Skills and Qualifications needed to be an Agency Nurse

Vaccinations for Nurses – What’s Required?

June 21, 2024

Answering your questions about what vaccinations are required for nurses in Australia

“The science is in, and the medical experts’ advice is absolute – vaccinations save lives, and they protect lives, and they are an essential part of a healthy society.

Vaccination recommendations are determined by the likelihood of contact with patients, blood or body substances. Healthcare workers should receive the vaccines they require before or within the first few weeks of employment. The exception is the influenza vaccine, which is usually administered every year between March and May. Work activities, rather than a job title, should be considered on an individual basis to ensure each healthcare worker has an appropriate level of protection.

Medical facilities typically have a comprehensive immunisation policy for all healthcare workers, however, each worker should be individually assessed for specific vaccines, taking possible contraindications into account.

Work practices should include the use of standard and additional precautions to minimise exposure to blood and body fluids. And of course, if exposure does occur, follow your organisation’s guidelines for post-exposure prophylaxis.

What are the vaccination requirements for nurses?

Vaccination requirements for nurses and midwives differ from state to state throughout Australia, and sometimes from hospital to hospital. All medical facilities do have vaccination protocols and policies in place. As an example, to practice as a uPaged nurse, you must provide evidence of the Vaccinations/Serology for:

  • Tuberculosis
  • Varicella (Chicken Pox)
  • Measles, Mumps, Rubella
  • Diphtheria, Tetanus, Pertussis
  • Hepatitis B
  • Influenza Vaccine*
  • COVID-19

*Concerning the ‘flu vaccine, you must have been vaccinated within the previous 12 months. 

All medical staff (in fact, everyone) should be up to date with routinely recommended vaccines such as diphtheria-tetanus-containing vaccines, poliomyelitis vaccines and measles-mumps-rubella vaccines. Some other vaccinations may be required by your medical facility because of your position as a nurse and the potential for exposure. Vaccinations are often needed based on the type of work you will be undertaking.

All healthcare workers, including all workers and students directly caring for patients, or handling human tissue, blood or body fluids, are recommended to receive vaccines against:

  • hepatitis B
  • influenza
  • MMR (if non-immune — see Measles)
  • pertussis (dTpa [diphtheria-tetanus-acellular pertussis])
  • varicella (if non-immune — see Varicella)

In addition to the vaccines for all healthcare workers, the hepatitis A vaccine is recommended for:

  • healthcare workers who work in remote Indigenous communities or with Indigenous children in Northern Territory, Queensland, South Australia or Western Australia
  • other specified healthcare workers in some states or territories – Other specified healthcare workers in some jurisdictions

In addition to the vaccines for all healthcare workers, consider the BCG (bacille Calmette–Guérin) vaccine for healthcare workers who may be at high risk of exposure to drug-resistant cases of tuberculosis (depending on state or territory guidelines).

Tuberculosis (TB)

The preferred strategy for TB in Australia is appropriate infection control measures, staff education and a tuberculin skin testing program that identifies and treats the at-risk infected healthcare workers. (The Bacille Calmette-Guérin – BCG vaccine – has been controversial since its first use in 1921 because of its effectiveness and applicability. BCG vaccination is still considered an important strategy in the National Tuberculosis Programs of countries with a high burden of tuberculosis (TB) because of its benefit to infants but its effect on the control of TB has been limited. By contrast, in countries with a low prevalence of TB, significant policy differences exist both within and between countries.)

“TB is a droplet infection – it’s spread by air when a person with TB disease of the lungs or throat coughs or sneezes, speaks or even sings, and you are the unlucky recipient of their airborne particles sent from them, to you. (Eeewww!)

TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine. Symptoms include feelings of sickness or weakness, weight loss, fever, and night sweats. When TB affects the lungs, symptoms also include coughing, chest pain, and the coughing up of blood. TB is spread by air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. Treatment is by a combination of drugs taken over 6 – 12 months.

Pertussis

A booster dose (given as dTpa vaccine) is recommended for healthcare workers, particularly those working in paediatrics, maternity and neonatal settings. A booster dose of dTpa is recommended if 10 years have elapsed since a previous dose.

