Need to know

Your official eNewsletter from the Nursing and Midwifery Council of NSW

Special edition: Your professional obligations, COVID-19 and vaccinations

Can I express my personal opinion on vaccination?

Nurses are among the first Australians to get vaccinated against COVID-19 and they are playing a key role in vaccinating everyone else and educating the public about the vaccine. We have recently noticed a spike in complaints from nurses, their employers and the public concerning unreliable information surrounding COVID-19 and the vaccine.

It is okay to have questions, concerns and opinions about the vaccine. However, nurses are trusted professionals who are viewed as such by the public, so it’s critical that you are aware of the power of your words and actions. In fact, Ahpra and the National Boards recently published a joint position statement that makes it clear any promotion of anti-vaccination statements or health advice which contradicts the best available evidence or seeks to actively undermine the national immunisation campaign (including via social media) is not supported by the National Boards.[1] This can result in real life consequences for the public and for you, including a complaint about your practice and possible regulatory action such as the imposition of conditions on your registration.

What is the 'best available' evidence?

Understanding that there are levels of evidence, with differing levels of reliability, is critical to making appropriate decisions as a nurse. This is especially important in the context of health, where the risk to the public is immediate and high if practitioners aren’t using reliable evidence.

Put simply, the quality of evidence is based on the strength of the research methods used to gather it. The Joanna Briggs Institute (JBI) Levels of Evidence table (pictured below) provides a visual depiction of forms of research from the least reliable (base) to the most reliable (top).[2] This is a useful tool to keep in mind when consuming information, inside and outside of your practice, and making decisions that impact the health and safety of the public. The key element you should look out for is critical appraisal, or, in other words, evidence that has been systematically assessed to judge its trustworthiness, value and relevance. Identifying appropriate databases to access information is also paramount and JBI offers an Evidence-Based Practice (EBP) Database that allows you to search a wide range of summarised and appraised evidence to inform your practice.

The Nursing and Midwifery Board of AustraliaMBA recognises the Australian National Immunisation Handbook 10th edition as providing advice on identifying the best available evidence to health professionals about the safe and effective use of vaccines and the public health benefits associated with vaccination.[3]

The WHO say they aren't just battling the virus - they're also battling an "infodemic"; a word they coined to represent the overabundance of information and the rapid spread of misleading or fabricated news, images, and videos.

The World Health Organization (WHO) on the risks of misinformation

Proliferating misinformation can have serious, and even social and lethal, health ramifications in the context of a global pandemic:

Rumours about impending food scarcity prompted people to stockpile supplies early on in the epidemic and caused actual shortages.
A person passed away from ingesting a fish tank cleaning product containing chloroquine after reports mentioned hydroxychloroquine as a possible - yet unproven - remedy for treatment of COVID-19.
Hundreds died after drinking methanol alcohol that social media messages said had cured others of the coronavirus.[4]

The WHO has put together some handy tips on dealing with the “infodemic” and telling the difference between reliable and unreliable information.

The JBI Levels of Evidence

Click here to complete the evidence-based practice learning modules on NSW Health’s CIAP website to sharpen your capability in this area.

View the database and guide

What about sharing my opinions in a private capacity, such as on social media?

The Nursing and Midwifery Board of Australia’s Social media policy provides clear guidance to nurses and midwives when using social media. It is unambiguous in stating that when using social media, in any context, the National Law, the NMBA’s code of ethics and code of conduct apply. The NMBA’s Codes of professional conduct is extremely clear in stating that all nurses and midwives have a responsibility to conduct themselves personally and professionally to exemplary standards and in a way that maintains public trust and confidence in the professions.[5] This means that nurses and midwives are expected to use the best available evidence when providing information to the public about public health issues, regardless of the setting.

It is an offence under the National Law to advertise a regulated health service (including via social media) in a way that is false, misleading or deceptive. Advertising that includes false, misleading or deceptive claims about COVID-19, including anti-vaccination material, may result in prosecution by Ahpra.[6]

Worried? Voice your concerns

You can voice any concerns about the COVID-19 pandemic and the vaccine in a safe, supportive environment through the Australian College of Nursing’s anonymous COVID-19 Disclosure Portal. Remember, regardless of personal opinions, nurses can still share factual information about the vaccine in a professional manner.

We have collated the following list of key facts and useful resources to keep nurses informed, safe and prepared to respond to the COVID-19 pandemic.

