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[2021] FWCFB 6015

COMMISSION DU TRAVAIL ÉQUITABLE

DÉCISION

Loi sur le travail équitable 2009

art.604 - Appel des décisions

Jennifer Kimber

Sapphire Coast Community Aged Care Ltd

(C2021/2676)

VICE-PRÉSIDENT ÉCOUVREUR

VICE-PRÉSIDENT DOYEN

COMMISSAIRE RIORDAN SYDNEY, 27 SEPTEMBRE 2021

Appel contre la décision [2021] FWC 1818 du commissaire McKenna à Sydney le 29 avril 2021 dans l'affaire numéro U2020/9867.

DÉCISION DU VICE-PRÉSIDENT HATCHER ET COMMISSAIRE RIORDAN

introduction

[1] Mme Jennifer Kimber a déposé un recours en vertu de l'article 604 du Fair Work Act 2009 (FW Act), pour lequel une autorisation de recours est requise, contre une décision du commissaire McKenna rendue le 29 avril 2021 1 (décision) dans laquelle elle a rejeté la demande de Mme Kimber de recours pour licenciement abusif contre Sapphire Coast Community Aged Care Ltd (Sapphire). Sapphire exploite des établissements de soins pour personnes âgées en Nouvelle-Galles du Sud, notamment à Imlay House à Pambula. Mme Kimber était, jusqu'à son licenciement le 6 juillet 2020, employée comme réceptionniste à Imlay House. Son licenciement résulte de son refus de se conformer à une obligation de se faire vacciner contre la grippe. Dans la décision, le commissaire a déterminé que le congédiement était motivé par un motif valable, qu'il était équitable sur le plan de la procédure et qu'il n'était pas sévère, injuste ou déraisonnable. Mme Kimber soutient dans son appel que l'octroi de l'autorisation de faire appel serait dans l'intérêt public et que la décision s'accompagnait d'une erreur susceptible d'appel.

Chronologie des événements

[2] Les faits de base de l'affaire, avec quelques commentaires supplémentaires, sont les suivants. Mme Kimber a commencé à travailler chez Sapphire à Imlay House en 2013. Au cours des cinq années précédentes, elle avait travaillé dans la cuisine à Imlay House en tant qu'employée d'une entreprise de restauration. Sapphire l'a alors employée comme commis, et elle a travaillé au comptoir de réception. Une partie de ses tâches consistait à accueillir les visiteurs et à les escorter jusqu'aux chambres des résidents.

[3] Sapphire semble avoir, à un moment donné, pris des dispositions pour que les vaccins contre la grippe soient administrés aux employés d'Imlay House. Mme Kimber a subi une telle vaccination le 22 avril 2015. Rien n'indique que cela ait causé des effets indésirables. Elle a subi une nouvelle vaccination le 27 avril 2016, qui lui a été administrée par une infirmière employée par Sapphire. Son témoignage a révélé qu'elle avait par la suite souffert d'une « inflammation cutanée majeure et débilitante » qui « couvrait la partie supérieure de mon corps, mon visage et mon cou avec des organes internes également touchés » et « qui a persisté pendant plusieurs mois ». L'opinion déclarée de Mme Kimber était qu'il s'agissait d'une "réaction allergique grave" à la vaccination contre la grippe. Toutefois:

● il n'y avait pratiquement aucun détail donné par Mme Kimber sur cette condition ; par exemple, elle n'a pas dit combien de temps après la vaccination la maladie a commencé, elle n'a pas expliqué pourquoi elle pensait qu'il s'agissait d'une réaction allergique à la vaccination, et elle n'a pas expliqué quels « organes internes » étaient touchés ou pourquoi elle pensait que c'était l'affaire;

● Mme Kimber n'a pas prouvé qu'elle avait déjà demandé un traitement médical pour cette condition alléguée, et il n'y avait aucune preuve distincte d'un examen ou d'un diagnostic contemporain par un médecin (sous réserve d'une question discutée plus tard) ;

● elle n'a jamais pris d'arrêt de travail à cause de cette condition ;

● elle n'a jamais informé personne dans la direction de Sapphire à l'époque qu'elle considérait qu'elle avait subi une réaction indésirable à la vaccination antigrippale qu'ils avaient fait administrer ; et

● le témoignage de Mme Anne Main, responsable de l'établissement à Imlay House, était qu'elle savait seulement que Mme Kimber s'était plainte à d'autres employés d'"avoir des problèmes de peau, de temps en temps et qu'elle consultait un naturopathe et testait thérapies alternatives pour une affection cutanée ».

[4] Mme Kimber a refusé de se faire vacciner contre la grippe en 2017, 2018 et 2019, et la direction de Sapphire n'a apparemment eu aucun problème avec cela.

[5] À partir de mars 2020 environ, Sapphire a dû faire face aux effets potentiels de la pandémie de COVID-19 à Imlay House. Il n'est pas contesté que la pandémie a été fatale de manière disproportionnée pour les personnes âgées et les personnes en soins pour personnes âgées. Au 30 août 2021, sur un total de 999 décès en Australie causés par COVID-19, 913 étaient âgés de 70 ans et plus, et 693 étaient placés dans des centres de soins pour personnes âgées lorsqu'ils ont été infectés.

[6] Le 24 mars 2020, le ministre de la Santé de la Nouvelle-Galles du Sud a pris l'ordonnance 2020 sur la santé publique (établissements de soins aux personnes âgées COVID-19) (ordonnance de mars) conformément à l'article 7 de la loi sur la santé publique de 2010 (NSW). L'arrêté de mars exigeait en conséquence qu'un employé de l'exploitant d'un établissement de soins résidentiels pour personnes âgées ne pénètre pas dans les locaux de l'établissement s'il n'avait pas «une vaccination à jour contre la grippe, si la vaccination est à la disposition de la personne». 2 L'ordonnance de mars exigeait également que l'exploitant d'un établissement de soins résidentiels pour personnes âgées « prenne toutes les mesures raisonnables » pour s'assurer qu'une personne n'entre pas ou ne reste pas sur les lieux en violation de cette exigence3. L'ordonnance devait être rendue par écrit par le ministre sur la base de la satisfaction que l'exemption était nécessaire pour protéger la santé et le bien-être des résidents ou du personnel d'un établissement de soins résidentiels pour personnes âgées4. La contravention à l'ordonnance de mars constituait une infraction. L'arrêté de mars devait expirer le 22 juin 2020.

