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Right to choose or duty of care? A workforce view of COVID vaccine mandate

Earlier in the week, the Federal Government announced it's making it mandatory for all staff working in aged care to be vaccinated for COVID-19. The mandate sparked many responses, some are in favour, others against.

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Aged care workers are required to be vaccinated against COVID-19, leaving some people to choose between their job or their right to choose. [Source: Shutterstock]

When the Government implemented the influenza vaccination as mandatory for aged care just after COVID-19 came to Australia's shores, not everyone supported their decision and some workers left the industry. 

A recent survey of members of the Australian Nursing Federation in Western Australia showed that a third of aged care workers in the State said they would leave the sector if the COVID-19 vaccine was made mandatory.

We asked different people working in the sector how they're feeling about this mandate.

No vaccine? Not the industry for you

*Kiki, an Assistant In Nursing (AIN) and Team Leader at an aged care facility in New South Wales, took the opportunity to get her COVID-19 vaccine at her nursing home when she heard there were leftovers from the older resident's vaccination program.

For Kiki, getting vaccinated is a no brainer as she wants to protect the older people in her facility.

"People are saying, if it is mandated, I'm leaving. Well maybe you shouldn't have been in the industry in the first place, it means you haven't actually dedicated yourself to the job or the position," says Kiki. 

"I feel blessed to be able to work with the elderly because I actually learn more from them than anyone else around me. They have lived a life before us. We are meant to look after them, we are their advocate, we are by their side. I would hate to bring COVID into my facility and hurt people. I couldn't live with that."

Kiki explains that getting a job in aged care already comes with a lot of blood tests and medical checks to make sure you are safe to work in aged care, and if you have low immunity in one area, for example like hepatitis, you have to get a vaccine.

She is upset to see other aged care workers not wanting to get vaccinated, she says she assumed that others in the industry entered it for the same reason as she did, to protect one of Australia's most vulnerable groups.

Kiki believes when you sign up to be an aged care worker, you essentially make a pledge that you will do everything in your power to protect the vulnerable people in your care, which now means getting the COVID-19 vaccine.

"To me personally, I was going to do everything to protect these elderly, no matter what. If that means having vaccines, then I am happy to do it. I know other aged care nurses think differently, but I think when you are in this industry, it is not about us, it is a bigger picture," explains Kiki.

She adds that she can understand people's point of view about not knowing how the vaccine may affect you in 10 years, however, she points out that people smoke and have poor eating habits knowing that it will affect them negatively in 15 years time, but they still do it.

Leaving the workforce

Stacey* has been working in aged care for over 12 years, however, after mandatory COVID-19 vaccinations were announced she is looking to exit the industry she has spent a large portion of her career in.

She is disappointed with the Government's decision to mandate vaccinations for aged care workers as she believes it takes away workers' right to choice when it comes to health care.

Stacey has concerns about the long term effect of the COVID-19 vaccine and says there is no data covering the efficacy of the vaccine and the effect on health over a longer period of time.

"We have older residents who have made the decision to not get vaccinated but yet the people that are caring for them have had that ability of choice taken away from them. It just doesn't make sense. It's absolutely rubbish," says Stacey.

"What about the 300 odd people that walk through the facility every day? And that is a conservative number. People coming into the facilities, like family or volunteers, don't have to be vaccinated. I could call for a plumber to come in and they don't need to be vaccinated. And we don't know where these people have been, but they don't have to be vaccinated?

"To ask an underpaid and overworked workforce to make a choice between their job security and their long term health is unfair."

When the flu vaccination was made mandatory for all aged care staff, some people chose to leave the sector. However, Stacey believes the comparison between the Influenza vaccine and COVID-19 vaccine isn't on par because the flu vaccine has been tried and tested over a number of decades compared to the COVID vaccine.

"I do think there will be people leaving the sector because of the mandatory COVID-19 vaccine. This is not just front line staff, this could include payroll staff that have never worked with an older person in their life but happen to work in the office building of an aged care facility, who now has to get the COVID-19 vaccine," says Stacey.

