In this lesson we will look at the different immunisations we require when we work in clinical healthcare settings. These immunisations are for ours and our patients’ protection. They form a part of the overall defense system of infection prevention and control and are important protection in the event that we have a contaminated sharps injury or are exposed to blood or body fluids of a person infected with a blood borne illness or other transmissible disease such as influenza.
DENTAL BOUTIQUE STAFF IMMUNISATION POLICY & CLINICAL GUIDELINE
OVERVIEW
Dental Boutique staff and clinicians are exposed to transmissible diseases due to the nature of the work they perform. The Dental Board of Australia (the Board) states that dental practitioners must be aware of their infection prevention and control (IPC) obligations when delivering dental care. Practices must ensure that their staff receive education surrounding the necessity of immunisations if they are assisting in or delivering dental care to the practice’s patients.
PURPOSE
Dental Boutique has developed the following guideline based on the recommendations the Board and the Australian Dental Association (the ADA) that dental practitioners and staff should be immunised against transmissible disease where possible, which in turn aims to reduce the risk of transmission of disease between Dental Boutique staff, clinicians and patients. This risk of transmission is bi-directional; thus this guideline aims to provide information on immunisation to protect both the Dental Boutique team and patients alike.
RELEVANT LEGISLATION
All dental practitioners and clinical support staff require immunisation against Hepatitis B Virus (HBV), unless they have documented evidence of pre-existing immunity (from natural infection or prior vaccination) prior to commencing work. Any staff who are new to dental practice must be assessed for their HBV status. It is essential that staff who are undergoing vaccination for HBV are tested for antibody levels after the full course of three injections has been completed. This will demonstrate immunity and identify poor responders who require additional vaccinations. The follow-up protocols for this are in the Australian Immunisation Handbook.
Note that there may be local jurisdictional requirements for COVID-19 immunisation for those working in certain environments, e.g. residential aged care facilities. Those working with remote Indigenous communities should also undergo vaccination for hepatitis A, while those at increased risk of exposure to drug-resistant cases of tuberculosis (TB) should consider vaccination with bacille Calmette-Guerin (BCG), once their immune response to tuberculosis has been tested using an appropriate challenge test. As the efficacy of the BCG vaccination in adults is more limited compared to children, tuberculosis prevention and control strategies should focus on pre-employment screening and infection control measures, including treatment for latent tuberculosis.
KEY ACTIVITIES
Infection prevention and control for dental practitioners and clinical support staff: Immunisation
Dental practitioners and clinical support staff are at risk of exposure to many common vaccine preventable diseases (VPDs) through contact with patients and the general community. Immunisations substantially reduce the potential for acquisition of disease, thereby limiting further transmission to other dental staff and patients.
Whether or not the spread of microorganisms results in clinical infection depends in part on the virulence (power to infect) of a particular microorganism and on the susceptibility of the host. Patients and dental staff have varying susceptibilities to infection depending on their age, state of health, underlying illnesses, and immune status (which may be impaired by medication, disease, cancer therapy, and other factors such as malnutrition and hormone deficiency, or assisted through immunisation).
The list of immunisations recommended for HCWs is provided in the current edition of the Australian Immunisation Handbook and is summarised below.
- A history of successful immunisation against HBV. This is shown by having developed antibodies to hepatitis B surface antigen in a blood test taken after the initial course of three injections
- Varicella (if seronegative)
- Measles, mumps, and rubella (MMR) (if non-immune)
- Pertussis (whooping cough) – every 10 years
- Viral influenza (required every year to cover new circulating strains of these viruses)
Dental practices should have education programs to support their immunisation strategy, and all dental staff must be advised of the potential consequences of non-immunisation. Consequences include an increased likelihood of acquiring infections in the workplace, increased probability of spreading infections to family members and close contacts, and restrictions on being able to work chairside when patients have active infections. While a staff member has the right to refuse vaccination, this refusal must be documented with their reason for refusal noted and signed by the employee.
It is highly recommended that when employing new staff, they are asked to complete a statement of their immunisation status and vaccination history. It is not appropriate to ask them for details of their immune status (i.e. actual levels of antibodies for all the listed conditions above); however, a statement from their medical GP regarding immunisation status can provide a practical way of determining immune status. Staff who are using the national health record system can produce of list of some vaccines by using the myGov database. For further information on immunisation requirements, consult the current edition of the Australian Immunisation Handbook.