“Also known as whooping cough, Pertussis is a highly contagious respiratory disease, which usually begins with cold-like symptoms. The cough gradually worsens, and there may be bouts of uncontrolled coughing, which may be followed by vomiting, choking, or a gasping breath that causes a distinctive ‘whooping’ sound. Pertussis can affect people of all ages but can be very serious for pregnant women and babies less than a year old. About 1 in 125 babies in Australia under the age of 6 months with whooping cough die from pneumonia or brain damage. Treatment is by antibiotics.”

Measles/mumps/rubella (MMR)

MMR vaccines are typically required for all non-immune staff born during or since 1966. Serological evidence of immunity to measles is also acceptable. Those born before 1966 are considered immune. If in doubt, two doses of MMR vaccine a minimum of one month apart may be required.

“Highly contagious, Measles is spread by the droplets from when an infected person coughs and sneezes. (Yikes!) Symptoms include a red rash and fever. In some people, it can be very serious and can affect non-immune people of all ages. About 1 in 15 infected people get pneumonia, and 1 in 1,000 develops brain swelling. For every 10 people who develop brain swelling, between 2 and 4 people will develop a brain injury, and 1 will die. Measles has no treatment and usually gets better on its own.

““A highly contagious disease, Mumps is spread through contact with an infected person. Symptoms include fever and swelling of the face, and can affect people of all ages. Mumps has no treatment – most people get better on their own. Mumps can lead to inflammation of the brain (encephalitis); inflammation of the lining of the brain and spinal cord (meningitis); inflammation of the heart (myocarditis), and infertility.”

About 1 in 200 children with mumps will develop brain inflammation, which can be very serious. Mumps can also damage nerves, which can lead to deafness. For women in the first 3 months of pregnancy, mumps can cause miscarriage.

“Rubella: Rubella (also known as German measles) is a viral illness that causes a skin rash and joint pain. Rubella infection is mild for most people, but it can have catastrophic consequences for an unborn baby. If a pregnant woman contracts rubella, her baby is at risk of severe and permanent birth defects or death. About nine in every 10 unborn babies exposed to rubella during the first 10 weeks of pregnancy will have a major congenital abnormality. There is no specific medical treatment for rubella.

Varicella (chickenpox)

A history of chickenpox is strongly predictive of prior infection (>90 percent). Serological screening of people with no definite prior history of chickenpox (approximately 50 % of this group) will be susceptible. All non-immune nurses who have direct or indirect contact with blood or body substances should be vaccinated with the varicella vaccine. Two doses of vaccine at least one month apart are usually required for adults. A small percentage of people vaccinated (<5 %) will develop a rash after the vaccine. These people, and only these, should be reassigned to duties that require no patient contact or placed on sick leave for the duration of the rash.

“Chickenpox is a highly infectious, viral condition with a rash of small, red spots that later develop blisters which become intensely itchy. The only treatment is to relieve the symptoms. It can be spread either through close person-to-person contact, or through sneezing and coughing – just like a cold or flu. Later in the illness, the virus is spread by direct contact with the fluid in the blisters. Chickenpox infection triggers an immune response and people usually don’t get it twice. Pregnant women should be especially careful to avoid chickenpox since it can affect the unborn baby by causing fetal malformations, skin scarring and other serious problems.

Hepatitis B

Usually, three doses of paediatric formulation hepatitis B vaccine or 2 doses of adult formulation hepatitis B vaccine are given between 11 and 15 years of age, or three doses of adult formulation of hepatitis B vaccine are administered. Non-immune healthcare workers will require a course of three doses of vaccine, and until immunity status is confirmed, it is essential for all staff that have direct contact with blood or body substances.

“Hepatitis B is a contagious disease, spread by body fluids from infected people. Hepatitis B affects the liver, with symptoms including abdominal pain and dark urine. It is a serious disease that causes inflammation of the liver. Most people recover completely. Some people have long-lasting effects, which can lead to liver disease (including cirrhosis), liver cancer and death. People who are infected with hepatitis B when they are children are more likely to have serious liver disease later in life.”

Some people who have recovered from hepatitis B can still carry the virus, meaning they can pass the virus to others even though they don’t show any symptoms. There is no specific treatment for Hepatitis B.

Influenza

Three different types of influenza viruses infect humans – types A, B, and C. Influenza vaccine is required every year because the most common strains of the virus that cause influenza change every year. The vaccine also changes every year to match these strains. Flu is especially serious for babies, people over 65 years of age, and pregnant women. Healthcare workers are at increased risk of transmitting influenza in the healthcare setting and are highly recommended to receive their annual influenza vaccination. Free influenza vaccines are provided for all healthcare workers.

