Document Review

Timeframe for review:               Every three years, or earlier if required

Document authorisation:          Council of Advocacy, Practice and Partnerships

Document implementation:      Council of Advocacy, Practice and Partnerships

Document maintenance:           Department of Policy, Research and Partnerships

Revision History

1. Purpose and scope

ACEM recognises that immunisation against vaccine-preventable disease is one of the cornerstones of modern public health.

Emergency departments (EDs) frequently provide healthcare for populations at risk of being incompletely immunised. It should be noted that EDs are not resourced to be primary providers of routine immunisation, but opportunistic immunisations may be given to incompletely immunised patients who have limited access to other immunisation providers.

The policy is applicable to EDs in Australia and Aotearoa New Zealand.

2. Policy

EDs will support primary health and public health in the implementation and maintenance of immunisation programs.

ACEM recommends collaboration between public health authorities and hospital resources (including EDs) to ensure a cooperative and efficient approach to rapid community immunisation and urgent response to infectious outbreaks.

ACEM believes that EDs offer an important opportunity to vaccinate vulnerable populations1 that may be difficult to reach by other health services. The population benefit of this vaccination will likely outweigh any cost to the health system, especially during a pandemic.

ACEM recognises that in response to pandemics, EDs will require supernumerary and earmarked resources to rapidly immunise the vulnerable populations that attend. Such supernumerary resourcing should specifically support activities including:

• gaining informed consent from populations who are presenting for entirely different purposes and may, for various reasons including language, have a limited capacity to provide such consent;
• evaluating for any possible exclusions, for example around surgery;
• documenting the immunisation, including accessing and checking for any previous doses on the Australian Immunisation Register or NZ National Immunisation Register;
• administering the vaccine and ensuring logistically, for example through batching, minimised vaccine wastage due to compromisation of cold-chain integrity;
• observing the patient for the necessary time post-immunisation; and
• ensuring follow-up for any additional doses required, including arranging an appointment at a specific time and place, and informing the primary health care provider (should there be one).

The transition from an elimination strategy to mitigation of the effects of pandemic illness on vulnerable populations is a particular example where EDs, while not promoting themselves as primary vaccination centres, are well placed to offer opportunistic vaccination to some vulnerable patient groups and contribute to broader vaccination strategies.

ACEM recommends collaboration between public health authorities and hospitals to ensure adverse vaccine reactions are recognised and reported.

ACEM supports the immunisation of all ED staff to prevent transmission of vaccine preventable diseases. ED staff should be advised about the benefits of immunisation against vaccine preventable diseases and supported through their employer to ensure complete immunisation, including for influenza.