[7] Au moment de l'arrêté de mars, il n'y avait bien sûr pas encore de vaccin COVID-19 disponible. L'objectif politique de l'ordonnance de mars (qui représentait une approche nationale émanant des conseils donnés par l'Australian Health Protection Principal Committee) était de minimiser la vulnérabilité à la maladie chez les résidents âgés, de maintenir le personnel de soins aux personnes âgées en bonne santé et de réduire la demande de soins de santé. système de soins. Le 3 avril 2020, le ministre des soins aux personnes âgées du Commonwealth, le sénateur Colbeck, a publié un communiqué de presse (communiqué de presse) qui a décrit cette justification politique de l'exigence de vaccination contre la grippe et, de manière pertinente, a déclaré :

« Le ministre Colbeck a déclaré avoir reçu les conseils suivants du médecin-chef du gouvernement australien, le professeur Brendan Murphy :

La seule contre-indication absolue à la vaccination antigrippale est un antécédent d'anaphylaxie après la vaccination, ceux qui ont eu le syndrome de Guillain-Barré après une vaccination antigrippale précédente et les personnes sous inhibiteurs de points de contrôle pour le traitement du cancer.

Le professeur Murphy a déclaré que les personnes souffrant d'allergies aux œufs - à moins qu'elles ne souffrent d'anaphylaxie - peuvent être immunisées en toute sécurité. "

[8] Le 3 avril 2020, M. Matthew Sierp, directeur général de Sapphire, a envoyé une lettre au personnel les informant des exigences du gouvernement de la Nouvelle-Galles du Sud en matière de vaccination contre la grippe et du programme annuel de vaccination contre la grippe de Sapphire. La correspondance de M. Sierp faisait également référence à l'Australian Immunization Handbook publié par le Commonwealth Department of Health, qui indiquait que la seule « contre-indication » pour le vaccin contre la grippe était l'anaphylaxie après une dose précédente du vaccin ou après tout composant du vaccin. La lettre concluait : « Si vous avez une contre-indication au vaccin, veuillez fournir une preuve écrite de votre médecin généraliste ou spécialiste à votre responsable ».

[9] Mme Kimber avait alors décidé, sans avoir consulté de médecin à ce sujet, qu'elle ne prendrait pas le vaccin conformément à l'exigence. Le 9 avril 2020, Mme Kimber a fourni une lettre à son responsable d'une Mme Virginia Kleine, qui se décrit comme une « praticienne en médecine chinoise ». Mme Kleine n'est pas médecin. La lettre de Mme Kleine indiquait :

"MADAME, MONSIEUR,

Je traite Jenny [sic] Kimber depuis fin 2016 jusqu'à aujourd'hui pour divers problèmes de santé ainsi que pour la maintenir en bonne santé générale.

Jenny m'a contacté avec des préoccupations concernant la vaccination obligatoire contre la grippe sur son lieu de travail. Jenny préférerait ne pas se faire vacciner contre la grippe. En tant que tel, je lui ai prescrit des herbes stimulant le système immunitaire ainsi que des herbes antivirales dans une formule qui a été [sic] utilisée en Chine dans la prévention de Covid-19 et des grippes saisonnières [sic]. La formule est basée sur une formule ancienne utilisée pour renforcer le système immunitaire en activant les cellules T et B ainsi que des herbes connues pour leurs qualités antivirales. Jenny suivra un cours prescrit de cette formule pour activer son système, puis chaque jour elle travaillera comme un complément.

Je suis convaincu que la voie à suivre pendant cette crise sanitaire consiste non seulement à dépendre des vaccinations, mais également à renforcer nos propres systèmes corporels afin de créer une immunité collective saine. »

[10] Curieusement, bien qu'elle ait « traité » Mme Kimber depuis 2016, Mme Kleine n'a fait aucune référence dans sa lettre à la prétendue réaction indésirable au vaccin antigrippal en 2016. Sa lettre n'est également manifestement pas basée sur la science médicale. La référence à une « ancienne formule » d'herbes utilisée pour prévenir le COVID-19 en Chine et pour obtenir « une immunité collective saine » en est une preuve suffisante.

[11] Le 21 avril 2020, M. Sierp a envoyé une nouvelle lettre au personnel dans laquelle il informait que Sapphire venait de recevoir un approvisionnement en vaccin antigrippal, que les vaccinations commenceraient la même semaine et que tout membre du personnel qui n'aurait pas été vacciné au 1er mai 2020 ne serait pas autorisé à travailler dans les soins aux personnes âgées. La lettre de M. Sierp citait également la partie du communiqué de presse qui faisait référence à l'avis du médecin-chef concernant les catégories limitées de contre-indications médicales au vaccin antigrippal.

[12] Le ou vers le 28 avril 2020, Mme Main a signalé à M. Sierp que Mme Kimber (et certains autres employés) avaient refusé de se faire vacciner. M. Sierp n'a pas admis, sur la base de la lettre de M. Kleine, que Mme Kimber avait un motif valable pour refuser la vaccination. Le 30 avril 2020, M. Sierp a adressé à Mme Kimber une lettre l'informant qu'à compter de cette date, elle avait été licenciée car elle n'était pas en mesure de produire un certificat médical attestant qu'elle présentait une contre-indication du type visé dans le Communiqué de presse. M. Sierp a déclaré dans cette lettre que Mme Kimber avait la possibilité de prendre un congé annuel ou un congé de longue durée, et il lui a ordonné d'assister à une réunion avec Mme Main le 4 mai 2020 pour discuter de la question. La lettre indiquait également :

« Veuillez noter que le non-respect des instructions légales et raisonnables est un motif valable de licenciement. En tant que tel, veuillez noter que si vous refusez toujours de recevoir le vaccin contre la grippe après notre réunion, le résultat peut être déterminant pour l'emploi.

[13] Mme Kimber a assisté à la réunion avec Mme Main le 4 mai 2020, comme indiqué. Lors de cette réunion, elle a fourni une « lettre de soutien » d'un médecin généraliste, le Dr Neil Mackay. La lettre indiquait :

"Lettre de support

J'ai assisté à Mme Jennifer Kimber le 27/4/2020.

Jennifer a une contre-indication médicale à la vaccination contre la grippe. Elle a déjà eu une grave réaction allergique au vaccin contre la grippe et on lui a conseillé de ne plus le recevoir.

Dr Neil Mackay

M.B.B.S.

[numéro de praticien et signature]

Déclaration du patient

Je, Mme Jennifer Kimber, certifie que les informations sur lesquelles cette lettre de soutien a été émise sont vraies et correctes.

[Signature]"

[14] Les observations suivantes peuvent être faites à propos de cette lettre :

(1) C'était la première fois que Mme Kimber a informé la direction de Sapphire de sa prétendue réaction indésirable à la vaccination contre la grippe qu'elle lui avait fait administrer en 2016, environ quatre ans plus tôt.

(2) Il n'y a aucune suggestion dans la lettre ou nulle part dans la preuve que le Dr Mackay ait jamais fréquenté Mme Kimber avant le 27 avril 2020. Le Dr Mackay n'avait commencé à exercer dans la région de Pambula que l'année précédente.

(3) La déduction évidente à tirer de la lettre est que la base entière de l'affirmation du Dr Mackay selon laquelle Mme Kimber avait déjà subi une réaction indésirable à la vaccination contre la grippe était ce que Mme Kimber lui avait dit.