“Influenza is a potentially life-threatening illness and is a contagious disease of the respiratory tract caused by influenza viruses.”

For example, in August 2019, the Australian national death toll officially stood at 430, although the real figure was estimated to be much higher because some deaths were attributed to other causes despite flu-related complications.

COVID-19

COVID-19 vaccines are recommended for everyone 5 years and older to receive the best protection against serious illness or death. Healthcare workers face a higher risk of COVID-19 infection and illness compared to the general population and might also be responsible for the transmission of the virus to the vulnerable people in care. 

Healthcare workers’ support and uptake of the vaccine will also support higher uptake in the community. 

“Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. 

Most people infected with the virus will experience mild to moderate respiratory illness and recover without requiring special treatment. However, some will become seriously ill and require medical attention. Older people and those with underlying medical conditions like cardiovascular disease, diabetes, chronic respiratory disease, or cancer are more likely to develop serious illnesses. Anyone can get sick with COVID-19 and become seriously ill or die at any age.”

COVID-19 vaccination requirements vary for each state for healthcare workers: 

  • NSW: 2 Doses of a COVID-19 vaccine
  • VIC: Category A, B & C healthcare workers are required to have 3 doses of the COVID-19 vaccine
  • QLD: As of 25 September 2023 Queensland Health and Queensland Ambulance Service no longer mandate COVID-19 vaccination for employees, prospective employees, contractors, agency workers, students, and volunteers.*
  • TAS: There are no longer requirements under the Public Health Act 1997 for any workers to be vaccinated. Public Health strongly recommends that all eligible Tasmanians stay up-to-date with their COVID-19 vaccinations

Why do you need these vaccinations?

As a medical professional, the need for immunisations or vaccinations is threefold:

  • Nurses who are vaccinated are part of the general population and contribute to ‘herd immunity’

  • Nurses who are vaccinated assist in preventing the spread of disease in healthcare settings

  • Vaccination provides a level of protection to the health of nurses who are exposed to diseases in healthcare settings. This contributes to the prevention of work-related disease.

How often do you need these vaccinations?

It’s recommended that nurses maintain a routine vaccination schedule to the fullest extent (unless medically contraindicated). See our further information to learn more.

  • Influenza – annually
  • Hep B – One complete course
  • Tuberculosis – Vaccination or evidence of immunity (once)
  • Varicella – once (show evidence of immunity in serology)
  • Measles, Mumps & Rubella – once only
  • Diphtheria, Tetanus & Pertussis – every 10 years
  • COVID-19

Where can you get your vaccinations?

Some employers cover the cost of some vaccines such as the influenza vaccination. Some people working in high-risk occupations may choose to pay for vaccinations which are available at your local GP or medical centre.

What will these vaccinations cost?

Over and above what hospitals may cover for you, the Australian Government provides funding for several vaccines to be provided to Australians who have a Medicare number, at no cost. A consultation fee may also be charged by a GP or medical clinic in addition to the cost of purchasing the vaccines – so ask about what is covered by Medicare.

Vaccines covered by the national program are considered routine and a list can be found here.

What if you can’t / won’t get vaccinated?

If you can’t or won’t get vaccinated for diseases such as influenza, it should not impact your employability. However, your work practices may need to change. For example, if you can’t/won’t be vaccinated for the flu, you may be required to wear a mask while working with patients.

“NSW Health requires all workers to comply with the COVID-19 vaccination requirements of Occupational Assessment Screening and Vaccination Against Specified Infectious Diseases. All NSW Health Service employees are also required to comply with the Determination. If you do not meet the COVID-19 vaccination two-dose requirement or do not have an approved medical exemption, you cannot continue to work within NSW Health.”

Where can I get additional information?

Disclaimer: We are not vaccination specialists or immunologists nor are we doctors. The information in this blog is based on our experience as nurses, and based on the vaccination requirements uPaged hospitals require. Always check with your doctor for definitive advice about your specific situation.

Online resources

A range of information on required vaccinations is available online:

Next steps

When you have your vaccination requirements in hand, uPaged is here to help you to find the very best nursing role to suit your timetable, lifestyle, speciality, and career path. In the interim, sign up for our newsletter at the bottom of this page and follow us on socials.

A nurse’s perspective on vaccination

Looking for a nurse’s perspective on the flu vaccination? Read the viral Facebook post (at the end of this post) written by RN Beth Purkey in October 2019.

