Health Worker (Restriction on Access) Directions (No 3) frequently asked questions

Why do health care and health support workers need to be vaccinated?

Based on the latest health advice from Western Australia’s Chief Health Officer, due to the evolving Delta variant and risks of COVID-19, healthcare and health support workers will need to be vaccinated to access health care facilities from 1 October 2021.

This will be done in a staged approach to ensure impacted health staff who work with the most vulnerable Western Australians get the COVID-19 vaccine.

All health care facilities have employees that will have come into contact with, or the potential to come into contact with, COVID-19 positive people.

Transmission of COVID-19 in health care settings has the potential to cause serious illness and death in staff, patients and visitors. Some patients, including those in intensive care, high dependency and respiratory units are particularly vulnerable if infected with COVID-19.

Based on the public health advice, hospitals need to take reasonable precautions to protect staff, patients and visitors from these risks. COVID-19 vaccinations have been shown to be highly effective in preventing infections in individuals and subsequently reducing transmission of the virus to others if a vaccinated person is infected.

Given the integrated nature of the public and private entities of the WA health system and occupational groups, there are risks to all employees and our patients and other users of the health care system unless the workforce is vaccinated, including those in administrative and office roles.

Staged approach to vaccination

Health care facility Healthcare workers Health support workers
Tier 1 1 October 2021 – First dose
1 November 2021 – Fully vaccinated
1 October 2021 – First dose
1 November 2021 – Fully vaccinated
Tier 2 1 November 2021 – First dose
1 December 2021 – Fully vaccinated
1 December 2021 – First dose
1 January 2022 – Fully vaccinated
Tier 3 1 December 2021 – First dose
1 January 2022 – Fully vaccinated
1 December 2021 – First dose
1 January 2022 – Fully vaccinated

Does this apply to me?

The access restrictions apply to all health care workers and health support workers employed and engaged in all health care facilities, as outlined in the Health Worker (Restrictions on Access) Directions (No 3) or any replacement directions as amended from time to time (Directions), unless you have an exemption.

This requirement will be implemented through a staged approach. By the final stage everyone employed by WA Health, other than workers with an exemption, must be fully vaccinated, including those employed in office roles, such as employees of Health Support Services and the Department of Health.

All health care and support workers in private hospitals must also be fully vaccinated, in accordance with the staged approach, in order to access those facilities. Health care and health support workers in other private healthcare settings (e.g. GP clinics, private or non-government organisation specialist centres, private dental practices) will not be subject to the Directions unless specified by the Chief Health Officer.

Which workers are covered by the Directions?

All health care and health support workers, as defined below, in public and private hospitals and in public health care facilities are covered by the Directions. When will the access restrictions apply to health care and health support workers outlines the date by which you will need to have been partially or fully vaccinated in order to access health care facilities.

Health care workers include:

  • all those who provide health, medical, nursing, midwifery, pathology, pharmaceutical, social work or allied health services to a patient at the health care facility in any capacity
  • assistants in nursing, orderlies and hospital service assistants
  • students on placement
  • ambulance officers.

The Directions at Column 1 of Schedule 1 sets out who is a health care worker, with Column 2 of Schedule 1 setting out the exemptions from the definition of health care worker.

Health support workers include those who provide goods or services at a health care facility, both in a paid and in a voluntary or unpaid capacity. This includes:

  • a person employed or engaged by a third party, including a labour hire firm who provides staff to supplement the permanent workforce
  • a direct care worker including a personal care worker
  • administrative staff including those working in administration, management or reception services
  • ancillary staff including cleaners, laundry staff, gardeners, food preparation services, security officers and maintenance services
  • those providing lifestyle and social care, for example music or art therapy
  • a person who provides commercial activities at premises that constitute a healthcare facility e.g. a person operating a kiosk on hospital premises
  • interpreters.

The Directions at Column 1 of Schedule 2 sets out who is a health support worker, with Column 2 of Schedule 2 setting out the exemptions from the definition of health support worker.

