Jun 3
Immunisation in Aged Care
Protecting Our Most Vulnerable
Aged care facilities are unique, where a high concentration of vulnerable individuals reside, making robust immunisation programs vital to not only protect residents but also the dedicated staff who care for them.
Introduction to Immunisation. What is it?
Immunisation, often referred to as vaccination, is a cornerstone of infection prevention in healthcare. Essentially, it boosts the body's natural defences to protect against infectious diseases. For older adults, who may have weaker immune systems and a higher susceptibility to severe illness, immunisation isn't just beneficial—it's critical. In communal living environments, such as aged care facilities, the risk of rapid disease transmission is significantly raised.
A vaccine contains a weakened, inactivated, or a small piece of a pathogen (virus or bacteria), called an antigen. It's enough for your immune system to recognise it, but not enough to cause the actual illness. Different types of vaccines use different forms:
A vaccine contains a weakened, inactivated, or a small piece of a pathogen (virus or bacteria), called an antigen. It's enough for your immune system to recognise it, but not enough to cause the actual illness. Different types of vaccines use different forms:
- Live-attenuated vaccines: These contain a weakened form of the living virus or bacteria (e.g., MMR, chickenpox). They often provide strong, long-lasting immunity with fewer doses.
- Inactivated vaccines: These consist of killed versions of the pathogen (e.g., some flu vaccines). Because they can't replicate, they usually require multiple doses (boosters) to establish strong immunity.
- Subunit, toxoid, or mRNA vaccines: Contain only specific parts of the pathogen (proteins or genetic material) that trigger an immune response (some COVID-19 vaccines).
Immune System Recognition and Response: The immune system produces antibodies to the antigen presented in the vaccine.
Antibody Production and Memory: Antibodies are highly specific molecules designed to bind to and neutralise the specific antigen they were trained against. They can block the pathogen from entering cells, have it destroyed by other immune cells, or neutralise the toxins it produces. Vitally, after fighting off this "imitation infection," the immune system creates "memory cells" which remain in the body for months, years, or even a lifetime.
Future Protection (The Real Benefit): If the vaccinated person is later exposed to the actual disease-causing pathogen, their memory cells quickly recognise it. They can then rapidly produce large numbers of the right antibodies and activate T-cells, often preventing the illness entirely or making the symptoms much milder and recovery faster. This rapid and robust response is why immunisation is so effective.
Herd Immunity: When a high percentage of residents and staff in an aged care facility are immunised, it creates herd immunity (or community immunity). This significantly reduces the spread of disease within a facility, protecting even those who cannot be vaccinated (e.g., due to medical reasons) or for whom the vaccine may be less effective.
Antibody Production and Memory: Antibodies are highly specific molecules designed to bind to and neutralise the specific antigen they were trained against. They can block the pathogen from entering cells, have it destroyed by other immune cells, or neutralise the toxins it produces. Vitally, after fighting off this "imitation infection," the immune system creates "memory cells" which remain in the body for months, years, or even a lifetime.
Future Protection (The Real Benefit): If the vaccinated person is later exposed to the actual disease-causing pathogen, their memory cells quickly recognise it. They can then rapidly produce large numbers of the right antibodies and activate T-cells, often preventing the illness entirely or making the symptoms much milder and recovery faster. This rapid and robust response is why immunisation is so effective.
Herd Immunity: When a high percentage of residents and staff in an aged care facility are immunised, it creates herd immunity (or community immunity). This significantly reduces the spread of disease within a facility, protecting even those who cannot be vaccinated (e.g., due to medical reasons) or for whom the vaccine may be less effective.
Diseases Most Vaccinated Against in Aged Care
Residents and staff in aged care facilities are typically prioritised for vaccines against respiratory illnesses due to their high transmissibility and potential for severe outcomes in older adults. The most common vaccinations include:
- Influenza (Flu): An annual flu shot is of high priority, as older adults are at a significantly higher risk of severe complications, hospitalisation, and death from influenza. Different strains circulate each year, hence annual boosters are recommended.