“Read RN Beth Purkey’s reply to a flu anti-vaxer’s post on Facebook in October 2019.

It went viral with good reason.

It’s pure gold.

“Welp, I went and did it. I read the comments on someone’s flu vaccine post and in the process lost 5,642 brain cells that I can never have back. I’m going to say this really clearly so that hopefully someone hears my voice louder than Lindsey the bartender who identifies as a ‘health wellness coach’ because she was “certified” by DoTerra essential oils company. At least I can sleep at night knowing that my friends (and whomever they share this with) heard the voice of an ACTUAL certified medical professional.

You cannot get the flu from the flu vaccine

You cannot get the flu from the flu vaccine. Ever. No matter what anyone’s told you. You CAN get an immune response such as low-grade fever, mild inflammation, or local redness and swelling. This is GOOD. It means your body is fighting the inactivated virus it’s been exposed to, and it will build immune cells specific to fighting that virus if it ever sees it again … hence the entire premise behind getting vaccinated. It takes your body about two weeks to build fighter cells and for the vaccine to reach its maximum protectiveness. If you get sick within a week or two of receiving the vaccine, then you were exposed to influenza and hadn’t yet received protection from your vaccine. Crappy timing. Period.

The vaccine does NOT cause strokes

It also doesn’t cause auto-immune diseases or severe allergic reactions. There is a very small percentage of people whose bodies do not react normally, and therefore those people should not receive the vaccine. Let me put it this way; I swell up like Violet in the Willy Wonka Factory if I eat avocado. I think we can all agree that avocados aren’t dangerous, my body is the problem, not the food. Likewise, the vaccine is safe, but like all things (even avocados), it can be dangerous for certain people. I cannot stress enough how rare this is, even though literally every online coach with a degree in alternative wellness claims to know someone it’s happened to.

If you’re healthy, good for you

No, seriously, good for you. You have the luxury of deciding whether or not you want to get poked. If you get the flu, you’ll miss a couple of days of school, maybe a week off of work and then you’ll return to your life. That’s not the case for many people in our community. When healthy people vaccinate, we protect the newborns and the grandparents and the chemo patients and the ones who truly cannot receive the vaccine. It’s called herd immunity, and it’s the cornerstone of a healthy society.

You did not get the “stomach flu” from the influenza vaccine

The stomach virus, commonly called the “stomach flu” is not the flu at all. Stomach viruses are commonly caused by norovirus or norovirus, not influenza. If you have symptoms such as vomiting and diarrhoea with a fever right after receiving the flu vaccine, you are the unfortunate recipient of a sad coincidence. This sad coincidence is not uncommon since peak seasons of these virus’ activity overlap. I know you don’t want that to be true, but … science. In that same vein, if you get “the stomach flu” in a year you’ve received the influenza vaccine, your vaccine did not fail. The vaccine you received does not protect against the stomach virus. Stay tuned though, vaccines for these viruses are all but guaranteed to be common in the coming years!

Other untruths, myths and conspiracies

  1. The drug companies and the CDC and all doctors and all nurses and everyone ever who advocated for vaccination are all paid by and/or brainwashed by big pharma to sell these vaccines by convincing others. Yeah … just no. I’ve never received a check or any other compensation from anyone to advocate for vaccinations of any kind.

  2. I don’t know a single person in the medical field (and I know a lot) who has ever received a bribe. I’m just about the most cynical, sceptical human out there and I require a lot of research & data to formulate my opinions, again, most of my colleagues are no different. If I really wanted to look out for number 1 (me) wouldn’t I try to drum up business at my ER by convincing others NOT to get the flu shots? Wouldn’t I WANT people to become sick so that I had job security?? $$ think about it people.

  3. This rationale is just ass backward. I advocate for vaccines because I’ve held a newborn with fever while the doctor does a lumbar puncture; because I’ve put a grandfather on a ventilator who couldn’t breathe, and because I’ve put the final drape over a mother of 3’s face after she beat breast cancer but died of the flu. I did all of this knowing full well that it was preventable. We had the ability to save those people as a society and we failed because of the Lindseys in this world that prey on people’s poor understanding and fear.

So, who are you going to trust on this one, me or Lindsey?

Source: Facebook – reprinted with permission and with big thanks to our new hero, Beth Purkey.

updated: June 2024

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