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4 Immunisation of special groups

4.6 Occupational and lifestyle risk

Certain occupations result in increased risk of contracting some vaccine-preventable diseases. Some infected workers, particularly health care workers and those working in early childhood education services, may transmit infections such as influenza, rubella, measles, mumps, varicella and pertussis to susceptible contacts, with the potential for serious outcomes.

Where workers are at significant occupational risk of acquiring a vaccine-preventable disease, the employer should implement a comprehensive occupational immunisation programme, including immunisation policies, staff immunisation records, information about the relevant vaccine-preventable diseases and the management of vaccine refusal. Employers should take all reasonable steps to encourage susceptible workers to be immunised.

The vaccines in Table 4.6 are recommended for certain occupational groups and in Table 4.7 for those with lifestyle risk factors. In addition to the vaccines listed below, all adults should be up to date with routinely recommended vaccines, such as MMR (see section 2.7 or Appendix 2).

If a non-immune individual is exposed to a vaccine-preventable disease, post-exposure prophylaxis and control measures should be administered where indicated (see the relevant disease chapters and the Communicable Disease Control Manual 2012).

Table 4.6: Recommended vaccines, by occupational group

Occupation Recommended vaccines
Health care workers  
Medical, nursing, other health professional staff and students Hepatitis B (if susceptible)
MMR (if susceptible)
Influenza, annually
Varicella (if susceptible)
Hepatitis A (if work with children)
Tetanus, diphtheria and pertussis (Tdap) (if work with children)
Individuals who work with children  
Early childhood education services staff Hepatitis A
Hepatitis B (if susceptible)
MMR (if susceptible)
Influenza, annually
Varicella (if susceptible)
Tdap
Other individuals working with children, including:
  • correctional staff working where infants/children live with mothers
  • school teachers (including student teachers)
  • outside school hours carers
  • child counselling services workers
  • youth services workers
Influenza, annually
MMR (if susceptible)
Tdap
Varicella (if susceptible)
Carers  
Health care assistants, long-term facility carers, nursing home staff Hepatitis A (if exposed to faeces)
Hepatitis B (if susceptible)
Influenza, annually
MMR (if susceptible)
Tdap
Varicella (if susceptible)
Emergency and essential service workers  
Police and emergency workers Hepatitis B (if susceptible)
Influenza, annually
Tetanus (Td or Tdap)
Armed forces personnel Hepatitis B (if susceptible)
Influenza, annually
MMR (if susceptible)
Tetanus (Td or Tdap)
Hepatitis A (if deployed to high-risk countries)
Meningococcal C conjugate or quadrivalent meningococcal conjugate (if living in close quarters)
Quadrivalent meningococcal conjugate, yellow fever, rabies, typhoid, Japanese encephalitis (as appropriate, if deployed to high-risk countries)
Staff of correctional facilities Hepatitis B (if susceptible)
Influenza, annually
MMR (if susceptible)
Staff of immigration/refugee centres Hepatitis B (if susceptible)
Influenza, annually
MMR (if susceptible)
Laboratory staff  
Laboratory staff Hepatitis B (if susceptible)
MMR (if susceptible)
Influenza, annually
Hepatitis A (if exposed to faeces)
IPV
Laboratory staff regularly working with Neisseria meningitidis Quadrivalent meningococcal conjugate vaccine
Individuals who work with animals  
Veterinarians, veterinary students, veterinary nurses Influenza, annually
BCG (if exposed to infected animals)
Zoo staff who work with primates Hepatitis A
Influenza, annually
Poultry workers and others handling poultry, including those who may be involved in culling during an outbreak of avian influenza, and swine industry workers Influenza, annually
Other individuals exposed to human tissue, blood, body fluids or sewage
Workers who perform skin penetration procedures (eg, tattooists, body-piercers) Hepatitis B (if susceptible)
Funeral workers, embalmers and other workers who have regular contact with human tissue, blood or body fluids and/or used needles or syringes Hepatitis B (if susceptible)
Sewerage workers, plumbers or other workers in regular contact with untreated sewage IPV
Hepatitis A
Sex workers Hepatitis B (if susceptible)
HPV

Table 4.7: Recommended vaccines for those with lifestyle risk factors

Lifestyle risk factor Recommended vaccines
Individuals living in hostels or other close quarters (eg, university hostels, boarding schools) Hepatitis B (if susceptible)
MMR (if susceptible)
Influenza, annually
Meningococcal C conjugate or quadrivalent meningococcal conjugate*
Individuals in correctional facilities Hepatitis B (if susceptible)
MMR (if susceptible)
Influenza, annually
Meningococcal C conjugate
Men who have sex with men Hepatitis B (if susceptible)
Hepatitis A
HPV
Intravenous drug users Hepatitis B (if susceptible)
Hepatitis A
Influenza, annually

* Quadrivalent meningococcal conjugate vaccine is recommended if future travel is likely.