- COVID-19: While the immediate crisis of the pandemic may have subsided, COVID-19 continues to pose a significant risk, especially to older adults with comorbidities. Staying up to date with booster shots is essential as protection wanes over time.
- Pneumococcal Disease: This vaccine protects against serious infections like pneumonia, meningitis, and bloodstream infections caused by Streptococcus pneumoniae. Older adults are particularly susceptible.
- Shingles (Herpes Zoster): Shingles is a painful rash caused by the reactivation of the chickenpox virus, which remains dormant in the body after the illness. Older adults have a weaker immune system, making them more prone to shingles and its debilitating complication, post-herpetic neuralgia.
- Diphtheria, Tetanus, and Pertussis (Whooping Cough - dTpa): A booster for this combination vaccine is often recommended, especially for staff and those who will be around new babies (e.g., visiting grandchildren). Whooping cough can be severe in infants and contagious in older adults.
Other vaccines that may be recommended based on individual health and risk factors include Hepatitis B, Measles, Mumps, Rubella (MMR), and Meningococcal vaccines.
Vaccine Refusal
Vaccine refusal, whether by residents or staff, can come about from a variety of interconnected factors:
Health Concerns:
Health Concerns:
- Perceived Side Effects: Concerns about common, mild side effects (like soreness, fever, or fatigue) can be a deterrent, especially if they are seen as disrupting daily life or existing health conditions.
- Fear of Adverse Reactions: While rare, serious adverse reactions are a significant fear for some.
- Underlying Health Conditions: Some individuals may genuinely believe their specific health conditions make vaccination unsafe, even if medical advice suggests otherwise.
- Waning Immunity/Perceived Ineffectiveness: For diseases like COVID-19 and influenza, where immunity can wane or new variants emerge, this can be perceived as being vaccinated is not worth the trouble.
Social Factors:
- Misinformation and Disinformation: The spread of inaccurate or misleading information, particularly through social media, can significantly reduce trust in vaccines and public health authorities. Conspiracy theories can also play a role.
- Peer Influence and Social Networks: Opinions of friends, family, and community groups can heavily influence the decision of an individual, creating social pressure to conform to the anti-vaccine sentiments of others.
- Lack of Trust in Healthcare System/Authorities: Historical injustices or negative personal experiences can lead to a general distrust of medical institutions and government recommendations.
- Loneliness and Anxiety: Studies suggest higher levels of social loneliness and anxiety can be associated with vaccine hesitancy among residents and staff in aged care.
Religious and Conscientious Objection:
- Specific Religious Beliefs: Certain religious doctrines may hold objections to vaccines based on concerns about ingredients (e.g., animal-derived products, foetal cell lines in the production of a vaccine) or a belief that natural immunity is preferable.
- Conscientious Objection/Personal Autonomy: Some individuals strongly believe in the right to bodily autonomy and view vaccine mandates as an infringement on personal freedom, regardless of specific health or religious reasons.
- Fear of Needles (Trypanophobia): A genuine and sometimes debilitating fear of injections can prevent individuals from being vaccinated.
- General Anxiety: The unknown nature of a new vaccine or general health anxiety can contribute to refusal.
Logistical Barriers (for Residents):
- Cognitive Impairment: Many aged care residents may have cognitive impairments, making it difficult to obtain informed consent directly. This requires careful discussion with legal guardians or next of kin.
- Access Issues: While less common within a facility, external appointments or complex scheduling for boosters can be a barrier.
Consequences for the Aged Care Facility
Low vaccination rates among residents and staff can have severe consequences for an aged care facility:
- Increased Outbreaks and Disease Transmission: This is the most immediate and critical risk. Unvaccinated individuals are more susceptible to infection and more likely to transmit diseases, leading to outbreaks that can spread rapidly within a close-knit aged care facility.
- High Morbidity and Mortality: Aged care residents are highly vulnerable to severe illness, hospitalisation, and death from vaccine-preventable diseases. Outbreaks can result in significant loss of life and severe deterioration in health for many residents.
