Immunisation and Infectious Diseases Prevention Policy

NQS

National Regulations

Aim

Immunisation is a simple, safe and effective way of protecting people against harmful diseases before they come into contact with them in the community. Immunisation not only protects individuals, but also others in the community, by reducing the spread of disease.

My Home Your Home Educators will ensure that every child, enrolled in their service, is up-to-date with their vaccinations. Educators will monitor and follow up with parents about this, and then email the office, the updated (Immunisation History Statement from Medicare) as soon as they receive it.

Our aim is to provide children with a care environment which is clean, well ventilated and has access to natural lighting. Food safety will be adhered to at all times.

Related Policies

• Enrolment Policy
• Health, Hygiene and Safe Food Policy
• Incident, Injury, Trauma and Illness Policy
• Medical Conditions Policy
• Privacy and Confidentiality Policy

Implementation

Immunisation Records

• Parents who wish to enroll their child are required to provide evidence of their child's immunisation record.
• Parents are required to present the child's immunisation record at the time of enrolment.
• This information allows children at risk of catching a vaccine preventable disease to be identified if there is a case of that disease at the service.
• Acceptable immunisation records are:
  • An Immunisation History Statement provided by the Australian Childhood Immunisation Register (ACIR) is a valid immunisation record.
  • The Australian Childhood Immunisation Register (ACIR) maintains immunisation records for children up until their seventh birthday. You can obtain an ACIR Immunisation History Statement for your child by calling 1800 653 809.

My Home Your Home Family Daycare must be able to quickly access immunisation records and determine who has not been immunised. If there is a case of a vaccine preventable disease, and your child has not been fully immunised for that disease, children will be excluded for the exclusion period specified by management.

From the 1st of January 2018

My Home Your Home Family Day Care will not enroll a child unless they are fully vaccinated. Our service will not enroll a child who are not immunised due to their parents conscientious objection. A medical exemption will be required.

No Jab No Pay

From 1 January 2016, there will be changes to the immunisation requirements for Child Care Subsidy.

What are the changes?

• CCS payments have been conditional on children up to the age of 7 meeting current immunisation requirements. From 1 January 2016, this requirement will be extended to apply to all children up to 20 years of age.
• Children will no longer be exempt from meeting the requirements for CCS payments if their parents have registered an objection to vaccination on the basis of personal or philosophical beliefs.
• A child must be fully immunised, on a catch-up immunisation schedule or have a valid exemption at the time a parent makes their very first claim for CCS.
• Previously, if parents met the other eligibility criteria, their CCS claim would be approved and they would have a 63 day 'grace period' for their child to meet the immunisation requirements. From 1 January 2016 the claim will not be approved if the immunisation requirements are not met.

What stays the same?

• Children with medical contraindications or natural immunity which are certified in writing by a General Practitioner will still be exempt from the immunisation requirements.
• Parents still have the right to choose not to vaccinate their child.
• Child care service providers can still set their own policies around whether or not they provide care to unimmunised children (in accordance with their state or territory requirements).
• If child care service providers or state / territory laws allow it, parents who are not eligible for child care payments can still use child care and pay the full fee.
• If a family is already eligible for CCS and the child misses a scheduled vaccination, the family receives a letter from Centrelink advising the vaccination is overdue.

Parents can contact the Department of Human Services' families line on 136 150 for more information.

Catering for Children with Overseas Immunisation Records

• Overseas immunisation schedules often differ from the schedule recommended in Australia and a child may require extra vaccinations to be up to date with the Australian schedule.
• Parents are responsible for having their child's overseas immunisation record transcribed onto the Australian Childhood Immunisation Register (ACIR), if your child is less than seven years of age.
• A medical practitioner, registered nurse, registered midwife, enrolled nurse, or a person authorised by the state/territory Health Officer may transcribe overseas immunisation records.

