Mandatory Vaccination, Health Exemptions, and Unvaccinated Patients

Tēnā koutou katoa,

This special Nursing Council pānui contains information about recent changes to the government’s mandatory vaccination order for nurses, and the new process that has been implemented for seeking health exemptions. It also provides clarification of obligations to care for unvaccinated people, ahead of formal guidance we intend to issue on Friday. We hope that this and our other recent messages are helping to clarify how recent vaccination policy decisions might affect your practice.

We realise that the profession is facing an unprecedented time of stress and strain. Not only are you as nurses at the forefront of our COVID-19 response, but you are also ensuring that our health system as a whole continues functioning despite the extra burdens being placed on it. On behalf of the Nursing Council’s co-chairs, members, and staff, I would therefore also like to take this opportunity to thank you once again for your work, your professionalism, and your commitment to the wellbeing of Aotearoa New Zealand.

Nāku noa, nā

Catherine Byrne,
Pouārahi – Pouroki
Chief Executive – Registrar

Mandatory COVID-19 Vaccination Order

Last Friday, the Minister for COVID-19 Response issued a new Order that amended several aspects of the existing mandatory vaccination legislation. As a result, the Order now only applies to nurses “providing health services to patients in person”.

This means that if your work does not involve being in the physical presence of patients – for example, you only work in a telehealth or digital environment – you are not subject to the Order. The same applies if your work does not involve providing health services to patients, such as nursing research or professional and policy advice. This only applies to the government’s mandatory vaccination order; your employer may have their own vaccination requirements that you need to abide by.

It is important to note that this exemption only applies if none of your work involves seeing health consumers. For example, if you work both as a telehealth nurse and physically in a GP or Nurse Practitioner clinic then you will need to be vaccinated as per the Order.

For more detailed information on who is covered by the Order, please contact the Ministry of Health or visit their information page.

The Nursing Council firmly believes that vaccination is a critical part of Aotearoa New Zealand’s response to the pandemic. The Pfizer and other vaccines have been through rigorous trials and assessment, and all reliable evidence is that they are safe. Unless you have a specific and credible health diagnosis to the contrary, we strongly recommend that you get vaccinated for the sake of your whānau, the people and communities you work with, and your colleagues in nursing and the health sector.

Vaccination Health Exemptions

Following concerns around potential abuse of health exemptions from vaccination requirements, a new centralised system for seeking exemptions has been established by the Ministry of Health. This is intended to cover all legally-mandated vaccination requirements, not just the current mandatory vaccination order. For example, it will be available to people seeking health exemptions from vaccination requirements to attend a major public event.

In this new system, a practitioner does not issue exemptions themselves. Instead they apply on behalf of their patient to a ministerially-appointed panel. This panel will consider the application and supporting evidence before deciding whether or not to issue the exemption.

Health exemptions can now only be applied for by a Nurse Practitioner or a Medical practitioner. It is also expected that any practitioner who applies for an exemption on behalf of a patient will have an existing clinical relationship with that patient, such as being their main primary health care provider. Exemptions will apply for limited period of time, to a maximum of six months, and are primarily intended to allow time for a suitable vaccine to become available.

If you have previously obtained or issued a health exemption, these are no longer valid. You will need to arrange for a new exemption through this system.

Please note that someone who receives a health exemption may still not be able to work in their current role or area. Their employer will need to conduct a risk assessment based on their unvaccinated status, and this may lead to being redeployed into other positions. For example, a nurse may be moved into a role that involves no physical contact with patients.
Please note that the Nursing Council has no role in the health exemption process and cannot provide advice or assistance in this area. More information about applying for an exemption is available through HealthPathways or the Ministry of Health.

Caring for Unvaccinated Patients

We are aware that some people in the health sector have expressed concern or reluctance around caring for people who are not vaccinated. We are working with the Ministry of Health and other health profession regulators on this issue, and expect to issue formal guidance by the end of this week. This will be posted on our website.

In the meantime, we would like to clearly state that every person in Aotearoa New Zealand is entitled to safe, competent, and respectful care. This is a key element of Principle One in our Code of Conduct: Respect the dignity and individuality of health consumers, and is also reflected in the codes of other health professions. A person must not be refused services or care – or experience poorer care – purely on the basis that they are not vaccinated.

Your employer does have an obligation to ensure that you can practise safely, and to protect the safety of others in your care. However, measures such as social distancing, use of PPE, hygiene practices, and telehealth delivery can all be used to mitigate risk and ensure unvaccinated people have equitable access to health services.