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We read with some concern the plans from the Ministry of Health to start COVID-19 vaccination of at-risk managed isolation facility (MIF), quarantine isolation facility (QIF) and frontline health workers “in the second quarter” of 2021.1

It will be the MIF and QIF employees who suffer the first occupationally acquired infections (and act as portals for community infection). Medical staff and healthcare workers (HCW) at the district health boards will meet the first unexpected infections placing them at risk of a potentially fatal occupational infection.

It is our opinion as practising occupational physicians working in, or with experience in, the healthcare sector that other protective interventions (eg, engineering solutions, work practices and personal protective equipment) will fall far short of the protective value of an effective vaccination.

The Health and Safety at Work Act (2105) requires “Persons in Control of a Business Unit” to take “reasonably practicable” steps to ensure the safety of those in their employ.

WorkSafe2 describes this as identifying the risks at work and their likelihoods; deciding what appropriate action is required given the potential seriousness of the illness or injury that may occur as a consequence of the exposure; and implementing “well known and effective industry practices”.

We argue that there is sufficient information about the infectivity of this agent and its potential lethality to make this a serious and significant risk to exposed staff, and that, given the workplace practices imposed on MIF, QIF and HCWs by the nature of their business, vaccination is the only effective risk-control vehicle.

We would urge an accelerated vaccination schedule for exposed MIF, QIF and HCWs as a national priority.

If there are to be delays in introducing COVID-19 vaccination to at-risk occupational groups, the Ministry of Health and WorkSafe would need to acknowledge in writing to the relevant employers that they are unable to fulfil their obligations under the Health and Safety at Work Act because of national policy, and then urgently review and reinforce the protective strategies in place in these at-risk workplaces. Vaccination for these priority groups will require inventive acquisition policies by the Ministry of Health.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Chris Walls, Occupational Physician Counties Manukau Health. Siobhan Gavaghan Occupational Physician Counties Manukau Health. Des Gorman Faculty of Medicine and Health Sciences, University of Auckland. David McBride, Associate Professor in Occupational and Environmental Medicine Department of Preventive and Social Medicine, Otago University.

Acknowledgements

Correspondence

Dr Chris Walls Occupational Physician Counties Manukau Health

Correspondence Email

chris.walls@middlemore.co.nz

Competing Interests

Nil.

1.      Ministry of Health [Internet]. COVID-19Vaccines. Available from: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-response-planning/covid-19-vaccine-planning17 December 2020

2.      Worksafe [Internet]. Reasonably practicable.Available from: www.worksafe.govt.nz/dmsdocument/848-reasonably-practicable

Contact diana@nzma.org.nz
for the PDF of this article

View Article PDF

We read with some concern the plans from the Ministry of Health to start COVID-19 vaccination of at-risk managed isolation facility (MIF), quarantine isolation facility (QIF) and frontline health workers “in the second quarter” of 2021.1

It will be the MIF and QIF employees who suffer the first occupationally acquired infections (and act as portals for community infection). Medical staff and healthcare workers (HCW) at the district health boards will meet the first unexpected infections placing them at risk of a potentially fatal occupational infection.

It is our opinion as practising occupational physicians working in, or with experience in, the healthcare sector that other protective interventions (eg, engineering solutions, work practices and personal protective equipment) will fall far short of the protective value of an effective vaccination.

The Health and Safety at Work Act (2105) requires “Persons in Control of a Business Unit” to take “reasonably practicable” steps to ensure the safety of those in their employ.

WorkSafe2 describes this as identifying the risks at work and their likelihoods; deciding what appropriate action is required given the potential seriousness of the illness or injury that may occur as a consequence of the exposure; and implementing “well known and effective industry practices”.

We argue that there is sufficient information about the infectivity of this agent and its potential lethality to make this a serious and significant risk to exposed staff, and that, given the workplace practices imposed on MIF, QIF and HCWs by the nature of their business, vaccination is the only effective risk-control vehicle.

