15 July 2022

COVID-19 Vaccines: Department of Health fact sheet on consent and substitute decision making

The Australian Government Department of Health (Department of Health) has published a fact sheet supporting providers to understand what they can do if a substitute decision maker says no to COVID-19 vaccination for a participant.

Key points

• The Australian Government encourages all people aged 5 years and over to get vaccinated.
• Vaccination against COVID-19 is particularly important for people with disability.
• COVID-19 vaccination is voluntary and a medical professional can only provide vaccination to a patient where consent is provided.
• Providers have an important role to play in providing assistance to participants to access COVID-19 vaccinations.
• A new fact sheet provides information on steps that providers can take when a substitute decision maker withholds consent for COVID-19 vaccination and there is no medical reason for that decision.

Consent and access to COVID-19 vaccinations and boosters

Vaccination against COVID-19 is particularly important for people with disability as many are at greater risk of severe illness from COVID-19 infection. People with risk factors for severe disease and people with increased risk of exposure to infection should receive their booster dose as soon as they are eligible to protect themselves against COVID-19. Vaccination is also important for many people with intellectual disability as they may find it hard to understand and comply with health protection measures.

People aged 16 and over can choose whether they get vaccinated and provide consent. People with disability, including intellectual disability, should be provided with the information and support they need to make a decision about COVID-19 vaccination. State and territory laws outline who can make medical decisions, including having vaccinations, on behalf of an adult who does not have capacity to consent.

Providers should take all necessary steps to assist participants to access COVID-19 vaccinations, including information and support, where they need assistance. Further information is available on the Department of Health website, including Easy Read and Auslan resources and a COVID-19 vaccination consent form in easy read format.

Our fact sheet, COVID-19 Vaccines: Informed consent, preparing for the vaccine, and restrictive practices aims to assist NDIS providers to understand their obligations when supporting people with disability to receive the COVID-19 vaccine. We have also issued a statement about the right of people with disability to make their own decision about COVID-19 vaccination, and the role of NDIS providers and workers in supporting participants.

Engaging with substitute decision makers

The Department of Health has published a new fact sheet with information for providers on what to do if a substitute decision maker does not consent to COVID-19 vaccination for a person with intellectual disability.

State and territory laws define who can make medical decisions on someone’s behalf if they cannot give consent, even with support. These people are known as substitute decision makers.

Substitute decision makers should act in accordance with state and territory laws. Generally, they are required to promote the person’s wellbeing and be respectful of the person’s known wishes and preferences and, in the case of medical decisions, the advice of the person’s treating doctor.

If a substitute decision maker withholds consent on behalf of an adult who does not have capacity to consent themselves, and there is no medical reason for that decision, there are some steps providers can take. This includes:

• Talking with the substitute decision maker and identifying the reason why they have withheld consent for vaccination
• Providing information/resources that help to address any concerns they have.

Where concerns cannot be resolved, providers can contact the relevant tribunal in their state or territory for information and advice.

For more information about steps that providers can take and the role of state and territory tribunals in relation to consent for medical treatment, read the fact sheet.

The COVID-19 Hesitancy and Refusal webinar addresses issues relating to vaccine consent, hesitancy and refusal that can arise when supporting people with intellectual disability, including the role of substitute decision makers. 

Reminder: Supporting NDIS participants to access COVID-19 vaccinations

All NDIS participants aged 5 years and over are eligible for the COVID-19 vaccine. Participants aged 16 and older are also eligible for a booster dose if they have completed their primary course of a COVID-19 vaccination at least three months ago.

Residents of aged care or disability accommodation facilities and people aged 16 years and older with disability, significant or complex health needs, or multiple comorbidities which increase the risk of a poor outcome are also eligible for a COVID-19 winter dose (second booster dose). ATAGI recommends these people should receive their COVID-19 winter dose three months after their initial booster dose.

Supporting participants to receive the COVID-19 vaccine and booster doses is consistent with your obligations under the NDIS Code of Conduct and conditions of registration. It helps to promote a safe service delivery environment and is one way that you can help manage risks of COVID-19 infection for the participants you support. You and your workers play a critical role by providing accurate and accessible information about COVID-19 vaccinations and boosters.

To assist people with disability to learn more about COVID-19 booster doses, the Department of Health has developed the following easy read resources:

• Fact sheet about the third dose
• Fact sheet about the booster dose
• Fact sheet about the difference between the third dose and a booster dose
• Fact sheet about the winter dose.

NDIS Commission COVID-19 vaccine information and resources

The COVID-19 vaccine information webpage on our website contains links to updates about COVID-19 vaccines and resources for NDIS providers.