The Control of Substances Hazardous to Health Regulations (COSHH) 2002 and the Control of Substances Hazardous to Health Regulations (Northern Ireland) (COSHH) 2003 legislation, require employers to sufficiently assess the risks to workers from becoming exposed to substances hazardous to health and identify adequate control measures to ensure all staff are protected, so far as is reasonably practicable. This includes exposure to pathogens (also referred to as biological agents in COSHH). Suitable and sufficient personal protective equipment (PPE), where identified by the risk assessment, should be provided by the employer and be readily available.
The green book states that all new employees should undergo a pre-employment health assessment, which should include a review of immunisation needs. This should be based on the COSHH risk assessment and which pathogens staff are likely to be exposed to in their workplace. Staff considered to be at risk should be offered appropriate immunisation.
Based on this, most health care employers will check immunisation status through pre-employment occupational health screening.
Specific guidance for blood born viruses (BBV) Integrated guidance on clearance and management of healthcare workers living with bloodborne viruses (gov.uk) provides information on hepatitis b vaccine. This is used by many organisations to inform their employment policies. All staff involved in exposure prone procedures (EPP) should be offered and encouraged to have the hepatitis b vaccine. See Health clearance for tuberculosis, hepatitis B, hepatitis C and HIV: New healthcare workers guidance from the Department of Health.
Legally therefore, under COSHH, employers must identify the steps that need to be taken to prevent exposure and the specific vaccination requirements for staff come from this. However, the requirement to be vaccinated is guidance only and it is not actually mandated anywhere.
Staff must have access to the correct information, encouragement and clear explanation of the benefit and value of the vaccine and an opportunity to explore any reasons why an individual is hesitant.
Employers must also monitor the impact of staff vaccination policies on staff recruitment and retention and any equality impact for staff in protected groups. Similarly, employers need to monitor the impact to service users in terms of the care they receive.
In their guidance to the COSHH regulations, the Health and Safety Executive (HSE) point out that immunisation should be seen only as a useful supplement to reinforce physical and procedural control measures, not as the sole protective measure.
The HSE advise that some employees may not wish to take up the offer of immunisation, or they may not respond to a vaccine and will, therefore, not be immune. Employers need to still consider the effectiveness of the other controls and consider whether any additional controls should be implemented to allow them to work safely. In practice this will mean the continued provision of respiratory and other protective equipment, effective ventilation and, where the risk of harm remains high, potentially redeployment. See HSE guidance for workplaces safe on coronavirus (COVID-19).
ACAS guidance on working safely during coronavirus also provides information on occupational health vaccination specifically for COVID-19.