“It was like being involved in a war effort,” says Sally Steffanoni, as she reflects on her experience delivering COVID-19 vaccines. Before 2021, Steffanoni was a Department of Health worker, but she’d never administered vaccines. Before joining the vaccine workforce, she was a school nurse.

The rollout of the COVID-19 vaccines in Australia is a unique one. The immense weight and the breadth of the pandemic has necessitated extensive mobilisation of health workers, not just doctors and nurses, but also pharmacists, community health workers and educational health specialists. This has been a significant and important decision made by state governments. and there are plans to expand it further.

Working as a school nurse until last year, Steffanoni transitioned into working as a vaccine nurse at Joondalup’s Vaccination Centre earlier this year. She’s come from a completely different area in health, and she says the shift wasn’t without challenges.

“To be honest, lots of us were quite anxious,” she says. “We hadn’t been in that role before, and suddenly we’re cast in quite a different role.” Despite this, Steffanoni says by the time she had spent a short time in the clinic, she was feeling reassured. “By the end of the first day, I was already feeling pretty comfortable in the role. You know you’re a nurse, and so you’re used to adapting to different situations.”

She does miss her usual day-to-day work at schools. She reflects on the importance of her work as a healthcare professional and an educator and says it’s hard not to feel like she’s left that role behind. However, she asserts the importance of the work she’s doing now.

“We’re in a pandemic. This priority is to vaccinate. That has to wait. The priority is getting the vaccination numbers up.”

Sally Steffanoni

She’s not alone. Steffanoni is one of many individuals who have set aside their regular jobs for the pandemic and worked to raise WA’s vaccination rate. Another such person is Sandra Carmody, also a public-school health worker, who has worked as a vaccine nurse at Joondalup. She echoes Steffanoni’s comments on the initial difficulty of the role: “Obviously it took a while to get used to doing completely different tasks, not having worked clinically for a long time,” she says.

For many, this job can be stressful and at times even dangerous. Only recently, vaccine workers were spat on and verbally abused by protestors in Melbourne.

But like Steffanoni, Carmody found the experience of helping Australia find its way out of the pandemic to be fundamentally rewarding: “I actually really enjoyed it, although it was tiring work. It was nice to feel like you’re contributing to the pandemic and keeping people safe.”

According to the WA Department of Health, a broader health force has been instrumental in tackling health crises since the 2009 swine flu epidemic. But this broader force has been brought into the national limelight this year with the continued coverage of Australia’s vaccine rollout.

Due to the immediacy of the pandemic, vaccine training was adjusted this year in order to expedite the process. Steffanoni describes the accelerated training program: “We did maybe 12 hours of training that was very specific to Pfizer and AstraZeneca, and learning the system that was used, and we also did a practical component at Perth Children’s Hospital.”

More than 100,000 Australians have enrolled in the vaccine training program this year. Under the Australian College of Nursing’s new training program for vaccinators at state run clinics, potential immunisers must complete a series of six core modules and three vaccine-specific modules. According to a spokesperson from the ACN, this training program has been designed and coordinated in collaboration with “key stakeholders and leaders from different healthcare professions” (known as the Course Advisory Healthcare Group) as well as consultation from the Australian Technical Advisory Group on Immunisation and the Department of Health.

A spokesperson from the WA Department of Health says the training of individuals to administer COVID vaccinations is crucial to the rollout: “Lay vaccinators are simply another step in ensuring the population of Western Australia can get vaccinated.

“The WA chief health officer has approved a legal instrument to enable lay vaccinators to administer COVID vaccinations under the direction of a registered health professional,” the spokesperson says, “The vaccine program is always mindful of the health system-wide demands and as such continues to pursue innovative opportunities to recruit staff from outside the WA health system.”

Although the extension of this program is currently in its early stages, the department is confident it will be able to source individuals to strengthen the vaccine workforce. “Lay vaccinators will likely be sourced from people in the health industry or studying something in a health-related field. It is a matter of going out to a broader, yet still relevant, pool of people who facilitate vaccinations as required,” the spokesperson says.

The department says it hopes to replicate the successes that have been made overseas and interstate in allowing for vaccine delivery to be coordinated by people other than doctors and nurses.

Whilst the department’s program is primarily focused on staffing and coordinating state-run vaccination clinics, this vaccine rollout has been a far-reaching one. With general practitioners and pharmacies also joining the vaccine force, it’s clear that the government is committed to rolling out vaccines in any way possible. 

With the announcement that the Moderna Vaccine will now be made available to all Australians aged 12 and up from pharmacies, the government is stressing the importance of a spread of vaccines options available to West Australians.

Pharmaceutical Society of Australia general manager of knowledge and development Stefanie Johnston says pharmacists are well placed to deliver COVID-19 vaccinations: “Pharmacists have undertaken immunisation as a core skill for over seven years now, ” she says. Johnston says pharmacists, with experience as immunisers prior to the pandemic, are best suited to aid the government’s rollout of the vaccines. “They have undertaken initial training as an immuniser either as part of their undergraduate degree, or as upskilling after becoming a registered pharmacist, and then undertaken that standard national training around COVID-19 vaccines.”

She says pharmacies are uniquely positioned to collaborate with state-run clinics in order to ensure a broad rollout of vaccinations: “One of the biggest barriers for anyone to obtain a vaccine is access,” she says. “There is a need to have as many immunisers as possible providing this so people can access the vaccines.”

“There is a need to have as many immunisers as possible”

Stefanie Johnston, Pharmaceutical Society of Australia

So far, pharmacists have been primarily involved with AstraZeneca vaccines, and Johnston says pharmacists, as trained healthcare workers and members of their community, are well placed to tackle issues such as vaccine hesitancy. “Pharmacists are ideally placed to help people with their questions. I think a lot of the time it’s about people wanting to know the implications for themselves and pharmacists have been upskilled and are ideally placed to have those conversations,” she says.

On September 13, the PSA announced pharmacists across the country had administered more than 500,000 doses in just a few short weeks. With another million doses of Moderna now being made available to pharmacies, it’s clear pharmacies will continue to have a significant impact on the efficacy of Australia’s vaccination program.

Whilst the decision to expand Australia’s vaccine workforce has generally been a popular one among vaccine workers, some are apprehensive and even in opposition to the program. WA state secretary of the Australian Nursing Federation Mark Olson says the inclusion of assistants in nursing in the vaccine rollout is a potentially dangerous one. In a statement to the media, Olson said: “While AINs play an important role in our health system, they are in no way trained, qualified or allowed under legislation to deliver medications to patients, let alone life-saving COVID vaccinations, as they have not received the two to three years of university training in anatomy and physiology required to deliver any injections safely.”

Olson says the extension of vaccine training to AINs has revealed issues within WA’s health system.

“It is a terrifying concept that this State Government is taking every opportunity it can to de-skill the WA health workforce.”

Mark Olson, Australian Nursing Federation

This cost-saving strategy will bring more risk to patient safety and decimate the last vestiges of morale in our nursing and midwifery workforce.”

Despite this criticism, the WA Health Department is steadfast in its decision to bolster WA’s vaccine rollout. The department asserts that despite any potential danger, it is important the state and the country does whatever it can in order to increase the spread and uptake of COVID-19 vaccines. Most state governments are now aiming for at least 80 per cent double vaccinated in their adult populations. It’s clear that a bolstered vaccine workforce is going to be crucial to the continuing rollout of the vaccine.