College of Health and Medicine students as well as Health Care Workers, are at a higher risk than the general population of having contact with vaccine preventable diseases. This place both the student and people in their care at risk of transmission of these diseases. All students must therefore submit evidence of immunity to the specified vaccine preventable diseases to the College of Health and Medicine Professional Experience Placement (PEP) Staff prior to PEP.
Students may have already received some or all vaccinations. Sources of vaccination evidence may include child health records, vaccination clinics, GP medical records and local councils. Students previously immunised in Australia may also be able to download their immunisation history from the Australian Immunisation Register. College of Health and Medicine students are required to upload their vaccination records into InPlace, together with relevant screening, serology and chest x-ray reports as appropriate. All evidence must be scanned into a single PDF file. All entries must be legible and in English.
Students are responsible for organising their own immunisations and all associated costs.
Diptheria, Tetanus AND Pertussis (dTpa)
Diphtheria is a contagious and potentially life-threatening bacterial infection, most commonly affecting the pharyngeal mucous membranes causing respiratory and eating difficulties.
Transmission: by respiratory droplets or fluid from the mouth, nose and skin. Infectious for up to 4 weeks from onset of symptoms.
Complications: diphtheria toxin, which is produced by the bacterial infection, can cause inflammation of the heart and may result in death.
At risk: anyone not immune through vaccination or previous infection.
Tetanus is a bacterial infection usually found in soil, animal faeces and dust. It causes painful muscle spasms.
Transmission: usually by injury and it is not spread from person to person.
Complications: toxin from the bacterial can attack the nervous system and may be fatal.
At risk: babies of mothers not fully immunised and older adults who have never been fully immunised.
Pertussis is a highly infectious, bacterial infection causing severe coughing bouts and apnoea.
Transmission: by respiratory droplets through the infected person coughing and sneezing. Cough may last for 3 weeks or more and severe coughing may lead to the ‘whoop’ sound or vomiting.
Complications: can be fatal in babies under 12 months of age.
At risk: anyone not immune through vaccination or previous infection.
Immunisation against dTpa
Diphtheria Tetanus and Pertussis are all combined into a single dTpa vaccine. All students who have not had an adult dTpa vaccination within the last 10 years will require a booster dTpa vaccination.
Evidence of Immunity to Diphtheria, Tetanus and Pertussis (dTpa)
Students must provide documented evidence, e.g.:
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Adult dose of dTpa vaccine within the last 10 years, listed on the Medicare Immunisation History Statement.
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Documentation of a dTpa vaccination on the Tasmanian Student Immunisation Record/NSW Vaccination Record, including the batch number of the vaccine.
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Serology, or tetanus toxoid or diphtheria/tetanus vaccinations ARE NOT ACCEPTED.
Hepatitis B Virus (HBV)
Hepatitis B Virus (HBV) is a blood-borne viral disease, causing liver infection.
Transmission: via blood or other bodily fluids entering broken skin &/or mucous membranes.
Complications: chronic hepatitis B infection, cirrhosis, and liver cancer.
At risk: health care professionals, injecting drug users who share IV needles, haemodialysis patients, people who are not immune through vaccination or from previous Hepatitis B infection.
Immunisation against Hepatitis B
All students should upload their Medicare Immunisation History Statement and hepatitis B immunity serology report to InPlace as soon as possible. Further advice will be provided by the College of Health & Medicine (CoHM) Senior Immunisation Advisors regarding the need for further hepatitis B vaccinations.
Evidence of Immunity to HBV
Students are required to provide evidence of a history of age-appropriate Hepatitis B vaccination AND Hepatitis B immunity serology.
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Evidence of a history of age-appropriate Hepatitis B vaccinations includes:
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Documented evidence of previous age-appropriate Hepatitis B vaccinations (Medicare Immunisation History Statement, GP Vaccination Summary, Child Health Record).
OR
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Where Hepatitis B vaccination records cannot be located a Health Care Provider must document on Tasmanian Student Immunisation Record/NSW Vaccination Record Card ‘confirmed verbal history of age-appropriate Hepatitis B vaccinations obtained from student’.
- In addition to the above, Hepatitis B declaration form must be completed by the student and witnessed by a Health Care Provider or an Authorised Nurse Immuniser. This must accompany the Tasmanian Student Immunisation Record/NSW Vaccination Record Card. This is only acceptable when all attempts to find Hepatitis B vaccination records have failed.
