Immunisation is a targeted public health initiative to protect the individual and community. The Council currently is managing a number of cases involving the inaccurate administration of immunisations, so we wanted to shed some light on your responsibilities and where you can get further information.

 

Significance and challenges

Vaccinations are currently saving an estimated three million lives a year throughout the world and top the list in terms of preventing disease and death. In fact, it could be considered one of the top four developments in medicine of the last 150 years (alongside sanitation, antibiotics and anaesthesia) and is the single most significant public health intervention of the last 200 years.

Modern vaccines are one of the most cost-effective health interventions available. They provide high levels of protection against an increasing number of diseases and symptoms, as well as the disability and death that can occur from the diseases. Serious reactions to vaccines are rare.

Largely thanks to vaccination, a number of diseases have become scarce. However, partly because the devastating effects of the diseases are no longer so prominent, public attention has shifted focus to the possible side effects from vaccination. There has been a downturn in vaccination rates and outbreaks of disease and concerns about the safety of certain vaccines may have attributed to this.

Most of the arguments against vaccination appeal to parents’ deep-seated concerns for the health of their children, particularly very young babies. There are also unfounded allegations regarding adverse effects from vaccines.  

As an administrator of vaccinations, it is important to be aware of the associated concerns and to listen to the concerns of clients. You must provide accurate and factual, scientific evidenced based information, which enables patients or clients to make informed decisions. 

Learn more about the myths and the facts surrounding vaccination here.

 

Keeping up to date; know your responsibilities

If administering vaccinations is part of your role, it is crucial to understand your professional obligations. Under the Poisons and Therapeutic Goods Act 1966 and NSW Health policy directive, registered nurses or midwives must administer vaccines under the direction and authorisation of a medical officer. Unless you are a nurse or midwife who is an Authorised Nurse Immuniser and therefore are able to provide immunisation services without direct medical authorisation. 

 

How do you become an Authorised Nurse Immuniser?

The NSW HEALTH Policy Directive, Immunisation Services - Authority for Registered Nurses and Midwives, details the requirements for becoming an Authorised Nurse Immuniser, one of which is undertaking the Australian College of Nursing's (ACN's) course 

This course covers theoretical foundations, public health perspective, the immune system and vaccination, myths and realities, valid consent and other legalities, handling, storage and administration of vaccines, adverse events and health promotion.

If you administer or give advice regarding immunisation and vaccines, it is your professional responsibility to maintain and provide evidence-based practice, whether you are an authorised nurse immuniser or act under the prescription of a medical officer.

The Australian Government's Immunise Australia Program has a fantastic website and resource for health professionals. Here you can find the latest information regarding clinical updates, the handling and storage of vaccines, the delivering of immunisation and adverse events.

You can also download a copy of The Australian Immunisation Handbook. The Handbook provides clinical advice for health professionals on the safest and most effective use of vaccines in their practice and is based on the best scientific evidence available at the time of publication.

The NSW Health Immunisation Program web pages is a source of invaluable information. With direct links to the NSW Childhood Immunisation Schedule, fact sheets around vaccinations for specific diseases and contacts for NSW Public Health Units to seek further expert advice. 

 

Practice points

Common errors that the Council receive complaints about;

• Failure to store vaccines according to the cold chain - resulting in a call back of clients to receive another vaccine, increasing their concern and decreasing their trust
• Administration of the incorrect vaccine - resulting in additional vaccines for the client
• Administration of the incorrect dose - resulting in additional vaccines for the client
• Insufficient or inaccurate knowledge about the vaccine, its administration and follow up information
• Poor communication to the patients or parents, resulting in unnecessary anxiety and mistrust
• Failure to document or inaccurate documentation of vaccines given
• Increased concern or errors when the vaccine is related to travel and not on the Australian schedule

If you do make an error, it is always best to alert your manager, seek expert advice regarding action required, accurately document the error and actions to manage. Errors should also be reported to the local public health unit immunisation coordinator, who will advise if an adverse event form is required.