Health care and health support workers in other healthcare settings (e.g. GP clinics, private and non-government organisation specialist centres, private dental practices) will not be subject to the Directions, unless those premises are specified by the Chief Health Officer.

See How do I get an exemption from the vaccination requirements for information on exempt workers.

Are all health care facilities covered by the Directions?

All public and private hospitals and public health care facilities are covered by the Directions.

GP clinics, private specialist centres, private dental practices and other private health care settings which are not hospitals, will not be covered by the Directions unless specified by the Chief Health Officer.

Health care facilities will be covered by a staged introduction of the vaccine requirements with health care and health support workers who work in high risk areas to be vaccinated first.

Tier one health care facilities, include the following public and private facilities:

  • intensive care units within a hospital
  • high dependency units within a hospital
  • respiratory wards within a hospital
  • emergency departments within a hospital
  • COVID (testing) Clinics
  • COVID-19 vaccination community clinics and regional COVID-19 vaccination clinics
  • wards with designated respiratory beds within certain regional hospitals.

Tier two health care facilities all hospitals, both private and public. This includes day hospitals and nursing posts.

Tier three health care facilities extend to:

  • all public health service facilities including vehicles from which public health services are provided
  • any premises occupied by the Department of Health or a public health service provider.

Tier three ensures all health care and health support workers at the Department of Health or a health service provider, other than those with an exemption, will be fully vaccinated by 1 January 2022 in order to access health care facilities.

See also When will access restrictions apply to health care and health support services.

When will the access restrictions apply to health care and health support workers?

From 1 October 2021, health care and health support workers will need to have received at least the first dose of a vaccine to enter the high-risk tier one health care facilities, both public and private. Tier one includes areas of highest risk as defined at Are all health care facilities covered by the Directions.

From 1 November 2021:

  • Health care and health support workers will need to be fully vaccinated to enter the high-risk tier one health care facilities.
  • Health care workers will need to have received at least the first dose of a vaccine to enter tier two health care facilities. This includes all hospitals, both private and public.

From 1 December 2021:

  • Health care workers will need to be fully vaccinated to enter tier two health care facilities.
  • Health support workers will need to have received at least the first dose of a vaccine to enter tier two health care facilities.
  • Health care and health support workers will need to have received at least the first dose of a vaccine to enter tier three health care facilities. Tier three facilities include all public health care facilities, including support services and Department of Health and health service provider, including Health Support Services, premises.

By 1 January 2022, all health care and support workers will need to be fully vaccinated to enter any health care facility.

Will I be able to be vaccinated before the deadline?

Additional Pfizer vaccine doses will be provided to health service providers for some public hospitals to offer on-site vaccinations for health care and health support workers in their area. 

There will also be additional capacity made available specifically for health care and health support workers in the WA Health community vaccination clinics.

Affected health care and health support workers will not be required to book a vaccine appointment but will be able to walk into a vaccination clinic, produce their employee identification and be vaccinated.

Which vaccines are available? Do I get to choose?

You will be eligible to receive a Pfizer COVID-19 vaccine, regardless of your age. However, you can choose to receive the AstraZeneca vaccine. The Moderna vaccine is also available from selected community pharmacies. This applies to all healthcare and health support workers covered by the Directions.

If you have already received the first dose of a vaccine, you must have the same vaccine for your second dose.

You will need to ensure you have received both doses of your chosen COVID-19 vaccination prior to the required date or apply for a temporary exemption from the Chief Health Officer if that is not possible.

When am I considered to be fully vaccinated?

In order to be considered fully vaccinated for the purpose of the Directions, you must have been administered with two doses of a COVID-19 vaccine registered by the Therapeutic Goods Administration (TGA). This includes the Pfizer, AstraZeneca and Moderna vaccines.

You will be partially vaccinated if you have been administered with at least one dose of a COVID-19 vaccine registered by the TGA.

