR, one month apart. For the latter scenario, you need to have one MMR shot then come back in 4 weeks for a serology test. The GPs would either write you a script for MMR II or Priorix. Just keep in mind that an MMR is a live vaccine. 

For Varicella, if you do not have immunity to this, you also need 2 doses of Varicella vaccine, one month apart. The GPs normally would give you a script for Varivax or Varilix. This is also a live vaccine. 

You can have all the four vaccines in one go, there is no affectation in doing so (you will just have a sore arm for about a week). You need to let your GP sign off the vaccination record card and make sure they would stamp (official stamp) and sign or initial your card. If the nurse has given you the vaccine on behalf of the GP, they can sign off the card but, you still need to let the GP stamp and sign the card. 

For Tuberculosis screening, you need a referral from the GP to go to the nearest chest clinic from where you are currently living. You also need to call the chest clinic to schedule an appointment. If you previously had a live vaccine injection, you need to wait for 28 days before they can perform the Mantoux test on you. It would greatly affect the results if you had the Mantoux test and you did not inform them about your live vaccine injection. If ever you are positive or if the wheal is more the 5mm, then you need to have a chest X-ray. Do not worry, as they would tell you what to do and when to come back. They tell you to come back after 3 days to read the results of the Mantoux test. Just remember to bring your vaccination card as they need to sign it off too.

Again, I would like to reiterate the importance of having this sorted out before you undergo your clinical placement. The vaccines can get a bit expensive so make sure you have allotted money for this.