Immunisation for Educators

• Occupational recommendations apply for the immunisation of educators at the service. It is important that educators remain up to date with their vaccinations in order to protect themselves as well as children in their care. The National Health and Medical Research Council (NHMRC) recommends that individuals who work with children, including child care and pre-school staff (including child care students) and outside school hours carers, should be vaccinated against pertussis (whooping cough), hepatitis A, measles, mumps and rubella
• (MMR), varicella (chickenpox), and influenza (required annually).
• The service will take all reasonable steps to strongly encourage non-immune workers to be vaccinated.
• As there are no mandatory requirements under the law for educators to be immunised, the service must follow the requirements that our service has developed:
• Educators who are not immunised may be excluded during an outbreak.

If you have any further questions about the National Immunisation Program (NIP) Schedule, please talk to your doctor or immunisation provider. Please also refer to the NSW Immunisation Schedule which can be found online here.

My Home Your Home Family Daycare will use the attached Recommended Minimum Periods of Exclusion to exclude children and educators and inform parents of exclusion and non-exclusion periods for infectious diseases. We will minimise the spread of potential infectious diseases between children, other children and educators by excluding children who may have an infectious disease or are too ill to attend the service and facilitating the prevention and effective management of acute illness in children.

Notification of the child's parents or nominated contacts will occur immediately and all appropriate notifications to the local Public Health Unit will be made by our supervisor.

Children might be brought to care with no symptoms or signs of illness or while in care and suddenly develop an illness that has not been diagnosed by a doctor, and that might be potentially infectious or potentially life-threatening for the child. Symptoms may not clearly fit those listed in exclusion diseases making it difficult for the service to decide whether to accept or exclude the child from the service. Many illnesses, while not fitting exclusion criteria, can transmit disease to other children in care, and many non-exclusion diseases can make a child too ill to participate in normal care activities.

If an infectious disease arises at the service we will respond to any symptoms in the following manner:

• Isolate the child from other children.
• Ensure the child is comfortable.
• Contact the child's parents or nominated emergency contact. If the child's parents are unavailable we will contact the next nominated person. We will inform the contact of the child's condition and ask for a parent or other authorised person to pick the child up as quickly as possible. Any person picking the child up from the service must be approved by the child's parents and be able to show identification.
• Ensure all bedding, towels and clothing which has been used by the child is disinfected. These items will be washed separately and if possible air dried in the sun.
• Ensure all toys used by the child are disinfected.
• Ensure all eating utensils used by the child are separated and sterilised.
• Provide information in the child's home languages to the best of our ability.
• Inform all service families and educators at the family day care residence or venue of the presence of an infectious disease.
• Ensure confidentiality of any personal health related information obtained by the service and educators in relation to any child or their family.
• If a child has been unable to attend the Service because of an infectious illness the person must provide a doctors certificate which specifically states the child/educator is ok to return to the Service.

Infectious Diseases requiring Notification to the local Public Health Unit

Our supervisor will notify the local Public Health Unit by telephone as soon as possible (and within 24 hours) after they are made aware that a child enrolled at the service is suffering from a vaccine preventable disease.

NSW local Public Health unit directory and contact details are available on the following NSW Health website – https://www.health.nsw.gov.au/Infectious/Pages/phus.aspx

A list of vaccine preventable diseases is available at www.health.nsw.gov.au/phact

Our nominated supervisor will comply with any direction given by the Public Health Unit in relation to the notification.

Immunisation and Educators

The National Health and Medical Research Council (NHMRC) recommend that educators should be immunised against:

• Hepatitis A.
• Measles-Mumps-Rubella (MMR).

Educators born during or since 1966 who do not have vaccination records of two doses of MMR, or do not have antibodies for rubella, require vaccination.

• Varicella if they have not previously been infected with chickenpox.
• Pertussis. An adult booster dose is especially important for those educators caring for the youngest children who are not fully vaccinated.
• Hepatitis B if caring for unimmunised children with intellectual disabilities (although the risk is low).