[15] Mme Kimber a déclaré lors de la réunion du 4 mai 2020 qu'elle n'allait pas se faire vacciner et qu'elle attendrait de voir si l'exigence de vaccination changerait. Elle a demandé à être autorisée à prendre un congé d'aidant jusqu'au 1er juin 2020, et cette demande a été acceptée. Mme Kimber a également indiqué lors de la réunion que, si l'ordonnance de mars devenait une exigence permanente, elle envisagerait de consulter un immunologiste. Mme Kimber n'a à aucun moment consulté un immunologiste.

[16] Le 12 mai 2020, alors que Mme Kimber est restée en congé d'aidant agréé, elle a adressé une longue lettre à M. Sierp. Dans cette lettre, Mme Kimber a fait référence à la décision de la retirer « malgré la production de (2) lettres de professionnels de la santé m'informant que j'avais eu une réaction allergique grave au vaccin contre la grippe dans le passé et qu'on m'avait conseillé de ne plus le reprendre » , et a réitéré qu'elle était prête à consulter un immunologiste, mais a déclaré qu'avant de prendre la décision de le faire, « j'aimerais clarifier certains points ». Ces « matières » étaient les suivantes :

«Pourriez-vous, s'il vous plaît, indiquer s'il y a eu une directive du gouvernement de l'État ou du gouvernement fédéral à l'organisation qui exigerait que le personnel reçoive le vaccin annuel contre la grippe? Si une telle directive a été faite, pourrais-je en avoir une copie s'il vous plaît? Si aucune directive gouvernementale n'a été donnée, sur quelle base légale me demandez-vous de me soumettre à la vaccination contre la grippe ?

Pourriez-vous s'il vous plaît me fournir les preuves scientifiques qui sont utilisées pour justifier la nouvelle politique?

Dès réception des informations ci-dessus, j'examinerai la question plus avant.

En attendant, je fournis ci-dessous le libellé pertinent de la notice de sécurité du vaccin FluQuadri.

D'un point de vue objectif, un vaccin contre la grippe n'est pas complètement sûr.

Effets secondaires graves :

inflammation des nerfs entraînant une faiblesse, telle que la faiblesse des muscles faciaux (paralysie faciale)

troubles visuels (névrite optique/neuropathie)

évanouissement (syncope)

vertiges

picotements ou engourdissement des mains ou des pieds (paresthésie)

inflammation temporaire des nerfs provoquant des douleurs

paralysie et troubles de la sensibilité (syndrome de Guillain Barré [SGB])

crises (convulsions) avec ou sans fièvre

réaction allergique sévère (anaphylaxie)

réduction temporaire du nombre de particules sanguines appelées plaquettes (thrombocytopénie)

ganglions enflés dans le cou, les aisselles ou l'aine (lymphadénopathie)

Mes recherches m'ont conduit à de nombreuses études qui appuient également ma conclusion qu'un vaccin contre la grippe n'est pas complètement sûr ou efficace. J'en ai fourni quelques-uns ci-dessous.

Revues de la Cochrane Library sur les vaccins antigrippaux

Efficacité du vaccin antigrippal dans la communauté et le ménage

Quelles sont, en fait, les preuves que la vaccination des travailleurs de la santé contre la grippe saisonnière protège leurs patients ? Un examen critique

Je sais également que dans le cadre du programme d'indemnisation des victimes de vaccins aux États-Unis, plus de 4 milliards de dollars d'indemnisation ont été versés aux victimes qui ont été blessées par les vaccins dans ce pays. La majorité des cas sont causés par le vaccin contre la grippe. Vous trouverez de nombreux cas de ce type sur ce lien

Je ne souhaite certainement pas avoir l'impression d'avoir transmis une grippe ou une autre maladie transmissible à un tiers. Cependant, je dois équilibrer ce désir avec le fait que j'ai des inquiétudes quant à la sécurité du vaccin contre la grippe. Il n'y a également aucune preuve convaincante que le fait de recevoir un vaccin contre la grippe rend une personne moins susceptible de le transmettre à d'autres. Dans n'importe quel pays civilisé comme l'Australie, je crois fermement que l'opportunité d'avoir une procédure médicale invasive est une décision personnelle et je ne devrais pas être soumis à la coercition. Mon travail ne devrait certainement pas être en danger comme cela semble être le cas à l'heure actuelle.

S'il devait arriver que mon emploi soit désormais subordonné à la soumission d'un vaccin annuel contre la grippe, êtes-vous prêt à m'indemniser, ainsi que ma famille, pour les pertes financières au cas où je subirais une réaction indésirable au vaccin annuel contre la grippe ?

Dès réception de votre réponse aux questions soulevées dans cette lettre, j'examinerai la question plus avant. »

[17] L'extrait ci-dessus de la lettre de Mme Kimber démontre que son objection à la prise du vaccin contre la grippe allait au-delà de son effet indésirable allégué en 2016, et qu'elle détenait une position anti-vaccination plus large. La « recherche » entreprise par Mme Kimber a été décrite par elle dans les termes suivants : « j'ai cherché sur Google toutes sortes de choses ». 5 Une grande partie du texte de la lettre de Mme Kimber semble avoir été « un brouillon que j'ai récupéré sur Internet ».6 M. Sierp a répondu à la lettre de Mme Kimber le 18 mai 2020. Dans sa réponse, en résumé, il a réitéré l'effet pertinent de la l'ordonnance de mars, a déclaré que la justification de l'ordonnance relevait du ministre qui l'avait rendue, et a déclaré que Sapphire ne fournirait aucune indemnisation à l'égard de l'ordonnance.

[18] Le 29 mai 2020, Mme Kimber a demandé une nouvelle période de congé d'aidant jusqu'au 29 juin 2020, ce qui a été approuvé par Sapphire. Le 1er juin 2020, Mme Kimber a envoyé un e-mail à Sapphire dans lequel elle faisait référence à l'expiration de l'ordonnance de mars le 22 juin 2020, l'informait qu'elle reprendrait le travail après la fin de sa période actuelle de congé d'aidant autorisé et demandait que à son retour, elle ne sera autorisée à travailler à temps partiel que deux jours par quinzaine (au lieu de quatre jours par semaine habituels). Cela a également été approuvé par Sapphire (bien qu'il ait apparemment compris que la demande était de deux jours par semaine).

[19] Le 22 juin 2020, le ministre de la Santé de la Nouvelle-Galles du Sud a pris l'ordonnance sur la santé publique (établissements de soins pour personnes âgées COVID-19) (n ° 2) 2020 (ordonnance de juin), qui est entrée en vigueur le lendemain. À des fins pertinentes, il a maintenu l'exigence de l'arrêté de mars selon laquelle les employés doivent être vaccinés contre la grippe afin de pouvoir entrer et rester dans les locaux d'un établissement de soins pour personnes âgées. Cependant, l'arrêté de juin diffère de l'arrêté de mars en ce qu'il prévoyait, à l'alinéa (6)(1)d)(ii), une base supplémentaire pour l'exemption de l'exigence de vaccination comme suit :

« … la personne présente à l'exploitant de l'établissement d'hébergement pour personnes âgées un certificat selon le formulaire agréé, délivré par un médecin, certifiant qu'elle a une contre-indication médicale à la vaccination contre la grippe.