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Hepatitis B immunity serology is required at least 4-6 weeks after the Hepatitis B vaccination course. Only a NUMERICAL value on the serology report will be accepted. A surface antibody level ≥10 IU/L indicates immunity.
Tasmanian students only:
Students are able to attend their 1st PEP in the first year of their course once they have had at least the first 2 doses of their initial course of Hepatitis B vaccination (if required). Second year students MUST have completed their full initial course of Hepatitis B vaccination (if required) AND provided evidence of their Hepatitis B immunity serology results before they can attend PEP.
NSW students only:
Students are able to attend their PEP if they have received NSW Health ClinConnect Hepatitis B Clearance (either full or 6 months temporary compliance). Once the temporary compliance period has elapsed, full Hepatitis B clearance will be required.
NOTE: NSW Paramedic students must have completed the full course of Hepatitis B vaccinations (if required), including Hepatitis B surface antibody serology prior to attending their first emergency ambulance placement.
Non-Responders
If, after completing an age-appropriate primary course of Hepatitis B vaccinations a student is Hepatitis B Surface Antibody (HBsAb) negative (<10IU/L), further advice will be provided by the CoHM Senior Immunisation Advisors, in line with recommendations in the Australlian Immunisation Handbook (online edition).
Students who have positive hepatitis B surface antigen (active hepatitis B) must complete the CoHM Safety in Practice Medical Declaration Form.
Measles, Mumps and Rubella (MMR)
Measles is a highly infectious viral disease causing generalised un-wellness, with a distinctive rash.
Transmission: by respiratory droplets. Infectious before symptoms appear and for several days afterwards.
Complications: ear infection, pneumonia or encephalitis.
At risk: anyone born during or after 1966 who have not been immunised and babies under 12months old who have not had their first MMR vaccination.
Mumps is a viral disease primarily affecting the salivary glands causing fever, loss of appetite, tiredness and headaches.
Transmission: by respiratory droplets.
Complications: if infected after puberty, serious complications can occur- swelling of testes/ovaries, encephalitis or meningitis (rare).
At risk: anyone not immune through vaccination or previous infection.
Rubella is a viral disease, causing fever, rash, runny nose, conjunctivitis and swollen lymph nodes. Aching joints are also common, especially in women.
Transmission: by respiratory droplets and direct contact. Infectious before symptoms appear and for several days afterwards.
Complications: if contracted in early stages of pregnancy, miscarriage & birth defects may occur.
At risk: anyone not immune through vaccination or previous infection.
Immunisation against Measles, Mumps and Rubella (MMR)
MMR vaccine is a combined single dose vaccine. All students without documented evidence of 2 MMR vaccinations or serological evidence of immunity to Measles, Mumps and Rubella are required to be immunised (2 MMR vaccinations at least 4 weeks apart). As it is a live vaccine, MMR vaccinations must be administered 1 month apart from a Tuberculin Skin Test (TST) /Mantoux or IGRA. If other live vaccines are to be administered, then these must be administered either on the same day as the MMR vaccine or there must be a 4-week interval between live vaccines.
Evidence of Immunity to Measles, Mumps and Rubella
Students are required to provide documented evidence:
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2 MMR vaccinations at least 4 weeks apart,
OR
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Serological evidence of immunity (positive IgG) to measles and mumps AND a Rubella serology report with a numerical value ONLY,
OR
Born before 1966.
Varicella (VZV)
Varicella is a viral disease with a rash that usually begins as small lumps that later turn into blisters then scabs.
Transmission: in the early stages of infection, varicella is spread through coughing and respiratory droplets. In later stages of infection, varicella is spread through contact with the fluid from the blisters.
Complications: relatively minor in children but can be severe in adults and the immunocompromised causing pneumonia and inflammation in the brain.
At risk: anyone not immune through previous vaccination or infection.
Immunisation against Varicella
Students without documented evidence of varicella vaccination or no serological evidence of varicella immunity are required to have 2 varicella vaccinations at least 4 weeks apart. As it is a live vaccine, varicella vaccinations must be administered 1 month apart from a Tuberculin Skin Test (TST) /Mantoux or IGRA. If other live vaccines are to be administered, then these must be administered either on the same day as the VZV vaccine or there must be a 4-week interval between live vaccines.