Under the current Directions, there is no requirement for boosters, but this may be considered in the future.

How do I demonstrate I have been vaccinated?

The Chief Health Officer has approved the forms of evidence that will be accepted as proof of vaccination against COVID-19. These are:

  • a COVID-19 digital vaccination certificate or an Immunisation History Statement recorded on the Australian Immunisation Register; or
  • written confirmation issued by the Department of Health to the health care worker or health support worker of the COVID-19 vaccination received by them

A health care worker or health support worker must produce for inspection and recording evidence of their vaccination if directed to do so by an emergency officer or required to do so by their employer or the owner/occupier/person in charge of the health care facility.

Will I still be paid if I have to leave work for my vaccine appointment?

For WA Health employees, consistent with advice from the Public Sector Commission, public sector employees are allowed reasonable work time in which to receive a vaccination. This includes reasonable travel time to and from the vaccination centre, pharmacy, Aboriginal health service general practice where you are receiving your vaccine.

You need to speak with your line manager before making a booking if you intend to receive the vaccine during work time. This will help your employer and your team ensure work and services continue. This is normal practice.

Employees in the private sector should seek advice from their employer.

How do I get an exemption from the vaccination requirements?

You will be an exempt person if:

  • You have a medical exemption. Immunisation medical exemption criteria is available from the Australian Government website.
  • You have a temporary exemption, for example you may be granted a temporary exemption if you have been vaccinated overseas with a vaccine that has not been approved by the Therapeutic Goods Administration or if you are in an area where vaccine availability is limited and you have made every effort to obtain a vaccine.
  • You are performing a specific duty as outlined in the Directions.
  • You are a person of the kind listed in the Directions as exempt.
  • You are any other person declared to be exempt, which will only occur in exceptional circumstances.

Decisions on temporary exemptions will be considered by the Chief Health Officer on a case by case basis and may be subject to terms and conditions. These temporary exemptions can be for an individual or for an organisation or a group of people. For example, a nursing post in remote WA may decide to apply for a temporary exemption for its staff due to the difficulty in accessing vaccinations within the prescribed timeframe.

Further guidance on exemptions are available on the WA Government website.

How do I obtain a medical exemption from having the COVID-19 vaccine?

Medical exemptions mean a medical exemption recorded on the Australian Immunisation Register and displayed on an individual’s Immunisation History Statement. This may be a temporary or a permanent medical exemption. Not every health professional can grant a medical exemption. Health professionals who can grant an exemption are:

  • General practice registrars on an approved 3GA training placement
  • Paediatricians
  • Public health physicians
  • Infectious disease physicians
  • Clinical immunologists
  • GPs who meet certain criteria.

GPs need to be one of the following:

  • Vocationally registered
  • A fellow of the Royal Australian College of General Practitioners (RACGP)
  • A fellow of the Australian College of Rural and Remote Medicine (ACRRM)

Your GP will know if they can grant an exemption. To grant an exemption, they must update the Australian Immunisation Register or complete a form.

There are limited reasons you might be able to get a medical exemption from having a vaccine including if you:

  • had anaphylaxis after a previous dose of a vaccine
  • had anaphylaxis after a dose of any component of a vaccine
  • are significantly immunocompromised – for live vaccines only (NB: COVID-19 vaccines are not live vaccines).

It is not anticipated that medical exemptions recorded on the Australian Immunisation Register will be granted on the basis of pregnancy alone. RANZCOG and ATAGI recommend that pregnant women are routinely offered the Pfizer vaccine (Comirnarty) at any stage of pregnancy. This is because the risk of severe outcomes from COVID-19 is significantly higher for pregnant women and their unborn baby. Further information is available at the Joint statement between RANZCOG and ATAGI about COVID-19 vaccination for pregnant women. If a person has previously been granted an exemption from a COVID-19 vaccine on the grounds of pregnancy and that exemption is recorded on the Australian Immunisation Register, that exemption will be accepted for the purpose of the Directions.