We would urge an accelerated vaccination schedule for exposed MIF, QIF and HCWs as a national priority.

If there are to be delays in introducing COVID-19 vaccination to at-risk occupational groups, the Ministry of Health and WorkSafe would need to acknowledge in writing to the relevant employers that they are unable to fulfil their obligations under the Health and Safety at Work Act because of national policy, and then urgently review and reinforce the protective strategies in place in these at-risk workplaces. Vaccination for these priority groups will require inventive acquisition policies by the Ministry of Health.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Chris Walls, Occupational Physician Counties Manukau Health. Siobhan Gavaghan Occupational Physician Counties Manukau Health. Des Gorman Faculty of Medicine and Health Sciences, University of Auckland. David McBride, Associate Professor in Occupational and Environmental Medicine Department of Preventive and Social Medicine, Otago University.

Acknowledgements

Correspondence

Dr Chris Walls Occupational Physician Counties Manukau Health

Correspondence Email

chris.walls@middlemore.co.nz

Competing Interests

Nil.

1.      Ministry of Health [Internet]. COVID-19Vaccines. Available from: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-response-planning/covid-19-vaccine-planning17 December 2020

2.      Worksafe [Internet]. Reasonably practicable.Available from: www.worksafe.govt.nz/dmsdocument/848-reasonably-practicable

Contact diana@nzma.org.nz
for the PDF of this article

View Article PDF

We read with some concern the plans from the Ministry of Health to start COVID-19 vaccination of at-risk managed isolation facility (MIF), quarantine isolation facility (QIF) and frontline health workers “in the second quarter” of 2021.1

It will be the MIF and QIF employees who suffer the first occupationally acquired infections (and act as portals for community infection). Medical staff and healthcare workers (HCW) at the district health boards will meet the first unexpected infections placing them at risk of a potentially fatal occupational infection.

It is our opinion as practising occupational physicians working in, or with experience in, the healthcare sector that other protective interventions (eg, engineering solutions, work practices and personal protective equipment) will fall far short of the protective value of an effective vaccination.

The Health and Safety at Work Act (2105) requires “Persons in Control of a Business Unit” to take “reasonably practicable” steps to ensure the safety of those in their employ.

WorkSafe2 describes this as identifying the risks at work and their likelihoods; deciding what appropriate action is required given the potential seriousness of the illness or injury that may occur as a consequence of the exposure; and implementing “well known and effective industry practices”.

We argue that there is sufficient information about the infectivity of this agent and its potential lethality to make this a serious and significant risk to exposed staff, and that, given the workplace practices imposed on MIF, QIF and HCWs by the nature of their business, vaccination is the only effective risk-control vehicle.

We would urge an accelerated vaccination schedule for exposed MIF, QIF and HCWs as a national priority.

If there are to be delays in introducing COVID-19 vaccination to at-risk occupational groups, the Ministry of Health and WorkSafe would need to acknowledge in writing to the relevant employers that they are unable to fulfil their obligations under the Health and Safety at Work Act because of national policy, and then urgently review and reinforce the protective strategies in place in these at-risk workplaces. Vaccination for these priority groups will require inventive acquisition policies by the Ministry of Health.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Chris Walls, Occupational Physician Counties Manukau Health. Siobhan Gavaghan Occupational Physician Counties Manukau Health. Des Gorman Faculty of Medicine and Health Sciences, University of Auckland. David McBride, Associate Professor in Occupational and Environmental Medicine Department of Preventive and Social Medicine, Otago University.

Acknowledgements

Correspondence

Dr Chris Walls Occupational Physician Counties Manukau Health

Correspondence Email

chris.walls@middlemore.co.nz

Competing Interests

Nil.

1.      Ministry of Health [Internet]. COVID-19Vaccines. Available from: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-response-planning/covid-19-vaccine-planning17 December 2020

2.      Worksafe [Internet]. Reasonably practicable.Available from: www.worksafe.govt.nz/dmsdocument/848-reasonably-practicable

Contact diana@nzma.org.nz
for the PDF of this article

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