- Staff Shortages and Burnout: Outbreaks necessitate isolation, increased personal protective equipment (PPE) usage, and often lead to staff illness or quarantine. This can cripple staffing levels, leading to increased workload and burnout for remaining staff, and potentially compromising care quality.
- Reputational Damage and Loss of Trust: Facilities with recurring outbreaks or high rates of vaccine-preventable illnesses can suffer significant damage to their reputations, leading to reduced occupancy, difficulty attracting new residents, and a loss of trust from families of residents and the wider community.
- Financial Strain: Managing outbreaks involves increased costs for PPE, testing, deep cleaning, staff overtime and temporary agency staff. Lower occupancy will also impact revenue.
- Regulatory Scrutiny and Penalties: Health authorities and regulatory bodies are likely to investigate facilities with poor vaccination rates and high rates of infection, potentially leading to fines, sanctions, or even closure in severe cases.
- Increased Burden on Healthcare System: Outbreaks in aged care facilities place a significant burden on local hospitals and emergency services, as residents may require acute care.
Should Staff in Aged Care Be Mandated for Vaccines?
The question of mandatory vaccination for aged care staff is a complex one, balancing public health decisions with individual rights.
Arguments for Mandating Vaccines for Aged Care Staff (Pros):
- Protection of Vulnerable Residents: This is the strongest argument. Aged care residents are often frail, immunocompromised, and unable to protect themselves. Mandating vaccination for staff significantly reduces the risk of transmission to this highly vulnerable population, potentially saving lives and preventing severe illness.
- Ethical Obligation (Fiduciary Duty): Healthcare workers, including aged care staff, have a professional and ethical responsibility to protect their patients. Vaccination is seen as a core component of this duty, demonstrating a commitment to patient safety.
- Maintaining Workforce Resilience: High staff vaccination rates can reduce staff illness, absenteeism, and the need for isolation, contributing to a more stable and resilient workforce, especially during outbreaks.
- Proven Effectiveness: Vaccine mandates have historically been effective in increasing vaccination rates and reducing disease spread in healthcare settings.
- Reduced Burden on Healthcare System: By preventing outbreaks, mandates can reduce the pressure on hospitals and emergency services.
Arguments Against Mandating Vaccines for Aged Care Staff (Cons):
- Violation of Individual Autonomy and Rights: Opponents argue that mandatory vaccination infringes on an individual's right to choose their medical treatment and make decisions about what to place in their own body.
- Potential for Staff Shortages: Mandates can lead to some staff resignations or an inability to recruit new staff who refuse vaccination, heightening the existing workforce shortages in aged care.
- Discrimination and Alienation: Mandates can be perceived as discriminatory, particularly if they disproportionately affect certain demographic groups or lead to the stigmatisation of unvaccinated individuals. It can erode trust and social cohesion.
- Ethical Concerns about Coercion: While the intent is public health, the use of job security as a lever for vaccination can be seen as coercive.
- Efficacy Against Transmission (especially for new variants): While vaccines are highly effective at preventing severe disease, their effectiveness in preventing transmission in the case of variants and the efficacy of the vaccine over time, which some argue will weaken the case for mandates solely on a transmission-prevention basis.
Conclusion on Mandates:
The decision to mandate vaccines for aged care staff is a policy choice that requires careful consideration of local context, disease prevalence, vaccine effectiveness, and ethical frameworks. Many jurisdictions have implemented such mandates, particularly during the height of the COVID-19 pandemic, citing the extreme vulnerability of aged care residents as the primary justification. However, it remains a contentious issue with ongoing debate about balancing public health needs with individual liberties. By highlighting these points, your blog post can provide a comprehensive and nuanced discussion on the critical role of immunisation in aged care facilities.
Conclusion
Immunisation in aged care is a dynamic and evolving area of practice. We must commit to understanding the science, addressing hesitancy with empathy, and advocating for robust vaccination programs. By doing so, we not only protect the physical health of our residents and colleagues but also uphold the highest standards of care, ensuring dignity, safety, and quality of life for those in our charge.
Read more on the science behind Immunisation. Fascinating stuff! For more information in general and other blogs, visit the IPS HUB.