Documentation and duty of care
Ensure an immunisation program for dental staff is in place and is in accordance with the current edition of the Australian Immunisation Handbook:
Key compliance items for immunisation
- Ensure all dental team members are aware of immunisation required for HCWs and have an opportunity to declare and update their immunisation and allergy status regularly
SCOPE
This document applies to all employees and contractors in Dental Boutique practice(s) throughout Australia and New Zealand.
ROLES & RESPONSIBILITIES
| ROLE | RESPONSIBILITY |
| Employees | Ensure that they complete LMS training, and provide evidence from their GP that they have been immunised against the transmissible diseases mentioned in both this guideline and the ADA’s Guidelines for Infection Prevention and Control Fifth Edition, or are completing a catch up course of immunisation as required, or have signed a waiver stating that they are aware of the risks of being unimmunised and have refused immunisation. |
| Practitioners | Ensure they provide evidence from their GP that they have been immunised against the transmissible diseases mentioned in both this guideline and the ADA’s Guidelines for Infection Prevention and Control Fifth Edition or are completing a catch-up course of immunisation as required, or have signed a waiver stating that they are aware of the risks of being unimmunised and have refused immunisation. |
| Practice Managers | Ensure they provide evidence from their GP that they have been immunised against the transmissible diseases mentioned in both this guideline and the ADA’s Guidelines for Infection Prevention and Control Fifth Edition or are completing a catch-up course of immunisation as required or have signed a waiver stating that they are aware of the risks of being unimmunised and have refused immunisation. Collect and collate team members’ immunisation status as part of the onboarding process for each new team member, and update this on a 12-monthly basis. Ensure that this information (in a deidentified format) is available when required as part of routine inspection and auditing. |
| Compliance Team | Ensure that internal clinical guidelines, policies and procedures are maintained with current information as per the ADA and the Board.Ensure that any material on immunisation that is available on the LMS has been updated to reflect current advice. |
APPENDIX A
Sample staff immunisation register
APPENDIX B
Sample staff immunisation waiver form
| Name: | Middle Name: | Last Name: |
| Date of Birth: | ||
| Immunisation(s) declined: | MMR (Measles, Mumps, Rubella | ☐ |
| Hepatitis B | ☐ | |
| Viral influenza | ☐ | |
| Pertussis (whooping cough) – every ten years) | ☐ | |
| Tetanus | ☐ | |
| Additional if required: | Hepatitis A | ☐ |
| Covid 19 | ☐ | |
| REASON FOR WAIVER/EXEMPTION: | PERSONAL OBJECTION: I hereby declare that the above immunisation(s) are in conflict with my moral and/or religious beliefs and I am requesting an exemption to the immunisation requirements. | |
| MEDICAL CONTRAINDICATION: I hereby certify that the immunisation(s) specified above are medically contraindicated for me. | ||
| PHYSICIAN FIRST NAME: | PHYSICIAN LAST NAME: | PHYSICIAN AHPRA REG: |
| Please upload physician statement or any other relevant document | ||
| DECLARATION: | ||
| I, the undersigned, agree with the following statements: | ☐ | I acknowledge that I have received and reviewed information on the risks associated with the aforementioned diseases. |
| ☐ | I voluntarily agree to release, discharge and hold harmless your organisation, officers, employees and ages from any and all costs, liabilities, expenses, claims, demands or causes of action on account of any loss or personal injury that might result from my decision not to be immunised. | |
| ☐ | I choose not to be immunised. | |
| NAME (PRINTED): | SIGNATURE: | DATE: |
ANY QUESTIONS?
Any questions regarding this policy should be directed to Dental Boutique’s HR team: hr@dentalboutique.com.au.
Alternatively, please contact the Compliance team: compliance@dentalboutique.com.au.
REFERENCES:
Authorised by Dr Scott Davis, President, Australian Dental Association (2024) Guidelines for Infection Prevention and Control Fifth Edition. Australian Dental Association, St Leonards NSW.
DOCUMENT CONTROL:
| Confidentiality: | Internal |
| Date of first issue: | August 2025 |
| Issue date of this document: | 4th August 2025 |
| Next revision date: | August 2026 |
| Document owner: | Myf Williams |
| Document approved by: | Philip Glowacki |
| Version: | V1.0 (initial) |
| Status (Draft/Final): | Final |
| Preceding published version: | NA |
| Summary changes in this version: | NA |
