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Unions challenge DHB on vaccination policy.

WAIKATO DISTRICT Health Board (DHB) has suspended four nurses "until further notice" because they are not vaccinated against influenza and have refused to wear respiratory masks. The DHB introduced a vaccination policy for its health-care workers in May this year. This requires staff to get vaccinated against influenza or wear respiratory masks

"while undertaking clinical duties or ... in a clinical area".

NZNO's DHB industrial adviser, Lesley Harry, said she had heard nine staff, including the nurses, had been suspended. "The five others come from midwifery and other staff groups."

NZNO and other health unions are working on a combined response to the DHB's policy. The unions have a number of concerns. These include lack of consultation; the policy is inconsistent with the education approach promoted by the national union/DHB bipartite action group (BAG); it discriminates against those who have a philosophical position on vaccination; there is no monitoring or control of visitors; and the DHB's approach is not fair or reasonable.

NZNO is representing the nurses, who have been suspended on full pay. It has also filed a dispute with the Employment Relations Authority on the grounds of flawed consultation, as has the Resident Doctors' Association (RDA) and the Association of Professionals and Executive Employees (APEX).

Harry said the nurses who had been suspended had made an informed decision regarding vaccination. "These are healthy, long-serving, experienced nurses who have chosen not to get immunised for their own reasons."

Consultation on the policy was very poor. "We put in a submission but were not told the policy was in place or informed of its implications, ie that not wearing masks could be a threat to people's employment," Harry said.

The DHB was taking a punitive approach, contrary to the national BAG'S guidelines on health worker vaccination. It is the only DHB threatening staff with disciplinary action or unpaid leave if they don't wear a mask. NZNO supported vaccination but not the DHB's punitive measures, Harry said. It is advising unvaccinated staff to wear masks as directed, to avoid disciplinary action.

The national BAG guidelines, developed with input from health experts, say vaccination is a public health issue and, while not the only mechanism, is the best method to protect against a range of vaccine-preventable diseases. "A positive health message is more effective than negative, consequential or threatening messaging or activity," according to the guidelines, which also state policies should promote education of staff.

Harry believes the DHB's policy is a one-way street. "If the DHB is genuine in its attempts to stop the spread of influenza, then everybody who is not vaccinated--staff, patients and visitors--should have to wear masks."

The suspension of the nurses had left their areas short staffed and had had a very negative impact on nursing morale, Harry said.

In a letter to the DHB about the policy, RDA national secretary Deborah Powell raises employment and human rights concerns. Requiring staff to wear personal protective equipment when the public did not have to defeated the purpose of the policy and "imposes an unreasonable burden (one might also say punitively so) on the employee".

The letter points out the policy is inconsistent with the national BAG guidelines and that the Human Rights Act 1993 prohibits discrimination on the grounds of illness, which includes "the presence in the body of organisms capable of carrying illness".

The letter said "any element of coercion, discrimination or mandatory treatment is an unconscionable exercise in this day and age; likewise the use of a position of power over employees to enforce vaccination uptake".

Harry said NZNO supported all the points raised in the letter. NZNO also has concerns about the efficacy of surgical or procedural face masks in preventing the spread of influenza. A 2010 American study showed the effectiveness of surgical masks was low, therefore the impact of wearing them during an epidemic was not significant. (1)

When Kai Tiaki Nursing New Zealand went to press, the DHB's director of nursing, Sue Hayward, had not replied to questions on the efficacy of masks, nurses' right to make informed choices on vaccination and the impact of the suspensions on nursing morale.


(1) Powell, D. (2015) Letter re Employee vaccination policy to Waikato DHB. Auckland: APEX, RDA, Medical Laboratory Workers Union.

(2) Tracht, S.M., Del Valle, S.Y. & Hyman, J.M. (2010) Mathematical modelling of the Effectiveness of Facemasks in Reducing the Spread of Novel Influenza A (H1N1). article?id=10.1371/journal.pone.0009018. Retrieved 31/07/15.
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Title Annotation:news & events
Publication:Kai Tiaki: Nursing New Zealand
Date:Aug 1, 2015
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