Our service will:

• Provide educators and staff with information about diseases that can be prevented by immunisation through fact sheets and the Staying Healthy in Childcare publication.
• Advise educators and staff that some infectious diseases may injure an unborn child if the mother is infected while pregnant through fact sheets and the Staying Healthy in Childcare publication. These infections include chickenpox, cytomegalovirus and rubella (German measles)

Recommended Minimum Periods of Exclusion

This is a guide only and My Home Your Home Family Day Care reserve the right to enforce longer exclusion periods. If your child remains unwell after the exclusion period, they must remain at home until well.

National Health and Medical Research Council. Staying Healthy in Child Care. 6th edition.

Children who are unwell should not attend the service. A medical clearance will be required prior to the child coming back to care.

Definition of 'Contacts' - Exclusion of contacts people who have been in contact with the person who is sick, but who have no symptoms; if they have symptoms, they should follow the same guidance as the person who is sick.

Disease-Specific Exclusion Guidelines

Asthma Not excluded. Exclusion of Contacts – Not excluded.

Bronchiolitis/Bronchitis If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), monitor them and exclude them if: - they have several respiratory symptoms at the same time or - they have developed new symptoms while at the service or - the respiratory symptoms are severe or - the respiratory symptoms are getting worse (more frequent or severe) or - they also have concerning symptoms (fever, rash, tiredness, pain, poor feeding)

A person can often have an ongoing cough after they have recovered from a respiratory infection. If their other symptoms have gone and they are feeling well, they can return to the service.

Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service. Check if your state or territory has different requirements for respiratory symptoms.

Exclusion of Contacts – Not excluded.

Campylobacter Exclude until there has not been a loose bowel motion for 48 hours. Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours. Exclusion of Contacts – Not excluded.

Chickenpox (Varicella) Exclude until all blisters have dried – this is usually at least 5 days after the rash first appeared in non-immunised children, and less in immunised children.

Exclusion of Contacts - Not excluded, however staff or children who are immunocompromised are at high risk of developing severe disease if exposed and may need to be excluded.

Common cold If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), monitor them and exclude them if: - they have several respiratory symptoms at the same time or - they have developed new symptoms while at the service or - the respiratory symptoms are severe or - the respiratory symptoms are getting worse (more frequent or severe) or - they also have concerning symptoms (fever, rash, tiredness, pain, poor feeding)

A person can often have an ongoing cough after they have recovered from a respiratory infection. If their other symptoms have gone and they are feeling well, they can return to the service.

Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service. Check if your state or territory has different requirements for respiratory symptoms.

Exclusion of Contacts – Not excluded.

Conjunctivitis Exclude until discharge from the eyes has stopped. Not excluded if a doctor has diagnosed non-infectious Conjunctivitis. Exclusion of Contacts - Not excluded.

COVID-19 If a person has respiratory symptoms (cough, sneezing, runny or blocked nose, sore throat), monitor them and exclude them if: - they have several respiratory symptoms at the same time or - they have developed new symptoms while at the service or - the respiratory symptoms are severe or - the respiratory symptoms are getting worse (more frequent or severe) or - they also have concerning symptoms (fever, rash, tiredness, pain, poor feeding)

A person can often have an ongoing cough after they have recovered from a respiratory infection. If their other symptoms have gone and they are feeling well, they can return to the service.

Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service. Check if your state or territory has different requirements for respiratory symptoms.

Exclusion of Contacts - Not excluded.

CMV (Cytomegalovirus infection) Exclusion is NOT necessary. Exclusion of Contacts - Not excluded.

Croup Same respiratory symptom guidelines as above. Exclusion of Contacts - Not excluded.

Cryptosporidiosis Exclude until there has not been any diarrhoea or vomiting for at least 24 hours. Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours (they can be assigned to other duties after at least 24 hours, or stay away from the service for at least 48 hours)

Talk to your local public health unit for advice if there are several children and staff with diarrhoea or vomiting at the service. Check if your state or territory has different requirements for gastroenteritis.

