How can licensees decide whether to impose the immunity requirement on general volunteers

All healthcare institution licensees should continue to assess their own situation and determine if there are circumstances where diphtheria and measles immunity requirements may need to be imposed on general volunteers.

This assessment should be risk calibrated, based on the potential exposure of general volunteers with no / unknown immunity to diphtheria and measles to vulnerable patients. In principle, this assessment should be conducted by undertaking a holistic review of the licensee’s circumstances, rather than applying key considerations mechanistically. For instance, if a licensee assesses that having unvaccinated volunteers in close contact with highly vulnerable patients (e.g., transplant recipients) places excessive risk to the patients, the licensee should be allowed to exercise discretion in imposing the immunity requirements on the volunteers regardless of the length of contact time between the volunteers and patients.

MOH may also reserve the right to impose immunity requirements on select licensees if there is an outbreak of diphtheria or measles or is a risk of an outbreak, to mitigate against future transmission.