A jab or your job: the push on vaccines

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As the rules get tighter and COVID-19 takes hold of aged care facilities, workers in the health sector are finding resistance to vaccines could cost them their jobs. Mitchell Ryan reports.

Norma Peterson* is a Melbourne dialysis technician who works closely with patients undergoing intensive care.

Ms Peterson said she works with dozens of severely injured and often immunocompromised patients every day – but in spite of this – she is anti-vaccination.

The “anti-vaxxer” movement has gained momentum around the world in recent years and adherents, such as Ms Peterson, see mandatory vaccinations as a breach of their rights.

Laws mandating vaccines in Australia, such as the “No Jab, No Pay” policy – where some child care benefits and a family tax supplement are withheld for parents of children who are not vaccinated or exempt – have been strenuously opposed by activists.

However, the new Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Act 2020 (Vic), which took effect from March 25, makes vaccines compulsory for health care workers in the public system.

The Health Department can direct workers in public hospitals, “health service establishments” and ambulance services to prove immunity to specified diseases or get vaccinated.

The vaccines required include influenza, whooping cough, chicken pox, hepatitis B and measles.

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For those covered by the Act, workers who refuse the vaccinations can face restrictions on their work or redeployment or other consequences. Healthcare providers can face suspension, revocation of their registration and/or a fine if they don’t comply.

While Ms Peterson does not work in the public system, she is concerned that the Act sets a dangerous precedent.

It will “open the floodgates” and result in an influx in employees being sacked, she says. “We’re already seeing it happen overseas.”

In 2012, TriHealth, a large employer in the United States, terminated 150 employees who refused to comply with the company’s mandatory vaccination policy.

Some civil liberty groups and activists fear incremental changes in Australia’s vaccine laws and policies will ultimately make vaccination compulsory for everyone.

Private facilities such as aged care homes have begun implementing policies that require staff to be vaccinated. Non-compliance can result in job loss.

“I think it would be a horrible thing if people were made to choose between their job and their personal or religious beliefs,” Ms Peterson said.

Dr Holly Seale, infectious disease specialist at the University of New South Wales, said Healthcare workers needed to be vaccinated because hospitals and aged care facilities are susceptible to rapid infection spread, she said.

“These environments have a high concentration of individuals who are at increased risk of influenza related complications, including infants, the elderly and immunocompromised patients,” she said.

Since 2017 there have been 591 institutional flu outbreaks in the state, mostly in aged care facilities, according to the Australian Influenza Report.

Death from flu is also relatively common in that environment. In 2019 there were at least 105 deaths from flu in aged care homes in Victoria alone, according to Victorian Health Department data.

COVID-19 has also caused major problems, with 1838 active cases relating to aged care facilities as of August 11, according to the department.

Given the extent of these outbreaks and the vulnerability of the elderly to infection, the expected resistance to a potential coronavirus vaccine is especially concerning.

According to The Lancet, 14.2 per cent of Australians would elect not to receive a COVID-19 vaccination or would be “indifferent” to it. Resistance may also rise in line with the US and Britain, where likely rejection rates are above 20 per cent.

Dr Seale said vaccination was particularly important for health care workers because they have higher rates of flu and are more likely to be asymptomatic than other working adults.

Institutional outbreaks in hospitals and aged care facilities are common because staff often continue working while infectious, she said.

A recent survey of hospital and aged care facilities reported that more than half (54.8 per cent) had staff vaccination uptake rates of less than 50 per cent, according to the National Centre for Immunisation Research.

The new rules have not yet been tested in the Fair Work Commission or courts.

Professor Sean Cooney, employment lawyer and Associate Dean of Melbourne Law School said, employees who refused to comply with mandatory vaccines would be unlikely to be able to sue for discrimination or unfair dismissal.

It would not be seen as “harsh, unjust, or unreasonable”, he said.

Studies suggest anti-vaccination groups are becoming increasingly influential through social media. The number of people objecting to vaccines increased six-fold between 1999 and 2015, according to the Australian Immunisation Register.

Anti-vaccination groups were linked to groups propagating conspiracy theories, alternative medicine and speculation about COVID-19. They were found to be more influential on Facebook than pro-vaccine groups, according to the science journal Nature.

* Norma Peterson is not her real name