Exclusion of Contacts - Not excluded.

Diarrhoea or vomiting Children and staff should go home as soon as possible after symptoms appear.

Exclusion of Contacts - Exclude until there has not been a loose bowel motion for 48 hours. Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours. If the diarrhoea or vomiting are confirmed to be due to norovirus exclude until there has not been any diarrhoea or vomiting for 48 hours.

Ear infection Not excluded unless associated with other concerning symptoms or the person is displaying discomfort. Exclusion of Contacts - Not excluded.

German measles (See 'Rubella')

Giardiasis Exclude until there has not been a loose bowel motion for 48 hours. Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours. Exclusion of Contacts - Not excluded.

Glandular fever (Mononucleosis, EBV infection) Exclusion is NOT necessary. Exclusion of Contacts - Not excluded.

Hand, foot and mouth disease Exclude until all blisters have dried. Exclusion of Contacts - Not excluded.

Haemophilus influenzae type b (Hib) Exclude until the person has received antibiotic treatment for at least 4 days. Exclusion of Contacts - Not excluded.

Head lice (Pediculosis) Exclusion is not necessary if effective treatment is commenced prior to the next day at child care (ie the child doesn't need to be sent home immediately if head lice are detected). However, If the educator deems the child to be uncomfortable and not able to participate in the daily activities, the child will need to go home to commence effective treatment. Exclusion of Contacts - Not excluded.

Hepatitis A Exclude until at least 7 days after jaundice starts, or if there is no jaundice, until at least 2 weeks after onset of other symptoms. Exclusion of Contacts - Not excluded.

Hepatitis B Exclusion is NOT necessary. Exclusion of Contacts - Not excluded.

Hepatitis C Exclusion is NOT necessary. Exclusion of Contacts - Not excluded.

Hepatitis E Exclude until at least 7 days after jaundice starts, or if there is no jaundice, until at least 2 weeks after onset of other symptoms. Exclusion of Contacts - Not excluded.

Herpes simplex (cold sores, fever blisters) Exclusion is not necessary if the person can maintain hygiene practices to minimise the risk of transmission.

If the person cannot maintain these practices (for example, because they are too young), exclude until the sores are dry.

Cover sores with a dressing, if possible Exclusion of Contacts - Not excluded.

Human Immunodeficiency Virus (HIV/AIDS) Exclusion is NOT necessary. If the person is severely immunocompromised, they will be vulnerable to other people's illnesses. Exclusion of Contacts - Not excluded.

Human metapneumovirus Same respiratory symptom guidelines as above. Exclusion of Contacts - Not excluded.

Hydatid disease Exclusion is NOT necessary. Exclusion of Contacts - Not excluded.

Impetigo (school sores) Exclude until antibiotic treatment has started. Cover any sores on exposed skin with a watertight dressing. Exclusion of Contacts - Not excluded.

Fever (temperature more than 38.0 °C) The person should go home as soon as possible.

Exclude until the temperature remains normal, unless the fever has a known non-infectious cause - If the child has gone home from the service with a fever but their temperature is normal the next morning, they can return to the service. - If the child wakes in the morning with a fever, they should stay home until their temperature remains normal. - Normal temperature is between 36.5 °C and 38.0 °C - If a doctor later diagnoses the cause of the child's fever, follow the exclusion guidance for that disease.

Exclusion of Contacts - Not excluded.

If children are given paracetamol or ibuprofen due to a fever prior to care, they must not attend and remain at home until the fever has passed.

Flu (Influenza)/Pneumonia Same respiratory symptom guidelines as above. Exclusion of Contacts - Not excluded.

Fungal infections of the skin or scalp (ringworm, tinea, athlete's foot) Exclude until the day after appropriate antifungal treatment has commenced. Exclusion of Contacts - Not excluded.

Measles Exclude for 4 days after the onset of the rash.

Immunised and immune contacts are not excluded. For non-immunised contacts, talk to your public health unit for advice.