[20] L'ordonnance de juin prévoyait son abrogation à compter du 21 septembre 2020. 7

[21] Le « formulaire de contre-indication médicale pour le vaccin antigrippal » (formulaire IVMC) approuvé pour l'exemption de l'obligation de vaccination comprenait, à des fins pertinentes, les éléments suivants :

Date …..

Madame, Monsieur

Demande d'accès à un établissement de soins résidentiels pour personnes âgées (RACF) pour des raisons autorisées en vertu de l'ordonnance NSW Public Health (COVID-19 Aged Care Facilities) Order (No 2) 2020 (l'ordonnance).

Je suis un médecin agréé.

Je certifie que, .… a la contre-indication médicale suivante au vaccin contre la grippe de cette saison :

[20] L'ordonnance de juin prévoyait son abrogation à compter du 21 septembre 2020. 7

Date …..

Madame, Monsieur

Je suis un médecin agréé.

Je certifie que, .… a la contre-indication médicale suivante au vaccin contre la grippe de cette saison :

[ ] anaphylaxie après une dose précédente de tout vaccin antigrippal

[ ] anaphylaxie après tout composant d'un vaccin antigrippal

[ ] antécédents de syndrome de Guillain-Barré dont le premier épisode est survenu dans les 6 semaines suivant l'administration d'un vaccin antigrippal

[ ] thérapies immuno-oncologiques anticancéreuses (inhibiteurs de points de contrôle) – Il a été conseillé au patient de consulter son oncologue traitant au sujet des risques et des avantages de la vaccination antigrippale

[ ] autre contre-indication médicale ; étant …..

*Remarque - Fluad Quad et Afluria Quad stipulent que les personnes allergiques aux œufs (non anaphylactiques) peuvent recevoir une dose adaptée à leur âge et ne seront donc pas admissibles à une contre-indication médicale.

Je certifie que la personne susmentionnée a une contre-indication médicale et n'est pas tenue d'avoir un vaccin à jour contre la grippe avant d'entrer dans un RACF.

. . .

[22] À la lumière de l'ordonnance de juin, Sapphire a envoyé par courrier électronique une lettre à Mme Kimber le 29 juin 2020 (le dernier jour du congé de soignant approuvé de Mme Kimber) qui faisait référence à l'ordonnance de mars et à l'ordonnance de juin et, de manière pertinente, a ensuite déclaré :

« …

Sapphire Coast Community Aged Care a lancé son programme de vaccination gratuite contre la grippe pour 2020 du 22/4/20 au 29/4/20. Tous les membres du personnel ont été informés de la disponibilité de la vaccination contre la grippe le 21/4/20. Vous avez refusé de vous faire vacciner contre la grippe alors qu'il était à votre disposition. Nous vous avons rencontré le 30/4/20 et vous avons expliqué qu'en raison de votre refus de vous faire vacciner et de votre incapacité ultérieure à vous conformer aux directives obligatoires de vaccination contre la grippe, il vous était interdit… d'entrer dans un établissement de soins pour personnes âgées. Par conséquent, nous ne sommes pas en mesure de vous fournir vos heures de travail conformément à votre contrat de travail. Vous avez choisi de prendre un congé.

Étant donné qu'un nouvel arrêté de santé publique a été publié au journal officiel qui impose les mêmes conditions et que vous refusez toujours de vous faire vacciner contre la grippe, vous ne pouvez pas remplir les exigences inhérentes à votre rôle et nous ne pouvons toujours pas vous fournir vos heures de travail dans conformément à votre contrat de travail. Nous n'aurons peut-être pas d'autre choix que de mettre fin à votre emploi en conséquence.

Vous êtes invité à assister à une réunion téléphonique, car vous ne pouvez pas assister au site car vous n'avez pas été vacciné contre la grippe, avec Anne Main le 2/7/20 à 14h00 par téléphone afin de justifier votre emploi chez Sapphire. Coast Aged Care ne doit pas être interrompu.

…"

[23] Le 30 juin 2020, sans aucun avertissement préalable, Mme Kimber est entrée dans Imlay House pour tenter de reprendre le travail. Cela constituait une contravention à la directive antérieure de Sapphire selon laquelle elle ne se présentait pas au travail à moins d'être vaccinée. 8 Il s'agissait également d'une contravention à l'arrêté de juin (puisqu'aucune des conditions d'exemption de l'obligation de vaccination n'était applicable). Mme Kimber a été confrontée à Mme Main. Mme Kimber a affirmé ne pas avoir reçu l'e-mail de la veille et a déclaré qu'elle se rendait au travail "comme indiqué" (ce qui était clairement faux puisqu'il lui avait été demandé de ne pas se rendre au travail à moins d'être vaccinée). L'épisode s'est terminé avec l'escorte de Mme Kimber hors des locaux. À ce moment-là, Mme Kimber (pour son propre compte) a déclaré : « J'ai eu un contact avec un avocat au sujet de cette question de vaccination ». Mme Main a renvoyé la lettre de Sapphire du 29 juin 2020 à Mme Kimber plus tard dans la journée.

[24] Le 1er juillet 2020, Mme Kimber a assisté à un autre rendez-vous médical avec le Dr Mackay. Cette nomination a conduit le Dr Mackay à produire deux documents le même jour. La première était une autre « lettre de soutien » qui indiquait :

“1/7/2020

Lettre de support

(Patients sans preuve clinique actuelle d'une maladie)

J'ai assisté à Mme Jennifer Kimber le 1/7/2020. Le patient a subi une grave réaction allergique au vaccin contre la grippe il y a 4 ans. Cela s'est traduit par un gonflement sévère du visage et du cou avec une éruption érythémateuse étendue sur le visage, la poitrine et les bras. Cette éruption a duré 10 mois et a nécessité de la prednisolone par voie orale pour la résoudre. Jennifer a fourni des photos de l'éruption cutanée que j'ai jointes comme preuve à l'appui.

À mon avis, l'historique tel qu'il est indiqué est conforme à ce qui précède et constitue donc une contre-indication médicale au vaccin antigrippal.

J'ai rempli le formulaire de contre-indication médicale du vaccin antigrippal sur le site Web de la santé publique de NSW.

[Signature]

Dr Neil Mackay

M.B.B.S.

. . .

Déclaration du patient

Je, Mme Jennifer Kimber, certifie que les informations sur lesquelles cette lettre de soutien a été émise sont vraies et correctes.

