Social and health care vaccinations – an important part of work and patient safety

Many social and health care workers as well as other professional groups need vaccinations for their work. Vaccinations given due to work-related infection risks can be obtained from occupational health care. 

According to the principles of occupational safety and health protection, the employer is responsible for providing the vaccinations that the employee needs for their work. If an employee is exposed to microbes that pose a significant health risk and there is a vaccine available against them, the employee must be vaccinated. The employer pays for the vaccination, says Kari Reijula, Professor of Occupational Health at the University of Helsinki and Vice Dean of the Faculty of Medicine.

According to Reijula, vaccinations for social and health care personnel are an important part of work and patient safety and quality operations.

Occupational health care assesses risks and vaccination needs

The Occupational Health Care Act requires that every employer provide occupational health care to their employees.

Vaccinations included in the national vaccination programme are obtained by the employee from their own health center, but vaccinations given due to work-related risks can be obtained from occupational health care.

− The employer must identify situations and tasks in which the employee is exposed to biological hazards, and occupational health care must conduct a workplace survey to identify different tasks and assess the risks and vaccination needs associated with them, explains Reijula, who has worked as an occupational health physician for 35 years.

Infectious risks within social and health care are prevented by vaccinations

− Social and health care employers, such as the chief physician of a health center or the chief physician of a hospital, must obtain a workplace-specific survey from occupational health care, which identifies what each employee does, what substances they handle, and which viruses or other microorganisms they are exposed to in their work. All employees must be reviewed and their risk of infection assessed.

− At HUS, for example, laboratories, emergency rooms, and isolation wards for infectious patients are the places where exposures to microbes are most likely to occur. Laboratories handle infection samples containing pathogens, which can cause exposure to viruses and bacteria. Feverish people and patients suffering from severe infectious diseases such as hepatitis B are brought to the emergency clinic. Both laboratory and emergency workers encounter and touch unknown patients, increasing the risk of infection. The risk of infection is also elevated for isolation ward and ambulance workers, says Reijula.

For example, laboratory workers should be vaccinated against hepatitis, COVID-19, influenza, chickenpox, and pertussis, as well as the MMR vaccine, which protects against measles, mumps, and rubella.

Personalized vaccination recommendations

According to Reijula, vaccination recommendations for social and health care workers should be based as much as possible on the employee’s starting situation.

− Vaccinations are tailored to each employee individually. They are based on the work they do, their previous vaccinations, any underlying illnesses, and their life situation.
The Occupational Safety and Health Act requires employees to be vaccinated if there is a possibility of getting sick at work.

− If occupational health care assesses that there is a health hazard and recommends vaccination, it must be taken. Vaccinations given based on job duties are not voluntary. Refusing vaccinations may even lead to termination, says Reijula.

Vaccinations prevent serious consequences of infectious diseases

The Communicable Diseases Act obliges the employer to protect their own employees and themselves, as well as those patients and customers who are susceptible to serious consequences of infectious diseases.

− Infectious diseases can be dangerous, for example, for organ transplant and cancer patients, who can get infected by an unvaccinated doctor or nurse. Serious consequences can also occur in infants under one year of age, those over 65 years of age, and pregnant patients. Social and health care workers and students in training who treat these groups should have appropriate protection.

Protection against measles and chickenpox is provided by either vaccination or a previous infection, and protection against influenza is provided by the flu vaccine. Those who constantly care for infants should obtain a pertussis vaccine.

− If necessary, occupational health care assesses whether the employee is suitable for working in premises where patients and customers susceptible to serious consequences of infectious diseases are treated. This can be done already in connection with the entry occupational health examination, Reijula explains.

When traveling abroad for work

Business trips are also covered by the Occupational Safety and Health Act and occupational safety.

− I work as an occupational health physician with international companies, and in my work, I have seen how the need for vaccinations increases as foreign business trips again become more common. This is why constantly updated instructions and recommendations for vaccinations for foreign business trips are needed in occupational health care, Reijula says.

If you are traveling to an area where there are known risks of microbial infections due to your work, it is a good idea to go through the necessary vaccinations with occupational health care.

− My advice is: Be vigilant, familiarize yourself with the instructions, and ask for advice from occupational health care, Reijula says.
You can find instructions in the Duodecim Health Library’s Traveler’s Health Guide, which also includes a link to country-specific instructions.

Vaccinations for training periods

Vaccinations for students going to training are provided by student health care, such as the Finnish Student Health Service (FSHS).

− It is good to go through vaccinations with student health care before starting training. Institution-specific practices have usually been established there for exposure situations in workplaces. Vaccinations specified according to workplace-specific risk assessment can be obtained from student health care or the workplace’s occupational health care, says Reijula.

More resources and research on vaccinations

Reijula emphasizes the importance of preventing diseases, and he believes that more resources should be allocated to vaccinations in Finland. More research on vaccinations is also needed. Targeted prevention is usually cheaper than disease treatment.

− Expertise related to vaccinations in occupational health care and the content of toolkits should be developed, and updated operating models for occupational health care vaccination should be created, he says.
 

Read also about vaccinations for other professional groups. 

Text: Leena Koskensalo