Exclude all immunocompromised children until 14 days after the rash appears in the last case at the service.

Meningitis (viral) Exclude until person is well. Exclusion of Contacts - Not excluded.

Meningococcal infection Exclude until the person has completed antibiotic treatment. Exclusion of Contacts - Not excluded.

Molluscum contagiosum Exclusion is NOT necessary. Exclusion of Contacts - Not excluded.

Mumps Exclude for nine days or until swelling goes down (whichever is sooner). Exclusion of Contacts - Not excluded.

Norovirus Exclude until there has not been any diarrhoea or vomiting for at least 48 hours.

Talk to your local public health unit for advice if there are several children and staff with diarrhoea or vomiting at the service. Check if your state or territory has different requirements for gastroenteritis.

Exclusion of Contacts - Not excluded.

Parvovirus infection (fifth disease, erythema infectiosum, slapped cheek syndrome) Exclusion is NOT necessary. Exclusion of Contacts - Not excluded.

Pertussis Exclude until at least 5 days after starting appropriate antibiotic treatment, or for at least 21 days from the onset of coughing if the person does not receive antibiotics.

Exclusion of Contacts - Talk to your public health unit for advice about excluding non-immunised contacts. Talk to immunocompromised or pregnant staff about risk and recommend they seek medical advice.

Pneumococcal disease Exclude until person has received antibiotic treatment for at least 24 hours and feels well. Exclusion of Contacts - Not excluded.

Respiratory Syncytial virus Same respiratory symptom guidelines as above.

Talk to your local public health unit for advice if there are several children and staff with respiratory symptoms at the service.

Check if your state or territory has different requirements for respiratory symptoms.

Exclusion of Contacts - Not excluded.

Roseola Exclusion is NOT necessary. Exclusion of Contacts - Not excluded.

Mosquito-borne diseases (Barmah Forest virus, Chikungunya virus, Dengue virus, Zika virus, Japanese encephalitis, malaria, Murray Valley encephalitis virus, Ross River virus, West Nile virus – including Kunjin virus) Exclusion is NOT necessary. Exclusion of Contacts - Not excluded.

Rotavirus infection Children are to be excluded from the service until there has not been a loose bowel motion or vomiting for 48 hours.

Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours.

Exclusion of Contacts - Not excluded.

Rubella (German measles) Exclude until fully recovered or for at least four days after the onset of the rash.

Exclusion of Contacts - Not excluded.

Talk to immunocompromised or pregnant staff about risk and recommend they seek medical advice.

Salmonella infection Exclude until there has not been a loose bowel motion or vomiting for 48 hours.

Exclusion of Contacts - Not excluded.

Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours (they can be assigned to other duties after at least 24 hours, or stay away from the service for at least 48 hours)

Talk to your local public health unit for advice if there are several children and staff with diarrhoea or vomiting at the service. Check if your state or territory has different requirements for gastroenteritis.

Scabies Exclude until the day after appropriate treatment has commenced. Exclusion of Contacts - Not excluded.

Shigella infection Exclude until there has not been a loose bowel motion or vomiting for 48 hours.

Exclusion of Contacts - Not excluded.

Staff members with these symptoms should not handle food until they have not vomited or had diarrhoea for at least 48 hours (they can be assigned to other duties after at least 24 hours, or stay away from the service for at least 48 hours).

Talk to your local public health unit for advice if there are several children and staff with diarrhoea or vomiting at the service. Check if your state or territory has different requirements for gastroenteritis.

Shingles (zoster infection) Exclude children until blisters have dried and crusted. Adults who can cover the blisters are not excluded (they are excluded if blisters cannot be covered).

Exclusion of Contacts - Talk to your public health unit for advice about pregnant women and anyone who is immunocompromised.

Staph infection (Staphylococcus aureus) Exclude until the person has received antibiotic treatment for at least 24 hours and feels well. Exclusion of Contacts - Not excluded.

