COVID-19 Advice for vaccine service providers

Introduction

The following recommendations are provided by the Queensland Department of Health in partnership with some of our key immunisation stakeholders to support vaccination services during the COVID-19 response.

We must all take steps to minimise the risk of COVID-19 transmission to staff and patients attending immunisation services. This document recommends procedures, based on current advice, to minimise that risk. Vaccine service providers will need to consider their specific operational processes based on staffing levels, physical layout of venues, fittings, resources, and patient numbers.

This situation is changing rapidly, and all information related to COVID-19 is being updated at Coronavirus (COVID-19)

Recommendation for provision of immunisation services

It is important to maintain high vaccination coverage levels to prevent outbreaks of vaccine preventable diseases in the community. All vaccine service providers, including general practice, community health and council run clinics should continue to offer immunisation services but with enhanced infection control measures.

Consider alternative models

Where possible, vaccine service providers should consider alternative models of providing immunisation services that are compatible with recommendations for social distancing.

Provision of “wellness clinics” could be considered. These clinics could involve allocating specific times each day/week during which well patients (especially older persons) could attend the premises for the purposes of being vaccinated without risk of contact with unwell patients who are potentially infected with COVID-19 or other infectious diseases.

Alternative locations for influenza vaccination clinics may also be considered if practicable, such as an outdoor area (e.g. practice car parks or other appropriate local community setting), or home visits for those identified as medically at risk. Conducting vaccination clinics in an alternative location could also include combining and sharing resources and staff with other practices in your local area.

Mandatory requirements for immunisation services

Mandatory requirements for immunisation services, including when implementing alternative models, are:

• Appropriate cold chain management.
• Access to adequate hand hygiene facilities and consideration of any enhanced infection control requirements.
• Establishment of processes to support social distancing (of at least 1.5 metres) particularly for pre-vaccination waiting and post vaccination observation areas.
• A screening process to exclude people who have acute respiratory illness. These people should be referred for medical review and/or testing.
• Measures to ensure vulnerable patients (elderly, those with pre-existing medical conditions, people of Aboriginal and/or Torres Strait Islander background) will not be exposed to people with respiratory symptoms.
• Measures to ensure patient and staff safety and comfort e.g. consideration of the weather and nearby traffic.
• Protocols to maintain confidentiality and undertake pre-vaccination assessments.
• Equipment for the appropriate management of sharps and waste.
• Equipment and medication and other facilities to manage adverse and emergency events.
• Systems to maintain vaccination records.
• Appropriate bathroom and break facilities for staff.
• Capacity and systems to message/communicate with patients.

Recommendation for venues

It is recommended that signage be displayed at the entrances of all vaccine service providers’ premises and larger community immunisation clinics. Such signage should include the following information:

• Due to the ongoing COVID-19 pandemic, we are taking measures to protect the community. It is vital that instructions are followed.
• Only one parent/guardian should accompany a child/children into the session.
• People should not attend the session if they or their child have signs or symptoms of a respiratory infection (such as fever, sore throat, shortness of breath or a cough), have had contact with a suspected or confirmed case or COVID-19 or have returned from overseas in the past 14 days and/or are under a quarantine notice.
• Wash hands or use hand sanitiser provided at the entrance to the reception or waiting area.

Consideration should be given to the translation of all signage and messaging into other key community languages, and to displaying an interpreter poster in the reception area so patients can see that interpreter services are available to help them with accessing services.

For people who have difficulties with reading, audio or video messages could be provided in relevant languages, and signage could include pictures and symbols to complement the text.

Staff considerations

Staff must not attend an immunisation service if unwell and, in the case of suspected COVID-19 infection, must not return to work until advised by a medical practitioner that they can do so.

If a member of staff is a health care worker and is a confirmed case of COVID-19, they must not return to work until they have been advised by a medical practitioner that they have met the requirements for release from isolation.

Any staff member who is a close contact of a case of COVID-19 will need to quarantine themselves as directed. Enquiries can be referred to the local public health unit.

If there are staff shortages, vaccine service providers will need to determine if an immunisation session can be undertaken safely.

Social distancing measures

Promoting social distancing is critical in preventing the spread of COVID-19. The following social distancing measures are recommended when delivering immunisation services:

General

• Vaccine service providers may need to consider moving vaccination services to larger spaced community venues.
• Consider longer immunisation sessions to implement procedures.

Pre-clinic preparation

• Send reminders to eligible patients that they can receive their vaccinations including the influenza vaccine and include advice that they should call in advance if they are not feeling well.
• Consider use of an appointment system for vaccinations.
• Ask patients not to arrive in advance of their appointment to minimise the number of people who are in the clinic.
• Ensure that a process is available to undertake a phone assessment and re-schedule the appointment if required.

Clinic set up

• Minimise patient movement through the clinic as much as possible.
• Make alcohol hand rub or hand washing facilities available at the entrance to your practice/clinic area and ensure patients use these on entry and before leaving.
• Arrange patient seating and queueing so that there is at least 1.5 metres between patients.
• Consider a separate room or monitored outdoor area for patients to wait post vaccination (dependant on numbers at each session).
• Allocate a staff member to monitor queueing. This is extremely important to ensure social distancing and maintain the order and flow into the administration area if multiple patients arrive at the same time. Options may include families waiting outside (if safe) or in their cars before and after vaccination (while monitored for an adverse event following immunisation), patients could be phoned when it’s time to come into the clinic.
• Ensure that seating and standing queuing areas meet the current recommendations for social distancing (at least 1.5 metres). If standing, mark each standing position with an ‘X’. If seated, chairs must be spaced appropriately to maintain social distancing and cleaned between use.
• Sit patients 1.5 metres from administration staff desk on check in and 1.5 metres from other patients at the nurse’s table (if applicable).
• Ensure administration, clinical and patient areas are wiped down frequently (and between patient encounters) using a sodium hypochlorite based solution, as per the COVID-19 cleaning and disinfection recommendations.
• Do not provide magazines or toys in the waiting room.

Vaccination process

• For childhood vaccination, limit the vaccine process to one adult with the child/children being vaccinated (unless there are extenuating circumstances).
• Encourage opportunistic vaccination of others present with the patient.
• Use a single printed page pre-immunisation checklist rather than a laminated version, with each patient receiving their own copy of the checklist.
• Use a separate pen supply for patients to sign their consent form, cleaning appropriately between use or ask patients to bring their own pens.
• Where possible, minimise physical contact with patient record documents.
• Encourage the person being vaccinated to turn their face away from the person administering the vaccination.
• Ensure that hand hygiene is performed before and after preparation and administration of the vaccine and between each patient (see The 5 Moments for Hand Hygiene).
• Use alternative entrance/exit (where available) to avoid patients walking through the administration area.

Post vaccination observation

• Please refer to the Australian Technical Advisory Group on Immunisation (ATAGI) ‘Statement on the duration of observation after vaccination in the context of minimizing risk of exposure to COVID-19 at health care facilities’.

Personal protective equipment (PPE)

PPE additional to that normally used as part of your routine immunisation service is not recommended.

More advice can be found on the department’s COVID-19 PPE information website.

Communication

Vaccine service providers should ensure that immunisation webpages, telephone messages and venue signage is updated regularly with COVID-19 information to ensure patients are aware of the expectations and changes that have been made to immunisation services. Communication should also consider the language needs of patients, including how to access interpreters and the availability of translated resources.

Further information and resources

For additional resources including translated materials and access to updated information about COVID-19, please go to Coronavirus (COVID-19)

For information related to changes to the Queensland Health Immunisation Program’s operations during the COVID-19 pandemic response, please go to COVID-19: Changes to Immunisation Program.