Our next blog will look at immunisation in the general population and why we are seeing the resurgence of the diseases thought to be dying out.
Take advantage of our expertise in IPC. See the HUB for policies, resources and courses relating to this very important subject. Ask EVE for a quick answer to your question.
Read more on the science behind Immunisation. Fascinating stuff! For more information in general and other blogs, visit the IPS HUB.
Our next blog will look at immunisation in the general population and why we are seeing the resurgence of the diseases thought to be dying out.
Take advantage of our expertise in IPC. See the HUB for policies, resources and courses relating to this very important subject. Ask EVE for a quick answer to your question.
Lyndon Forrest
Managing Director | CEO
Lyndon is the Managing Director of Infection Prevention Services (IPS), bringing over 30 years' experience supporting aged care providers across Australia and New Zealand.
With a background spanning outbreak response, compliance, and infection risk management — alongside hands-on experience leading teams, managing multi-site operations, and navigating business turnaround — he understands both the clinical and organisational pressures aged care providers face. Lyndon holds a Master of Commerce (Industrial Relations), and applies that foundation to the people, process, and growth challenges that come with running a complex healthcare services business.
He is passionate about building the systems and capability that make infection prevention sustainable — not just compliant — and about helping organisations grow their confidence alongside their practice.
Lyndon's focus is straightforward: strengthen operations, develop the right people, and drive proactive infection prevention strategies that protect residents, staff, and communities for the long term.
Lyndon is the Managing Director of Infection Prevention Services (IPS), bringing over 30 years' experience supporting aged care providers across Australia and New Zealand.
With a background spanning outbreak response, compliance, and infection risk management — alongside hands-on experience leading teams, managing multi-site operations, and navigating business turnaround — he understands both the clinical and organisational pressures aged care providers face. Lyndon holds a Master of Commerce (Industrial Relations), and applies that foundation to the people, process, and growth challenges that come with running a complex healthcare services business.
He is passionate about building the systems and capability that make infection prevention sustainable — not just compliant — and about helping organisations grow their confidence alongside their practice.
Lyndon's focus is straightforward: strengthen operations, develop the right people, and drive proactive infection prevention strategies that protect residents, staff, and communities for the long term.
Erica Callaghan
Marketing Manager
Erica Callaghan is a dedicated professional with a rich background in agriculture and nutrient management. Growing up on her family's farm in Mid Canterbury, she developed a deep passion for farming. She currently resides on her partner's arable property in South Canterbury.
In 2017, Erica joined the Farm Sustainability team, focusing on nutrient management and environmental stewardship. In February 2024, she became the Manager of Marketing and Sales at Bug Control New Zealand - Infection Prevention Services, where her passion now includes improving infection prevention outcomes.
Outside of work, Erica loves cooking and traveling, often combining her culinary interests with her explorations in Italy and Vietnam. She enjoys entertaining family and friends and remains actively involved in farm activities, especially during harvest season.
Erica Callaghan is a dedicated professional with a rich background in agriculture and nutrient management. Growing up on her family's farm in Mid Canterbury, she developed a deep passion for farming. She currently resides on her partner's arable property in South Canterbury.
In 2017, Erica joined the Farm Sustainability team, focusing on nutrient management and environmental stewardship. In February 2024, she became the Manager of Marketing and Sales at Bug Control New Zealand - Infection Prevention Services, where her passion now includes improving infection prevention outcomes.
Outside of work, Erica loves cooking and traveling, often combining her culinary interests with her explorations in Italy and Vietnam. She enjoys entertaining family and friends and remains actively involved in farm activities, especially during harvest season.
Toni Sherriff
Clinical Nurse Specialist
Toni is a Registered Nurse with extensive experience in Infection Prevention and Control. Her career began as a kitchen hand and caregiver in Aged Care facilities, followed by earning a Bachelor of Nursing.
Toni has significant experience, having worked in Brisbane’s Infectious Diseases ward before returning home to New Zealand, where she continued her career as a Clinical Nurse Specialist in Infection Prevention and Control within Te Whatu Ora (Health NZ).