[Signature]

Signature du patient »

[25] La lettre ci-dessus était accompagnée de deux photos non datées, l'une montrant Mme Kimber avec des rougeurs sur le visage et l'autre montrant des rougeurs sur une autre partie de son corps, pas clairement identifiable. La référence à «érythémateux» dans la lettre signifie simplement rougeur.

[26] Trois observations peuvent être faites à propos de la lettre.

(1) Aucune base pour l'affirmation du Dr Mackay selon laquelle Mme Kimber a souffert d'une "réaction allergique grave au vaccin contre la grippe il y a 4 ans" n'est discernable dans la lettre, à l'exception du fait que Mme Kimber lui a dit cela. Il n'y a aucune suggestion dans la lettre que le Dr Mackay ait eu accès à l'un des dossiers médicaux antérieurs de Mme Kimber.

(2) La lettre ne fait aucune référence aux « organes internes » de Mme Kimber, comme elle l'a allégué dans son témoignage devant la Commission.

(3) La référence du Dr Mackay à la «prednisolone orale» ayant résolu la condition alléguée est à nouveau vraisemblablement basée sur ce que lui a dit Mme Kimber. La prednisolone orale est, comme nous le comprenons, un médicament délivré uniquement sur ordonnance. Si Mme Kimber a effectivement pris ce médicament (une question à laquelle elle n'a fait aucune référence dans son témoignage), il doit vraisemblablement exister des dossiers médicaux de son état détenus par le médecin qui l'a prescrit. Aucun dossier médical de ce type n'a jamais été présenté à la Commission.

[27] Le deuxième document produit par le Dr Mackay (comme indiqué dans sa lettre d'appui) était un formulaire IVMC rempli pour Mme Kimber. Dans ce formulaire, le Dr Mackay a coché la case « autre contre-indication médicale », qu'il a identifiée (écrit à la main) comme étant « Gonflement grave du visage et éruption cutanée durant 10 mois à compter de la vaccination ».

[28] Conformément à la lettre de Sapphire du 29 juin 2020, Mme Kimber a assisté à une réunion téléphonique avec Mme Main le 2 juillet 2020. Avant la réunion, Mme Kimber avait envoyé la deuxième lettre de soutien et formulaire d'exemption de Sapphire Dr Mackay. Lors de la réunion, qui a été brève, Mme Main a confirmé la réception de ces documents et a demandé s'il y avait d'autres informations que Mme Kimber souhaiterait ajouter concernant le retour au travail. Après une discussion sur la question de savoir si M. Sierp avait demandé au ministre une exemption au nom de Mme Kimber, Mme Main a déclaré qu'elle transmettrait les informations à M. Sierp pour qu'il prenne une décision. Ce faisant, elle a indiqué que la position de M. Sierp était que l'anaphylaxie, le syndrome de Guillain-Barré ou une dérogation ministérielle étaient les seuls motifs de dérogation à l'obligation de vaccination, mais qu'il demanderait conseil.

[29] Le témoignage de M. Sierp était qu'il considérait que la lettre de soutien et le formulaire IVMC fournis par le Dr Mackay ne constituaient pas une contre-indication médicale conformément à l'avis du médecin-chef tel qu'indiqué dans le communiqué de presse ou conformément à d'autres informations. tels que l'Australian Immunization Handbook. Il a également donné les preuves suivantes :

« Même si les informations fournies constituaient une contre-indication médicale, nous aurions été contraints de retirer la demanderesse car nous ne pouvions pas la faire travailler ailleurs que ce soit à Imlay House ou ailleurs. Dans son rôle, elle devait interagir avec d'autres membres du personnel et des visiteurs de l'établissement et les escorter dans l'établissement. Tous les résidents ne sont pas vaccinés contre la grippe et, par conséquent, elle présente un risque potentiel pour eux et est elle-même à risque d'infection et compte tenu de son âge, elle fait partie d'une catégorie de travailleurs plus vulnérable à l'infection grippale ainsi qu'à l'infection Covid-19.

…

La réalité est que nous ne pouvons pas prendre le risque qu'une épidémie de grippe se produise dans nos établissements, sans parler du Covid-19, car nos résidents courent un risque important de mourir si cela se produit. »

[30] En conséquence, M. Sierp a décidé que Mme Kimber devait être licenciée. Le 6 juillet 2020, Mme Main a téléphoné à Mme Kimber pour l'informer de cette décision et une lettre de licenciement a été envoyée le même jour. La lettre indiquait les raisons du licenciement comme suit :

«Malgré plusieurs instructions légales et raisonnables pour se faire vacciner contre la grippe conformément à l'ordonnance 2020 (n ° 1) de la santé publique de NSW (établissements de soins pour personnes âgées résidentielles COVID-19), clause 5 (d) et de la santé publique de NSW (établissements de soins pour personnes âgées COVID-19). ) Ordonnance 2020 (No 2) clause 6(1)(d), vous avez refusé de vous faire vacciner et, en tant que tel, vous êtes incapable de remplir les exigences inhérentes à votre rôle.

L'arrêté sur la santé publique prévoit qu'une personne, y compris un employé, ne doit pas demeurer dans les locaux d'un établissement d'hébergement pour personnes âgées si elle n'a pas un vaccin à jour contre la grippe.

Vous avez assisté à une réunion avec Anne Main le 5/4/20 au cours de laquelle il vous a été proposé d'évoquer votre refus de vous conformer à l'arrêté de santé publique. Au cours de cette rencontre, vous avez déclaré : « J'attendrai de voir si la législation devient permanente et je consulterais un immunologiste pour voir si vous auriez probablement une autre réaction débilitante si vous vous faisiez vacciner contre la grippe ». Vous avez été informé à l'époque et par lettre (voir ci-joint) que si vous choisissiez de ne pas vous faire vacciner contre la grippe, vous ne pourriez pas légalement retourner au travail et votre emploi serait résilié.

Vous avez participé à une réunion « de justification » avec Anne Main le 2/7/20 par téléphone afin de « montrer les raisons pour lesquelles votre emploi chez Sapphire Coast Aged Care ne devrait pas être résilié ». Cela a été décrit dans une lettre qui vous a été envoyée le 29/6/20 en relation avec l'incapacité de remplir les exigences inhérentes au rôle de commis de classe 3. Vous avez indiqué lors de la réunion avec Anne que « votre opinion sur le vaccin n'a pas changé, vous voudriez aimerait savoir si le PDG Matt demande une exemption pour moi ».

