Providers fear more COVID outbreaks as policies lag

Vaccine mandates for employees have been a huge challenge for aged care providers over the last six months, with those operating in multiple states or territories having to keep up with different and changing requirements.

With staff who had their vaccines in the first half of the year as part of the Government’s Group 1A cohort now eligible for booster shots, providers are again grappling with lagging policies and outdated health orders that place residents and staff at risk.

All states and territories have mandated COVID-19 vaccination in residential aged care through public health orders. The public health orders define which workers the mandate applies to and any limited exemptions that may apply, which vary from state to state.

Despite the Australian Health Protection Principal Committee (AHPPC) recommending a national framework for mandatory COVID-19 vaccination requirements for in-home and community aged care workers be established, the below summary shows the difference in mandates across jurisdictions:

 Residential CareHome and Community Care
ACTFrom 11.59 pm on 16 September 2021 a worker at a residential aged care facility must not enter or remain on the premises of a residential aged care facility in the Australian Capital Territory if they have not received at least one dose of a COVID-19 vaccination.  Both doses by 13 December 2021
NSWAt least one dose by 17 September, 25 October or 31 October 2021, depending on their job, and have had two doses of a COVID-19 vaccine by 25 October or 4 December 2021.Both doses by 29 November 2021.  
NT1st dose: by 17 September 2021
2nd dose: by 31 October 2021
1st dose: by 13 November 2021

Both doses: by 25 December 2021 
QLD1st dose: by 16 September 2021
2nd dose: by 31 October

Non-health service employees must have had the second dose, or a booking for the second dose, by 31 October 2021.

From 11 November 2021, a student cannot enter a residential aged care facility for placement, unless they are fully vaccinated.
By 15 December 2021 workers must have had the prescribed number of doses of the COVID-19 vaccine
SAFrom 17 September 2021, residential aged care workers and visiting medical and allied health professionals needed to have received at least one dose of a TGA approved or recognised COVID-19 vaccine and has received, or has evidence of a booking to receive, a second dose of a TGA approved or recognised COVID-19 vaccine within the interval after the first dose recommended by the ATAGI for that COVID-19 vaccine.

From 6 December 2021, a person is not permitted to enter or remain on the premises of a RACF unless they have received at least two doses of COVID-19 vaccine approved by the TGA, or, all dosages of a recognised COVID-19 vaccine in accordance with the dosage schedule recommended by ATAGI for that vaccine, unless exempt.
From 30 November 2021, in-home and community aged care and disability support workers must have received at least one dose of a TGA approved or recognised COVID-19 vaccination and received, or have evidence of a booking to receive, a second dose of a TGA approved COVID-19 vaccine within the interval after the first dose recommended by ATAGI for that COVID-19 vaccine.   
TAS1st dose or vaccination booking: by 17 September 2021
1st dose or vaccination booking:
by 30 November 2021 
VIC1st dose: by 1 October
Full dose: by 15 November
1st dose: by 29 October
Full dose: by 15 November
WA1st dose: by 22 September
2nd dose: by 17 November  
1st dose: by 1 December
2nd dose: by 31 December

With the exception of South Australia and New South Wales, most health directions have not specified vaccine requirements for residents or visitors.

In NSW, as of 30 November, residents are permitted to have two fully vaccinated visitors aged 12 years and over, plus two children aged under 12 years per day. Visitors aged 12 years and over must have received a second dose of a COVID vaccination at least 14 days prior to their visit and children under 12 years are only permitted to visit provided if accompanied by a fully vaccinated person.

At this point, no health directions refer to vaccine boosters, despite boosters having been available at the time that most directions were written or amended.

One frustrated provider who requested not to be named, said clearer directions are needed.

“Aged care is funded and regulated by the Commonwealth, yet each state and territory government has developed their own requirements for employee vaccination. This has created inconsistencies, confusion and frankly a minefield for providers with facilities in more than one state or in border towns.”

“The concern for us now is that we don’t know if we can require our staff to get booster shots or what the legalities would be around doing that. But those who were fully vaccinated back in March / April should be having them. We have these strongly-worded health directions that are already outdated and no clear way forward.”

“On top of this, we have easing travel restrictions in most states and a new strain of the virus. Some health officials have taken their directions a step further to include vaccine requirements for visitors, but again, unless that is mandated, it’s very difficult for our Admin people to enforce.”

“As we come into Christmas and more people coming and going from our facilities to see their loved ones, this perfect storm means it’s highly likely there will be more outbreaks in aged care.”

Is this causing concern in your organisation? If you have more to share about this, we would love to hear from you:

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