"And replacing the workforce is not the issue we are going to face. We can replace them. But the quality of workers we will be hiring, because COVID-19 vaccines will be mandatory to be hired, will greatly reduce if we are just hiring any old Tom, Dick or Harry who are vaccinated. We will lose experienced workers."

Prior to the announcement of mandates, the facility where Stacey works did a survey of their staff and whether they would be thinking of exiting the sector if the COVID-19 vaccine was made mandatory. Out of the nearly 150 staff at the facility, half of the workers indicated that they may leave and according to Stacey her facility is not the only one to be facing this issue.

The organisation is now looking at how to support any workers who want assistance leaving the sector, which Stacey points out is above and beyond what other facilities would be able to afford.

A nurses duty of care

Nurse of 37 years and Facility Manager at Bethanie Gwelup Aged Care Home in Western Australia, Sue Whitten, has said that getting the vaccine is a part of her duty of care towards her residents.

Ms Whitten was unsurprised that the COVID-19 vaccine was made mandatory by the Federal Government.

She finds it interesting that there is anti-COVID vaccine and mandatory vaccination discussion among aged care workers when it is pretty common for all who work in the sector to keep up on health regulations.

Ms Whitten recalls her university days where she says it was mandatory to be vaccinated against an array of different diseases.

"When I was a student, to keep my patients in my care safe, it was my duty of care as a health care worker to individuals. I find that a little odd if you look at it as that. It really is non-negotiable to be trained as a nurse, you need to be immune to those diseases," explains Ms Whitten.

Most of Ms Whitten's staff who were concerned about the vaccine had support from Bethanie through education and information discussions, which she says has helped immensely with quelling confusion. 

Ms Whitten believes that the reason people are becoming scared about getting vaccinated is due to mixed messages or false information from the media, social media, and the Government.

"I don't think we can probably dispute that the rollout has had issues, and alongside differing messages coming from different sources I do think in part that was because of COVID. It is an evolving beast and even the professionals making vaccine decisions are still learning," says Ms Whitten.

According to her, a lot of aged care workers at Gwelup say they are getting the vaccine for their residents to keep them safe, but also so they can travel, since many of them have family overseas.

Government "applauded" for mandates

From a provider point of view, some have responded positively to the Government's mandate that staff should be vaccinated against COVID-19 in order to work in the sector.

Chief Executive Officer (CEO) of RSL LifeCare, Graham Millett applauds the decision.

RSL LifeCare has facilities across New South Wales (NSW) and the ACT and a 2,600 strong cohort of aged care workers.

"I think this initiative by the Government is a really positive step forward, both for the sector but also for the broader population because it sends them a message that we need to get on top of this virus," says Mr Millett.

Currently only 10 percent of RSL LifeCare workers have been fully vaccinated with a further 10 percent having at least their first jab. Mr Millett believes that the only way to get the remaining 80 percent vaccinated is to put in place the right processes to streamline the inoculation of staff, such as onsite vaccination clinics.

Mr Millett says he believes his whole workforce is supportive of the mandate as many were facing issues getting the vaccine as it was. 

He has been talking to his workers at the moment to get their thoughts and see if there are any concerns, but says there hasn't been a single issue raised with him so far.

Mr Millett believes that when the flu vaccination was made mandatory, there was no loss of staff at RSL LifeCare and he expects this to be the same for the case of the COVID-19 vaccine.

"I have heard of those [vaccine hesitancy] concerns, but first hand I haven't seen or heard any of it, which is interesting. So hopefully those concerns are misplaced. We are not anticipating people leaving the company because of this at all," says Mr Millett.

"I would be very disappointed, I think, if that occurred because it would be indicating that people don't want to be vaccinated and the logic of not being vaccinated, frankly, just escapes me when this is such a, potentially anyway, such a hideous disease."

While the organisation is supportive of the mandates, Mr Millett says that the Government needs to back this decision up through targeted pop up injection clinics on-site of aged care homes if they want to meet their September deadline of vaccinating all aged care workers with at least one dose.

*Disclaimer: Some names in this article have been changed by request.

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