De plus, nous notons que nous avons reçu de votre part une lettre médicale de soutien datée du 27 avril 2020 indiquant que vous avez une réaction allergique grave au vaccin contre la grippe. Nous vous avons informé qu'une réaction allergique grave n'est pas considérée comme une contre-indication médicale en vertu de l'ordonnance et que le vaccin contre la grippe vous était donc toujours disponible. Nous avons également demandé des informations complémentaires à votre [sic] médecin traitant. Nous avons maintenant reçu une autre lettre de soutien médical de votre part [Lettre de soutien du Dr Mackay datée du 1er juillet 2020] avec plus d'informations indiquant que les contre-indications médicales sont un gonflement du visage sévère et une éruption cutanée d'une durée de 10 mois après le vaccin. Après avoir examiné l'avis du médecin-chef, nous considérons que votre contre-indication médicale n'est PAS une contre-indication médicale admissible et, par conséquent, la clause 6(1) (a)-(c) de l'ordonnance s'applique toujours. »

[31] Mme Kimber a déposé sa demande de licenciement abusif le 20 juillet 2020.

Preuve devant le commissaire

[32] À l'audience devant le commissaire, Mme Kimber était le seul témoin dans sa propre cause. Le Dr Mackay n'a pas été appelé à témoigner. Sapphire a fait comparaître M. Sierp et Mme Main et, en outre, a produit un rapport d'expertise médicale du professeur Denis Wakefield. Le professeur Wakefield a été contre-interrogé à l'audience.

Témoignage du professeur Wakefield

[33] Le professeur Wakefield est un immunologiste spécialisé avec plus de 40 ans d'expérience dans le diagnostic et la gestion des allergies, des déficiences immunitaires et des maladies auto-immunes. Il était auparavant professeur de médecine et directeur de l'École des sciences médicales de l'Université de Nouvelle-Galles du Sud et, au moment de l'audience, était professeur de médecine et directeur d'immunologie et d'immunopathologie au South East Sydney Local Health District. Il a fourni un rapport concernant l'état présumé de Mme Kimber, pour lequel il a été préparé et a examiné l'ordonnance de mars, l'ordonnance de juin, l'Australian Immunization Handbook, le National Center for Immunization Research and Surveillance Influenza Vaccines for Australians fact sheet - Mars 2020, la lettre de Mme Kleine, la lettre de soutien du Dr Mackay et le formulaire IVMC, et les deux photos de Mme Kimber qui avaient accompagné la lettre de soutien. Dans son rapport, le professeur Wakefield énonce, en résumé, les conclusions suivantes :

● Les éruptions cutanées peuvent représenter une réaction allergique aux vaccins antigrippaux, mais ces réactions sont généralement de durée limitée et peuvent durer de plusieurs jours à une semaine. Il serait extrêmement rare que de telles réactions durent 10 mois, à moins que la réaction ne représente une exacerbation d'une affection préexistante telle que la dermatite atopique. Compte tenu de l'apparition d'éruptions cutanées sur le visage de Mme Kimber, il est plus probable qu'elle souffre d'une forme chronique de dermatite ou d'œdème de Quincke qui sont rarement liées à des réactions vaccinales.

● Une urticaire chronique associée à un œdème de Quincke a été rapportée après une vaccination antigrippale. De telles réactions peuvent être traitées et ne sont actuellement pas considérées comme une contre-indication à la poursuite de la vaccination avec le vaccin antigrippal.

● Il est plus probable qu'improbable que l'éruption cutanée de Mme Kimber n'était pas liée à la vaccination antigrippale et représentait une dermatite chronique dont la cause n'a pas été déterminée.

● Il existe très peu de contre-indications à la vaccination antigrippale. Le virus de la grippe est cultivé dans des œufs et auparavant, les patients allergiques aux œufs avaient été avisés de ne pas se faire vacciner contre la grippe. Cette contre-indication a été supprimée et l'allergie aux œufs n'est plus une contre-indication à une telle vaccination. Les principales contre-indications à la vaccination antigrippale sont des réactions anaphylactiques documentées au vaccin ou à un composant du vaccin, des antécédents de syndrome de Guillain-Barré dans les 6 semaines suivant l'administration du vaccin ou des patients qui sont traités avec des « inhibiteurs de points de contrôle » comme partie de la thérapie contre le cancer.

● Il n'y a aucune preuve dans les informations fournies que Mme Kimber avait l'une de ces contre-indications. L'éruption qu'elle a développée n'a pas été vue par son responsable comme étant liée à sa vaccination et le Dr Mackay ne fournit aucune preuve d'une relation aussi contemporaine avec un diagnostic définitif qui impliquerait la vaccination antigrippale comme étant la cause de son éruption. Il n'y a aucune preuve qu'elle ait été testée, avec des tests cutanés, pour une allergie au vaccin contre la grippe.

● Les réactions mineures sont beaucoup plus fréquentes après la vaccination antigrippale et celles-ci ne nécessitent généralement pas de traitement ou nécessitent une simple analgésie (par exemple Panadol) car elles sont transitoires avec un gonflement local et une douleur qui disparaissent en une semaine. Les réactions sévères telles que l'urticaire, l'œdème de Quincke ou les réactions induites par un adjuvant nécessitent une évaluation, une investigation et un traitement soigneux, généralement avec des corticostéroïdes pour supprimer la réponse immunitaire. Il existe des thérapies efficaces pour ces conditions.

● La grippe peut avoir des effets dévastateurs sur les résidents des établissements de soins pour personnes âgées avec des taux élevés de morbidité et de mortalité. Il s'agit d'une cause fréquente de décès chez ces patients qui ont une résistance réduite, des comorbidités importantes et peuvent développer une pneumonie à la suite de cette maladie. La récente pandémie de Covid-19 a alerté tout le monde sur les effets potentiellement dévastateurs d'une épidémie d'infection virale chez les personnes âgées. Des effets dévastateurs similaires se sont produits dans des populations plus âgées lors de précédentes flambées de grippe. La vaccination contre la grippe est l'une des thérapies les plus efficaces pour limiter cette maladie potentiellement dévastatrice.

Les employés des établissements de soins pour personnes âgées ont la responsabilité et le devoir de diligence envers les résidents de ces établissements de ne pas introduire de risque d'infections dévastatrices, telles que la grippe, dans l'établissement de soins résidentiels. Mme Kimber appartient également à un groupe d'âge qui serait plus sensible aux effets et aux complications d'une infection grippale grave et il lui serait conseillé de se faire vacciner contre la grippe chaque année.

Manuel australien de vaccination

[34] L'Australian Immunization Handbook, qui est publié par le Commonwealth Department of Health et fournit des « directives cliniques pour les professionnels de la santé et autres sur l'utilisation sûre et efficace des vaccins » sur la base des « meilleures preuves scientifiques disponibles, issues de la littérature publiée et non publiée », a été mis en preuve par Sapphire. De manière pertinente, le manuel traite de ce qui constitue un « événement indésirable suivant la vaccination » (AEFI), c'est-à-dire tout événement médical fâcheux qui suit la vaccination. En ce qui concerne les MAPI, le Manuel indique que :

● les MAPI graves sont rares, et il est encore plus rare que les MAPI soient causés par des vaccins ;

● dans de nombreux cas, les MAPI sont simplement fortuites ;

● les personnes qui ont eu une MAPI grave peuvent généralement recevoir des vaccins sous surveillance médicale étroite ;

● des preuves épidémiologiques solides indiquent qu'il n'y a pas d'association causale entre la vaccination et de nombreuses maladies ou affections qui ont été suggérées comme étant liées aux vaccins ; et

● les MAPI graves ou inattendus doivent être signalés en temps opportun.

