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 places the student and people in their care at risk of transmission of these diseases. All students must therefore submit evidence of protection against 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. The best source of vaccination evidence is the Australian Immunisation Register. Other sources of vaccination evidence may include child health records, vaccination clinics, GP medical records and local councils. 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 vaccinations and all associated costs (Utas does however provide an influenza vaccination program free of charge each year).
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 protected 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 infection 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 difficulty breathing.
Transmission: by respiratory droplets through the infected person coughing and sneezing. The cough may last up to 3 months 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 protected through vaccination or previous recent infection.
Immunisation against Diphtheria, Tetanus and Pertussis
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 Protection against Diphtheria, Tetanus and Pertussis
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 protected 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. 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’.
AND
- The Hepatitis B declaration form must be completed by the student and witnessed by a Health Care Provider or an Authorised Nurse Immuniser. This must be attached to 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 protection.
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). Prior to completing any further placements, the students must have completed their full course of hepatitis B vaccinations and follow-up hepatitis B immunity serology, and be actively scheduling their booster doses (with input from CoHM immunisation staff), if required.
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 vaccination, 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 Australian Immunisation Handbook (online edition).
Students who have positive hepatitis B surface antigen (i.e. active hepatitis B) must complete the CoHM Safety in Practice Medical Declaration Form in conjunction with their health care provider.
Measles, Mumps and Rubella (MMR)
Measles is a highly infectious viral disease-causing generalised illness, with a distinctive rash.
Transmission: by respiratory particles. 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 the age of 12months 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 protected 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 and birth defects may occur.
At risk: anyone not protected through vaccination or previous infection.
Immunisation against Measles, Mumps and Rubella (MMR)
MMR vaccine is a combined vaccine. All students without documented evidence of 2 MMR vaccinations or serological evidence of protection against Measles, Mumps and Rubella are required to be vaccinated (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
- Serological evidence of protection (positive IgG) to measles, mumps and rubella (the rubella serology result must be documented as a numerical value and a copy of the serology report attached.
OR
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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 particles. 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 protected 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 varicella 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 varicella positive IgG OR
- Australian Immunisation Register (AIR) History Statement that records natural immunity to chickenpox
Tuberculosis (TB)
Tuberculosis (TB) is a bacterial infection that can infect any part of the body, with lungs the most common site.
Transmission: by respiratory particles 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
- 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.
NB: 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.
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 protected 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, or GP immunisation summary/list/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.
COVID-19
COVID-19 is an infectious disease caused by Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) virus. It affects people of all ages. Older adults and people with certain medical conditions have an increased risk of severe disease or death from COVID-19.
Transmission: COVID-19 is spread via respiratory droplets or aerosols generated through breathing, talking or coughing. Infection can also occur through contact with contaminated surfaces.
Complications: Severe COVID-19 can be fatal. A range of metabolic, cardiovascular, respiratory, immunological, and neurological complications have been reported following COVID-19. People can also suffer from “Long COVID-19”, consisting of various physical symptoms (e.g. fatigue, difficulty breathing, chest pain, cough, cognitive and psychological symptoms).
At risk: Anyone not protected through vaccination or recent infection. Those who are at higher risk of serious illness if they become infected include:
- older people
- people with chronic medical conditions, e.g. cancer, chronic kidney disease, HIV
- Pregnant women
Immunisation against COVID-19
An appropriate course of an Australian approved or recognised COVID-19 vaccine is strongly recommended for all College of Health and Medicine students undertaking PEP.
Evidence of COVID-19 Vaccination
- Evidence of the COVID-19 vaccine course should be provided at least 2 weeks prior the commencement of PEP. Acceptable evidence includes:
- Medicare Immunisation History Statement (full version or influenza/COVID-19 statement) OR
- GP records, pharmacy record, overseas vaccination records (legible and in English)
References
Australian Technical Advisory Group on Immunisation (ATAGI). Australian Immunisation Handbook, Australian Government Department of Health and Aged Care, Canberra, 2022, immunisationhandbook.health.gov.au.
NSW Health. Occupational Assessment, Screening and Vaccination Against Specified Infectious Diseases (Policy Directive, NSW Government, NSW, 2024, health.nsw.gov.au/pds/ActivePDSDocuments/PD2024_015.pdf.
