It is generally understood and accepted that schools occupy a special place in the community as they are responsible for both the health and welfare of sick and healthy students who attend school, and they have additional obligations under law in several states and territories to request and record the immunisation status of children being enrolled.
In June 2014 in one of our first School Governance articles regarding immunisation issues in schools, we advised schools that the proper management of infectious diseases was more than the default policy that a sick child should be sent home. We argued that schools required an infectious diseases policy with some key features. These included:
- clear guidelines for managing the diseases
- staff training on how to recognise infectious diseases
- instructions on how to notify the relevant health authorities, in compliance with legal obligations
- maintenance of records of student immunisations.
In May 2016, we reminded schools that the management of vaccinations and infectious diseases required a raft of policies to deal with children, parents, health authorities and regulatory officials. This was followed up with our first article regarding staff immunisation “Immunisation of Staff - Winter is Coming”.
Unlike the requirement in some jurisdictions to collect and store student immunisation data, there are no legal requirements for schools to collect and store staff immunisation records. In fact, there are few regulatory requirements to maintain staff medical records. There are a number of exceptions such as for medical records relating to an employee’s workers’ compensation claim, health monitoring in relation to exposure to asbestos and some chemical hazards, and medical records relating to pregnancy.
Could a school ask staff to provide this type of sensitive personal information? Is the collection and storage of this type of information considered to be an essential part of the school’s overall operational procedures? A prudent employer would always ask if an employee has a health condition such as anaphylaxis that may impact on their ability to work or that the employer should be aware of in terms of preparing emergency plans. The employee retains the right not to provide personal health information, although that may result in an employer not taking appropriate control or mitigating measures to prevent harm, for example not stocking EpiPens or not realising that an employee who falls unconscious is in fact diabetic or anaphylactic. In Western Australia, failure by a job applicant to provide relevant medical information if requested when applying for a job may prevent a future claim for workers’ compensation.
How Can a School Mitigate the Staff Immunisable Diseases Risk?
Does your school offer free immunisation for common infectious diseases to your staff on an annual basis?
From a financial perspective, it is clear that the fewer days spent by staff on sick leave, the less pressure it will put on a school’s relief teaching budget. A rough cost analysis would show that the cost of 20 x $20 immunisations equates to less than the cost of employing a single relief teacher for one day.
It is in the best interests of the school to not have staff falling ill with the flu and being off work for a week or so. It can cost a school as much as $2500 extra per week in relief teacher costs alone for each staff member who does not get a flu shot and then succumbs to whatever strain of flu happens to be prevalent within its school community.
Most schools allocate tens of thousands of dollars for replacement staff for personal (sick and carers’) leave, professional development leave and other forms of approved leave with pay. Unlike many other industries, schools generally need to replace teachers who are on paid leave during the school term because they owe a duty of care to the students in their classes. It is common practice for other staff to be allocated ‘relief’ sessions once a week to cover classes for staff who are not on campus. This practice is generally very cost effective, but it relies heavily on staff goodwill and it is not a long-term strategy for managing the absence of all staff who become ill with an infectious disease.
In addition, if you do not spend as much of your relief budget on personal (sick or carers’) leave, how much more funding do you then have available for staff professional development? Will it improve staff morale and overall work performance?
Apart from the obvious cost saving benefits, sick staff can also take considerable time to return to their normal high levels of engagement with their classes. The children also lose the continuity of the teacher-especially if you must get five different relief teachers in one week. The cost of student disengagement is not as easy as financial costs to either identify or prove. However, any breach of teacher continuity can result in students failing to gain the greatest educational benefit and any significant loss of learning could be argued to be a greater risk than financial costs.
Some non-government schools that offer free influenza or hepatitis B shots, do so as part of their Enterprise Agreements (EA) and some have a policy that encourages immunisation. A school may consider making it a condition of employment in some roles for an employee to have hepatitis vaccinations but only if this is reasonable to do so, as a matter of the employer’s duty of care under workplace health and safety legislation. This would not normally be sustainable for teachers undertaking normal duties. If the employee refuses a direction to be vaccinated this should involve further consultation and consideration of “reasonable accommodation” principles. However, a school would be on shaky ground to insist that staff be immunised in relation to more common vaccine-preventable diseases such as the flu, rubella and mumps. Legitimate staff responses for refusing vaccinations can range from refusal due to religious beliefs, concerns about adverse reactions, belief that they are naturally immune, or that they faint at the sight of needles.
As an aside, the Australasian Society of Clinical Immunology and Allergy (ASCIA) notes that, where vaccines may contain some egg proteins, even if people are allergic to eggs, the amount of residual egg ovalbumin present in each vaccine dose is substantially less than the amount of egg protein that is likely to trigger reactions in people with an egg allergy. And, according to Health Direct, you cannot catch the flu from the influenza immunisation shot.
In addition, schools rarely, if ever, offer other immunisations such as tetanus, measles, mumps, rubella (MMR), pertussis, chicken pox etc. They should, however, especially for all staff in the early years. Also, staff who are trying to fall pregnant or who may be pregnant should have been immunised against rubella, but some may not. We still have non-immunised children in schools. If there is an outbreak of rubella, you may have to move non-immunised pregnant staff to a safer job or they may have to stay at home on full pay.
What about staff taking students overseas? Who pays for the raft of preventative immunisations that they should have such as cholera, typhoid etc?
If there is an outbreak of an infectious disease, does your school have a policy to advise all staff and are you aware if there are any staff who may be particularly susceptible to the type of disease – for example in relation to pregnant staff and rubella? In addition, are you aware of staff who may have a history of other diseases, or whose age or medical background may cause them to be severely affected? For example, it has been quoted that those most at risk of catching measles include many adults aged between 33 and 47 who may not have received the vaccine as children. Also, at risk are people whose immune systems are compromised including those undergoing treatment for cancer.
So what would happen in your school? Are you in a financial position to exclude staff (on full pay) if they are at risk of catching an infectious disease for which they have never been immunised? Are you able to insist that they are to take personal leave? Is it an issue of workers’ compensation? Does your insurance company provide for this type of situation? And remember that any breach of teacher continuity can result in students failing to gain the greatest educational benefit. Any significant loss of learning could be argued to be a greater risk than financial costs.
About the Authors
With 37 years of educational experience, Craig D’cruz is the National Education Lead at CompliSpace. Craig provides direction on education matters including new products, program/module content and training. Previously Craig held the roles of Industrial Officer at the Association of Independent Schools of WA, he was the Principal of a K-12 non-government school, Deputy Principal of a systemic non-government school and he has had teaching and leadership experience in both the independent and Catholic school sectors. Craig currently sits on the board of a large non-government school and is a regular presenter on behalf of CompliSpace and other educational bodies on issues relating to school governance, school culture and leadership.
Svetlana is a Principal Consultant at CompliSpace. She has over 20 years of experience in strategic and operational human resource management, occupational health and safety, and design and implementation of policies and change management programs. She has held national people management responsibility positions in the public and private sectors, and is now the content specialist at CompliSpace for Privacy, HR, harmonised WHS (and OHS/OSH), and general governance and compliance matters for not for profits. She holds a LLB , Masters in Management (MBA), Master of Arts in Journalism, and a Certificate in Governance for not-for-profits.