[35] Le Manuel indique clairement qu'une MAPI ne constituera généralement pas une contre-indication vaccinale, qui est définie comme une raison pour laquelle un vaccin ne devrait pas être administré. Il identifie l'anaphylaxie d'une vaccination précédente ou d'un composant vaccinal comme le seul contre-indicateur absolu. Le manuel n'identifie nulle part le type d'éruption cutanée et de gonflement décrits par Mme Kimber et mentionnés dans le formulaire IVMC comme une contre-indication médicale pour le vaccin contre la grippe. Conformément aux preuves du professeur Wakefield, il décrit l'urticaire (urticaire) et l'œdème de Quincke comme un événement indésirable « très rare » après la vaccination contre la grippe, mais cela n'est pas identifié comme une raison de ne pas administrer la vaccination.

La décision

[36] Après avoir exposé les faits de l'affaire d'une manière qui semble non controversée, la commissaire, dans sa décision, a pris en considération chacune des questions devant être prises en compte en vertu de l'article 387(a). En ce qui concerne l'article 387(a) (s'il y avait une raison valable pour le licenciement liée à la capacité ou la conduite de la personne), le commissaire a d'abord examiné si la proposition dans la lettre de licenciement de Sapphire que Mme Kimber « a refusé de se faire vacciner » malgré « plusieurs instructions légales et raisonnables de se faire vacciner contre la grippe ». La commissaire a conclu qu'aucune directive en de tels termes n'avait été donnée, bien qu'elle ait admis que « l'intimé a néanmoins fermement communiqué au demandeur … la portée pratique des communications était effectivement d'indiquer que l'intimé s'attendait ou exigeait du demandeur … qu'il se fasse vacciner contre la grippe à moins qu'il n'y ait une contre-indication médicale telle que décrite dans l'avis du CMO ». Le commissaire a conclu que si une instruction avait effectivement été donnée de se faire vacciner contre la grippe, une telle instruction aurait non seulement été légale, car elle reflétait la loi telle qu'elle s'appliquait en 2020 concernant les employés des établissements de soins pour personnes âgées de NSW, mais aurait également un corollaire ont été raisonnables.

[37] En ce qui concerne l'affirmation contenue dans la lettre de congédiement selon laquelle Mme Kimber était incapable de remplir les exigences inhérentes à son travail sans la vaccination contre la grippe, le commissaire a reconnu que tel était le cas. Le commissaire a constaté que si Mme Kimber n'était pas autorisée à entrer ou à rester à Imlay House sans se faire vacciner, elle ne pourrait pas remplir son rôle de réceptionniste ou les autres exigences de bureau inhérentes à son poste. Ce faisant, la commissaire a déclaré qu'elle acceptait la soumission de Sapphire concernant le formulaire IVMC fourni par Mme Kimber (ces soumissions étant qu'il n'y avait aucune exemption de l'exigence de vaccination dans l'ordonnance de juin parce que le formulaire IVMC n'identifiait rien qui était, objectivement termes, une contre-indication médicale au vaccin).

[38] Le commissaire a également conclu que Sapphire avait agi d'une manière objectivement « prudente et raisonnable » en ne permettant pas à Mme Kimber de travailler à Imlay House et que M. Sierp avait agi selon sa meilleure compréhension du manuel australien d'immunisation conditionné dans le contexte de l'avis du médecin-chef, comme indiqué dans le communiqué de presse. Le commissaire a accepté l'argument de Mme Kimber selon lequel le communiqué de presse n'avait pas force de loi, mais a estimé qu'« il aurait été vraiment téméraire pour M. exemple, de substituer sa/ses propre(s) opinion(s) à celles du CMO sur les questions concernant les contre-indications à la vaccination antigrippale ». Elle a estimé que M. Sierp "a adopté une approche objectivement prudente et appropriée en se fondant sur … le communiqué de presse" et qu'il n'y a eu aucun changement dans l'avis du médecin-chef entre le communiqué de presse et la date du licenciement, et a conclu qu'il y avait « une raison valable liée à la capacité pour le licenciement étant donné que le demandeur a choisi de ne pas avoir de vaccin antigrippal à jour en 2020 ».

[39] En ce qui concerne les articles 387(b) et (c), le commissaire a conclu que Mme Kimber avait été avisée du motif de son congédiement et avait eu la possibilité de répondre. Il n'est pas nécessaire, à la lumière des motifs d'appel, de se référer aux conclusions du commissaire concernant les articles 387 (d)-(g).

[40] En ce qui concerne l'article 387(h) (toute autre question que la Commission juge pertinente), le commissaire a examiné deux questions. Premièrement, le commissaire a examiné si Mme Kimber avait effectivement souffert d'un problème de santé à la suite de sa vaccination contre la grippe en 2016. Le commissaire a souligné les points suivants :

● il n'y avait aucune preuve médicale d'un diagnostic contemporain que l'état de Mme Kimber était attribuable à la vaccination de 2016 ;

● il n'y a eu aucune identification des médecins consultés par Mme Kimber en 2016-17 ou qui ont établi le diagnostic que la maladie était attribuable à la vaccination de 2016, ni aucune preuve d'un examen ou d'un traitement spécialisé ni d'aucun rapport en cours n'a été décrit par Mme Kimber comme une « réaction sévère à un vaccin contre la grippe administré sur le lieu de travail » ;

● hormis l'affirmation de Mme Kimber selon laquelle la maladie était attribuable à la vaccination de 2016, il y avait peu de preuves médicales concernant un lien entre la vaccination et la maladie ;

● il n'y avait aucune preuve que Mme Kimber ait signalé sa réaction à la vaccination à toute personne employée par Sapphire, et le commissaire a accepté le témoignage de Mme Main selon lequel elle n'en était pas informée ni au courant jusqu'à ce qu'elle l'apprenne pour la première fois en 2020 ; et

● aucun dossier médical d'aucune consultation avec un médecin ou un spécialiste en 2016-2017 en relation avec l'état de Mme Kimber n'a été mis en preuve, bien que l'état nécessitait des médicaments sur ordonnance (prednisolone orale), ce qui présuppose que Mme Kimber a consulté un médecin pour se faire soigner.