Key facts

Key resources

Globally, vaccination prevents 2-3 million deaths per year.[7]
Any vaccine used in Australia must be approved by the Therapeutic Goods Administration (TGA) as being safe and effective.[8]
The vaccines cannot cause COVID-19 infection.[9]
The vaccines cannot change human DNA.[10]
Even when the vaccine starts to be administered to the general community in NSW, it will still be important to practise COVID safe behaviour.[11]
The COVID-19 vaccine is voluntary, universal and free.[12]
The Australian Technical Advisory Group on Immunisation (ATAGI) has provided advice to the Australian Government on which groups should be prioritised for the first doses for possible COVID-19 vaccination in Australia.[13]
Regulators and health authorities continue to rigorously monitor the safety, effectiveness and quality of vaccines after they are approved and released for use.[14]

Video – How vaccines work

Video – How COVID-19 vaccines are tested and approved

Video – Vaccine confusion? Here are the facts - Australian Academy of Science

ACN’s COVID-19 disclosure portal

Australian Nursing and Midwifery Journal - Safety and reactogenicity of COVID-19 vaccines

Department of Health COVID-19 vaccination training program

Subscribe to the COVID-19 Vaccines Update

The National Rollout Strategy

ATAGI clinical guidance on COVID-19 Vaccine in Australia in 2021

COVID-19 vaccination: information for NSW healthcare workers

WHO – Immunizing the public against misinformation

References

[1] Australian Health Practitioner Regulation Agency - All profession information. (n.d.). Australian Health Practitioners Authority. https://www.ahpra.gov.au/News/COVID-19/All-profession-information.aspx

[2] Ingham-Broomfield, R. I. B. (2016). A nurses’ guide to the hierarchy of research designs and evidence. AUSTRALIAN JOURNAL OF ADVANCED NURSING, 33(3), 38–43

[3] Nursing and Midwifery Board of Australia - Position statement on nurses, midwives and vaccination. (n.d.). Nursing and Midwifery Board of Australia. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Position-Statements/vaccination.aspx

[4] Immunizing the public against misinformation. (2020, August 25). Who.Int. https://www.who.int/news-room/feature-stories/detail/immunizing-the-public-against-misinformation

[5] Nursing and Midwifery Board of Australia - NMBA position clear, we will take action on anti-vaccination promoters. (2016, October 20). Nursing and Midwifery Board of Australia. https://www.nursingmidwiferyboard.gov.au/News/2016-10-20-statement.aspx

[6] Australian Health Practitioner Regulation Agency - All profession information. (n.d.). Australian Health Practitioners Authority. https://www.ahpra.gov.au/News/COVID-19/All-profession-information.aspx

[7] ICMRA statement about confidence in vaccines (for the general public) | International Coalition of Medicines Regulatory Authorities (ICMRA). (n.d.). International Coalition of Medicines Regulatory Authorities. http://icmra.info/drupal/en/strategicinitiatives/vaccines/statement_general_public

[8] C. (2021, March 2). Safety and reactogenicity of COVID-19 vaccines. Australian Nursing and Midwifery Journal. https://anmj.org.au/safety-and-reactogenicity-of-covid-19-vaccines/

[9] C. (2021, March 2). Safety and reactogenicity of COVID-19 vaccines. Australian Nursing and Midwifery Journal. https://anmj.org.au/safety-and-reactogenicity-of-covid-19-vaccines/

[10] C. (2021, March 2). Safety and reactogenicity of COVID-19 vaccines. Australian Nursing and Midwifery Journal. https://anmj.org.au/safety-and-reactogenicity-of-covid-19-vaccines/

[11] COVID-19 vaccination: information for the NSW community - Vaccination. (n.d.). NSW Health. https://www.health.nsw.gov.au/Infectious/covid-19/vaccine/Pages/community.aspx

[12] COVID-19 vaccination FAQs - COVID-19 (Coronavirus). (n.d.). NSW Health. https://www.health.nsw.gov.au/Infectious/covid-19/Pages/covid-vaccination-faqs.aspx

[13] COVID-19 vaccination FAQs - COVID-19 (Coronavirus). (n.d.). NSW Health. https://www.health.nsw.gov.au/Infectious/covid-19/Pages/covid-vaccination-faqs.aspx

[14] ICMRA statement about confidence in vaccines (for the general public) | International Coalition of Medicines Regulatory Authorities (ICMRA). (n.d.). International Coalition of Medicines Regulatory Authorities. http://icmra.info/drupal/en/strategicinitiatives/vaccines/statement_general_public

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