Toni brings her expertise and dedication to our team, which is instrumental in providing top-tier infection prevention solutions to our clients.
Toni is a Registered Nurse with extensive experience in Infection Prevention and Control. Her career began as a kitchen hand and caregiver in Aged Care facilities, followed by earning a Bachelor of Nursing.
Toni has significant experience, having worked in Brisbane’s Infectious Diseases ward before returning home to New Zealand, where she continued her career as a Clinical Nurse Specialist in Infection Prevention and Control within Te Whatu Ora (Health NZ).
Toni brings her expertise and dedication to our team, which is instrumental in providing top-tier infection prevention solutions to our clients.
Julie Hadfield
Accounts & Payroll
Julie is experienced in Accounts & Payroll Administration & after a long career in both the Financial & Local Government Sectors, is now working with our team. Julie brings her strong time management & organisational skills to our team, which is important to keep the company running in the background to enable the rest of our team to provide top notch service to all of our clients.
Julie is experienced in Accounts & Payroll Administration & after a long career in both the Financial & Local Government Sectors, is now working with our team. Julie brings her strong time management & organisational skills to our team, which is important to keep the company running in the background to enable the rest of our team to provide top notch service to all of our clients.
Andrea Murray
Content Editor
I attended Otago University in NZ and graduated as a Dental Surgeon. After 40 years in the profession, I retired in 2022. Infection prevention knowledge was part of everyday practice, dealing with sterilisation, hand hygiene, and cleaning.
Before retiring, I began doing some editing and proofreading for Bug Control as I am interested in the subject and in the English language. During the COVID-19 lockdown, I attended the ACIPC course "Introduction to Infection Prevention and Control", which increased my interest in the subject. I now work part-time as the Content Editor for the company.
I attended Otago University in NZ and graduated as a Dental Surgeon. After 40 years in the profession, I retired in 2022. Infection prevention knowledge was part of everyday practice, dealing with sterilisation, hand hygiene, and cleaning.
Before retiring, I began doing some editing and proofreading for Bug Control as I am interested in the subject and in the English language. During the COVID-19 lockdown, I attended the ACIPC course "Introduction to Infection Prevention and Control", which increased my interest in the subject. I now work part-time as the Content Editor for the company.
Personally, I lived in the UK for 10 years. My two children were born in Scotland, and now both are living in Europe, one in Amsterdam, Netherlands, and the other in Edinburgh, Scotland. I live close to Fairlie on the South Island of NZ, a beautiful part of the country, and I love being out of the city.
Princess
Customer Support
Princess began her career as a dedicated Customer Service Representative, honing her communication and problem-solving skills. She later transitioned into a Literary Specialist role, where she developed a keen eye for detail. Her journey then led her to a Sales Specialist position, where she excelled in client relations.
Now, as a Customer Support professional in Infection Prevention Services. Princess focuses on ensuring customer satisfaction, building loyalty, and enhancing the overall customer journey.
Princess began her career as a dedicated Customer Service Representative, honing her communication and problem-solving skills. She later transitioned into a Literary Specialist role, where she developed a keen eye for detail. Her journey then led her to a Sales Specialist position, where she excelled in client relations.
Now, as a Customer Support professional in Infection Prevention Services. Princess focuses on ensuring customer satisfaction, building loyalty, and enhancing the overall customer journey.
Dianne Newey
Senior Infection Prevention and Control Consultant
Dianne is a Senior Clinical Consultant at Infection Prevention Services (IPS), bringing over 35 years of nursing experience and a depth of clinical knowledge that most people would need two careers to accumulate.
Having served as Clinical Director at Royal Ryde Rehabilitation Hospital alongside a career spanning the full breadth of clinical practice, Dianne has seen it all — and more importantly, knows exactly what to do about it. She is the person in the room that everyone quietly hopes will speak first.
For more than seven years she has been a cornerstone of the IPS team, providing clinical advice, developing and reviewing policies and procedures, delivering monthly IPC webinars to IP Leads, and conducting environmental audits in aged care facilities across Australia and New Zealand. If infection prevention has a question, Dianne almost certainly has the answer — and she'll deliver it with a laugh that you'll hear from the other end of the corridor.