Streptococcal sore throat Exclude until the person has received antibiotic treatment for at least 24 hours and feels well. Exclusion of Contacts - Not excluded.

Thrush (candidiasis) Exclusion is NOT necessary. Exclusion of Contacts - Not excluded.

Toxoplasmosis Exclusion is NOT necessary. Exclusion of Contacts - Not excluded.

Trachoma (Chlamydia trachomatis eye infection) Exclude until antibiotic treatment has started and talk to your local public health unit for advice. Exclusion of Contacts - Talk to your public health unit for advice.

Tuberculosis (TB) Talk to your local public health unit for advice about exclusion. Exclusion of Contacts - Talk to your public health unit for advice about screening, antibiotics and TB clinics.

Typhoid, Paratyphoid Exclude until cleared by the local public health unit. Contacts - Not excluded unless considered necessary by public health authorities.

Viral gastroenteritis (viral diarrhoea and vomiting) Children are to be excluded until there has not been a loose bowel motion or vomiting for 48 hours. Exclusion of Contacts - Not excluded.

Warts Exclusion is NOT necessary. Exclusion of Contacts - Not excluded.

Worms Not excluded. Exclusion of Contacts - Not excluded.

Guidelines for COVID-19 as at 15th of August 2024

It is no longer mandatory to self-isolate if you test positive to COVID-19, but it is recommended you stay home and take steps to protect others.

If you test positive on a rapid antigen test (RAT) please register this with Service NSW.

Voluntarily registering your result can help you access medical support from NSW Health, including antiviral medicines if you are eligible.

Read more information on the self-isolation changes and how to stay safe.

Vaccination - Educators

It is recommended that educators are fully vaccinated with an approved vaccine. If vaccinated, the service will hold evidence of educators and household members vaccination status.

Any educator who has even the mildest of symptoms including fever, runny nose, muscle aches and pains, fatigue, cough, sore throat, shortness of breath, loss of taste or smell, acute blocked nose (congestion), headache, diarrhoea, nausea/vomiting, loss of appetite, unexplained chest pain and conjunctivitis should stay closed until they are well and get tested.

Masks - Adults

Wearing a mask in indoor public spaces helps protect everyone in our community and especially those that are at higher risk of severe illness. Face masks are recommended in Early Childhood Education and Care settings.

Children

Children who are unwell and displaying any of the symptoms mentioned above should not attend care. Children are to remain at home until the child is well. If a child becomes unwell in care the child will be asked to be picked up and the family will be encouraged to do a RAT test or PCR prior to returning to care.

Family Members - Child

If a child's family members have tested positive to COVID it is strongly recommended that the child be kept at home even if they aren't displaying any COVID-19 symptoms. It will be at the discretion of the educator should they wish to accept the child into care. A RAT test or PCR will be encouraged prior to the child attending care.

Educators will:

• Continue to adhere to the services Health, Hygiene and Safe Food Practices Policy with increased cleaning of the home and resources.
• We will be encouraging all of our educators to get the influenza vaccine and the COVID-19 vaccine.

Sources

• Education and Care Services National Regulations 2017
• National Quality Standard
• NSW Health Immunisation Schedule https://www.health.nsw.gov.au/immunisation/app/Pages/schedule.aspx
• NHMRC. Staying Healthy in Child Care - 6th edition
• Medicare Australia - http://www.medicareaustralia.gov.au/provider/patients/acir/schedule.jsp
• http://www.health.nsw.gov.au/immunisation/Publications/immunisation-enrolment-toolkit.pdf
• Work Health and Safety Act 2011
• Work Health and Safety Regulation 2011
• Public Health Act 2010
• Public Health Regulation 2012
• Australian Government Department of Health
• education.nsw.gov.au

Review

The policy will be reviewed annually. The review will be conducted by:

• Management
• Employees
• Families
• Interested Parties

Last reviewed: 15th August 2024

Date for next review: 15th August 2025