As confirmed in the joint statement, “women who are trying to become pregnant do not need to delay vaccination or avoid becoming pregnant after vaccination”. This also applies to breastfeeding women. You may find this information useful: COVID-19 vaccination decision guide for women who are pregnant, breastfeeding, or planning pregnancy.

Please note that the Chief Health Officer is able to grant temporary or permanent exemptions in rare circumstances where a medical exemption cannot be recorded on the Australian Immunisation Register but an expert or experts approved by the Chief Health Officer have provided advice about the need for an exemption.

If you are in the process of applying for a medical exemption but that process is not yet complete, you may be able to apply for a temporary exemption.

If you have a medical exemption, alternative work arrangements may then be considered by your employer.

If I have an adverse reaction to the vaccination and need to take time off work, does this come out of my personal leave/annual leave/paid leave? Can I access COVID-19 leave?

The most common side effects after COVID-19 vaccination are usually mild and include:

  • pain, redness and/or swelling at the injection site
  • headache
  • fatigue
  • muscle and/or joint ache
  • mild fever.

When they occur, these symptoms typically start within 24 hours of vaccination, last one to two days, and resolve without treatment

If you are concerned about your symptoms you should seek advice from your doctor. If you believe your reaction is severe or life-threatening you should call triple zero (000) for an ambulance or go to your closest emergency department.

Any reactions that are causing you concern, whether minor or serious, should be reported to the Western Australian Vaccine Safety Surveillance (WAVSS) system (external site). Your immunisation provider, GP or other health professional should report all suspected significant reactions, but you can also do it yourself on the WAVSS reporting website (external site).

Please stay home and do not come to work if you feel unwell and seek treatment from your doctor as required. Permanent and fixed term employees can access accrued personal/sick leave as with any other illness.

WA Health employees who experience an adverse reaction to a COVID-19 vaccination and are unable to attend work can access COVID-19 leave under Government Sector Labour Relations Circular 6/2020 if they do not have any personal or sick leave entitlements. This includes casual employees.

Circular 6/2020 allows your Employer to request reasonable evidence (for example, a medical certificate) supporting your entitlement to COVID-19 leave.

In the rare situation that you suffer a moderate or significant adverse reaction to the COVID-19 vaccine, then there is a no fault vaccine claims scheme set up by the Commonwealth government. The scheme will cover the costs of injuries $5,000 and above due to an adverse reaction to or administration of a TGA approved COVID-19 vaccination. More information about the scheme is available at COVID-19 vaccine claims scheme.

Alternatively, in the unlikely event that you suffer a moderate or significant adverse reaction to the COVID-19 vaccine, you may also be able to access workers’ compensation in the usual way.

What happens if I choose not to get vaccinated?

Once the Directions apply, an unvaccinated employee without an exemption, must not access their workplace as set out in the staged approach to vaccination table. This may mean an employee can no longer perform their role, potentially putting their employment at risk.

Workers engaged in the private sector should seek advice from their employer.

It is also an offence to fail to comply with the Directions without a reasonable excuse, punishable by a fine of up to $20,000.

However, if you have a legitimate medical reason for refusing a vaccination, please refer to I have a medical certificate saying I cannot have the vaccine due to medical reasons. What do I do.

Do the access restrictions apply to visitors to healthcare facilities?

Vaccination is strongly encouraged for any visitors entering a healthcare facility, but the access restrictions do not apply.  The Government may place limitations on visitors in the event there is community spread.

What happens if I need to attend hospital as a patient or visitor?

The Directions only apply to you in your capacity as a health care or health support worker.

The access restrictions do not apply if you attend a health care facility solely as a patient or visitor, but vaccination is strongly encouraged.

Where can I go for more information about vaccines?

For more information regarding vaccination eligibility and bookings, visit the following websites:

If you have questions about the Directions you can send any questions to the following addresses at your respective workplace:

Last reviewed: 05-10-2021