Evidence of Immunity to Varicella
Accepted evidence of immunity to varicella include:
- If vaccinated under 14 years of age, 1 dose of varicella vaccination OR
- If vaccinated 14 years or older, 2 doses of varicella vaccination at least 4 weeks apart OR
- Serological evidence of immunity (positive IgG) to varicella
Tuberculosis (TB)
Tuberculosis (TB) is a bacterial infection that can affect any part of the body, with lungs the most common site.
Transmission: by respiratory droplets spread by the infected person coughing, sneezing or speaking.
At risk: anyone who was born or lived and travelled for more than 3 months in a country with a high incidence of TB, or those who have been in contact with anyone who has TB infection of the lungs or respiratory tract.
Tuberculosis Screening
Tuberculosis screening is only required if the jurisdiction-specific Tuberculosis risk assessment identifies the need for a student to have tuberculosis screening.
Evidence of Tuberculosis Screening
Students should ensure that if they have previously had a BCG vaccination it is recorded on their Tasmanian Student Immunisation Record/NSW Vaccination record Card.
- IGRA blood test – an IGRA blood is an acceptable tuberculosis screening method.
- Tuberculin Skin Test (TST) – TST results will only be accepted if performed by an accredited tuberculosis service within Australia.
Tuberculosis Clinical Review
A tuberculosis clinical review is required for all positive or indeterminate tuberculosis screening results. Contact CoHM Senior Immunisation Advisor for further advice regarding clinical review.
Influenza (FLU)
Influenza is a highly contagious viral infection causing fever,chills, cough, sore throat and runny or stuffy nose.
Transmission: by respiratory droplets through the infected person coughing and sneezing, or through touch, e.g.handshake. Spreads easily in small or crowded spaces.
Complications: pneumonia or heart failure.
At risk: anyone not immune through annual vaccination, but the elderly and small children are particularly at risk.
Immunisation against Influenza
The Influenza vaccine is adapted each year to meet anticipated strains of influenza. One Southern Hemisphere seasonal annual influenza vaccination is mandatory for all College of Health and Medicine students undertaking PEP.
Evidence of Annual Influenza Vaccination
Evidence of the annual influenza vaccination MUST be provided 2 weeks prior to 1st June each year using the
- Medicare Immunisation History Statement
- Other forms of evidence include Tasmanian Student Immunisation Record/NSW Health Vaccination Record Card, pharmacy/ hospital influenza consent form, GP immunisation summary/list/statement or statement. These other forms of evidence MUST include student name, date of birth, influenza vaccine name, vaccine batch number, date of administration, vaccinator name, signature and practice stamp/letterhead.
References:
COVID-19
COVID-19 is caused by SARS-CoV2, a new strain of coronavirus that has not previously been identified in humans. It was first identified in 2019, when it caused a large and ongoing outbreak. It has since been declared a global pandemic.
Transmission: Current evidence suggests that the main way the virus spreads is by respiratory droplets among people who are in close contact with each other.
Complications: COVID-19 can cause medium to long-term illness in some people. Most people experience mild symptoms and recover from the virus in under 2 weeks, however if people do develop long-term health impacts, symptoms most commonly persist for 2 to 8 weeks after infection. There have been reports that some people experience symptoms for over 12 weeks.
At risk: Anyone not immune through previous vaccination or infection. Those who are at higher risk of serious illness if they become infected include:
- people 65 years and older with chronic medical conditions
- people with compromised immune systems (e.g. from cancer)
- people diagnosed with chronic medical conditions
- people 70 years and older
- Aboriginal people with one or more chronic medical conditions.
Immunisation against COVID-19
An appropriate course of an Australian approved or recognised COVID-19 vaccine is mandatory for all College of Health and Medicine students undertaking PEP.
Evidence of COVID-19 Vaccination
Evidence of the COVID-19 vaccine course MUST be provided at least 2 weeks prior the commencement of PEP. The only forms of acceptable evidence are:
- Medicare Immunisation History Statement OR
- COVID-19 and Influenza (flu) Immunisation History Statement OR
- International students (who have had their COVID-19 vaccinations administered overseas) – in order for the vaccinations to appear on the Australian Immunisation Register (AIR) you must visit a health care provider in Australia who can access the AIR. They can manually enter the details of your vaccinations onto this register so that the vaccinations will appear on your Medicare immunisation History Statement (see help adding overseas vaccinatons) OR
- A Medicare or state-specific COVID-19 exemption form:
- Medicare
- Tasmania
- NSW