A true fountain of knowledge, wrapped in the kind of warmth and humour that only three decades of nursing can produce. Customers don't just trust Dianne — they look forward to hearing from her.
Dianne is a Senior Clinical Consultant at Infection Prevention Services (IPS), bringing over 35 years of nursing experience and a depth of clinical knowledge that most people would need two careers to accumulate.
Having served as Clinical Director at Royal Ryde Rehabilitation Hospital alongside a career spanning the full breadth of clinical practice, Dianne has seen it all — and more importantly, knows exactly what to do about it. She is the person in the room that everyone quietly hopes will speak first.
For more than seven years she has been a cornerstone of the IPS team, providing clinical advice, developing and reviewing policies and procedures, delivering monthly IPC webinars to IP Leads, and conducting environmental audits in aged care facilities across Australia and New Zealand. If infection prevention has a question, Dianne almost certainly has the answer — and she'll deliver it with a laugh that you'll hear from the other end of the corridor.
A true fountain of knowledge, wrapped in the kind of warmth and humour that only three decades of nursing can produce. Customers don't just trust Dianne — they look forward to hearing from her.
Caoimhe (Keva) Stewart
Clinical & Business Operations Manager
Caoimhe is the Clinical & Business Operations Manager at Infection Prevention Services (IPS), bringing a clinical background as a Registered Nurse across the UK and Australia — and an almost unsettling ability to make technology do exactly what she wants.
With experience in Occupational Health, Palliative Care, and Community Nursing, she understands the real challenges faced by healthcare teams. What she may lack in stature she more than makes up for in impact — Caoimhe is the kind of person who walks into a problem, sizes it up, and has three solutions before anyone else has finished reading the brief.
Customers love her. Not just because she delivers — though she always does — but because she genuinely cares about the outcome on the other side. She is passionate about creating seamless learning experiences and empowering organisations with the tools, knowledge, and support needed to strengthen infection prevention practices and improve care outcomes.
Small in size. Mighty in results. Completely irreplaceable.
Caoimhe is the Clinical & Business Operations Manager at Infection Prevention Services (IPS), bringing a clinical background as a Registered Nurse across the UK and Australia — and an almost unsettling ability to make technology do exactly what she wants.
With experience in Occupational Health, Palliative Care, and Community Nursing, she understands the real challenges faced by healthcare teams. What she may lack in stature she more than makes up for in impact — Caoimhe is the kind of person who walks into a problem, sizes it up, and has three solutions before anyone else has finished reading the brief.
Customers love her. Not just because she delivers — though she always does — but because she genuinely cares about the outcome on the other side. She is passionate about creating seamless learning experiences and empowering organisations with the tools, knowledge, and support needed to strengthen infection prevention practices and improve care outcomes.
Small in size. Mighty in results. Completely irreplaceable.
Bridgette Mackie
Clinical Nurse Educator
Bridgette is an experienced New Zealand Registered Nurse, qualified Healthcare Auditor, and Healthcare Educator with a strong background in clinical quality, competency assessment, and infection prevention. She has led large-scale OSCE and CAP training programmes for internationally qualified nurses, developed sector-specific educational resources, and coordinated HealthCERT audit preparation in the surgical sector.
Known for her engaging teaching style and genuine passion for supporting learners, Bridgette excels at making complex topics accessible and relevant. She blends operational leadership with a deep commitment to professional development and safe, effective practice.
Bridgette is an experienced New Zealand Registered Nurse, qualified Healthcare Auditor, and Healthcare Educator with a strong background in clinical quality, competency assessment, and infection prevention. She has led large-scale OSCE and CAP training programmes for internationally qualified nurses, developed sector-specific educational resources, and coordinated HealthCERT audit preparation in the surgical sector.
Known for her engaging teaching style and genuine passion for supporting learners, Bridgette excels at making complex topics accessible and relevant. She blends operational leadership with a deep commitment to professional development and safe, effective practice.