[41] Sur la base de ces questions, la commissaire a déterminé qu'elle n'était « pas convaincue que la condition résultait du vaccin contre la grippe de 2016 (ou, autrement dit, la demanderesse n'a pas établi de dossier sur la preuve de cause à effet). entre le vaccin antigrippal 2016 et l'état de nature à démontrer toute contre-indication médicale à la vaccination antigrippale) ». En ce qui concerne les deux lettres du Dr Mackay et le formulaire IVMC, le commissaire a estimé qu'il était raisonnablement clair que le Dr Mackay n'avait pas personnellement examiné Mme Kimber en 2016-2017, qu'il avait procédé sur la base de ce que Mme Kimber lui avait déclaré comme s'étant produit. en 2016-2017 et les deux photos non datées qu'elle a fournies, et que la base sur laquelle il a certifié que Mme Kimber avait une contre-indication médicale dans le formulaire IVMC n'était pas claire. La commissaire s'est référée en détail au témoignage du professeur Wakefield, qu'elle a accepté, et a déclaré que sa conclusion selon laquelle « les éléments de preuve du demandeur n'ont pas établi que la condition était une réaction au vaccin antigrippal de 2016 tend fortement à favoriser la justesse de la position adoptée. par l'intimé en ce qui concerne le demandeur concernant la question du vaccin antigrippal et son adhésion aux conseils du [médecin en chef] concernant les contre-indications à la vaccination antigrippale ».

[42] Deuxièmement, le commissaire a examiné la question de savoir si une exemption ministérielle aurait pu être disponible en vertu de l'arrêté de juin si elle avait été demandée, et a estimé que M. Sierp a correctement évalué qu'une demande d'exemption ne devrait pas être faite car l'octroi d'une telle exemption ne serait pas "nécessaire pour protéger la santé et le bien-être des résidents ou du personnel" d'Imlay House.

[43] Sur la base de ces motifs, le commissaire n'était pas convaincu que le congédiement de Mme Kimber était sévère, injuste ou déraisonnable et a rejeté sa demande.

Motifs d'appel et conclusions d'appel de l'appelant

[44] Les motifs d’appel de Mme Kimber sont nombreux et divers mais, tels qu’énoncés dans les observations écrites et orales, ils semblent soulever les propositions générales suivantes :

(1) La conclusion du commissaire selon laquelle il y avait un motif valable de licenciement n'était pas fondée sur l'interdiction de l'ordonnance de juin, mais plutôt (à [62]-[63]) que Sapphire (par l'intermédiaire de M. Sierp) a agi de manière manière objectivement prudente et raisonnable de ne pas autoriser Mme Kimber à travailler sans une vaccination antigrippale à jour et de se fier aux conseils du médecin-chef figurant dans le communiqué de presse. Cette base pour conclure qu'il y avait un motif valable de licenciement n'a pas été avancée par Sapphire, et le commissaire n'a pas informé Mme Kimber qu'elle envisageait de traiter l'article 387(a) de cette manière. En conséquence, Mme Kimber s'est vu refuser l'équité procédurale. En outre, il n'y avait aucune base valable pour conclure que la détermination de M. Sierp que la vaccination contre la grippe conformément au communiqué de presse était une exigence inhérente à l'emploi de Mme Kimber.

(2) Le commissaire a commis une erreur en ne concluant pas qu'il n'y avait pas de motif valable de licenciement, en ce sens qu'il n'y avait aucun obstacle juridique empêchant Mme Kimber d'entrer sur son lieu de travail en vertu de l'ordonnance de juin. Le formulaire IVMC signé par le Dr Mackay a permis d'exempter Mme Kimber de l'obligation de vaccination dans l'ordonnance de juin. La présomption de régularité et la présomption de fraude s'appliquaient, et il n'y avait aucune contestation sérieuse de la bonne foi de la certification du Dr Mackay. Contrairement à la conclusion contraire du commissaire, la base sur laquelle le Dr Mackay a certifié que Mme Kimber avait une contre-indication médicale était claire dans le formulaire IVMC. Le défaut de Sapphire d'examiner et d'accepter correctement le formulaire IVMC signé par le Dr Mackay a rendu le licenciement inéquitable, et le commissaire a commis une erreur en concluant le contraire.

(3) Le commissaire a commis une erreur en tirant des conclusions contraires à la règle dans Browne v Dunn. Mme Kimber a témoigné que sa vaccination contre la grippe en 2016 avait causé son problème de peau ultérieur en raison d'une réaction allergique, et elle n'a pas été contestée lors du contre-interrogatoire à ce sujet. Cependant, le commissaire a estimé qu'elle n'était pas convaincue que la vaccination de Mme Kimber avait causé son problème de peau et, en substance, le commissaire a contesté la franchise et l'exhaustivité du témoignage de Mme Kimber et a laissé entendre que la vérité avait été délibérément dissimulée. Cette erreur a eu un effet secondaire en ce qui concerne la non-acceptation par la commissaire du formulaire IVMC signé par le Dr Mackay et sa conclusion qu'il y avait un motif valable de licenciement.

(4) Le commissaire a accepté le témoignage du professeur Wakefield sans aborder les arguments de Mme Kimber sur les raisons pour lesquelles son témoignage ne devrait pas être invoqué. Cela constituait une insuffisance dans ses motifs de décision.

(5) Le commissaire a conclu que M. Sierp, dans trois cas, avait fait des déclarations trompeuses ou mensongères, mais a néanmoins reconnu que M. Sierp faisait de son mieux et a adopté une approche objectivement prudente, appropriée et raisonnable en se fondant sur les conseils du Médecin-chef.

[45] Les motifs pour lesquels Mme Kimber prétend que la permission d'en appeler devrait être accordée dans son avis d'appel sont les suivants :

"1. Cet appel porte sur l'exercice approprié de la compétence et/ou du pouvoir de la Commission en vertu de la section 4, partie 3-2, chapitre 3 de la Loi. En particulier, l'appel soulève des questions quant à la compétence/le pouvoir et le rôle de la Commission dans la détermination des motifs de licenciement.

2. Le demandeur s'est vu refuser un procès équitable et cela devrait être corrigé en appel.

3. La décision et les ordonnances du commissaire ont été rendues par erreur et il est souhaitable que la Commission corrige l'erreur et il y a un grand intérêt public à l'égard de celle-ci.

4. La décision et l'ordonnance de la Commission étaient injustes envers le requérant.

[46] Mme Kimber demande une nouvelle audition de sa demande si son appel est accueilli. La réparation qu'elle demande en définitive est la réintégration ou, à défaut, une indemnisation.

Considération

[47] Le paragraphe 400(1) de la Loi FW s'applique au présent appel. Par conséquent, nous ne pouvons accorder la permission d'interjeter appel à moins que nous ne soyons convaincus que cela serait dans l'intérêt public.

[48] Pour les motifs qui suivent, nous ne considérons pas que l'octroi d'une autorisation d'appel serait dans l'intérêt public.

[49] Premièrement, alors que nous considérons que Mme Kimber a avancé un cas défendable selon lequel elle était exemptée de l'exigence d'une vaccination antigrippale à jour dans l'ordonnance de juin au moment de son licenciement, ce cas n'était finalement pas soutenable à l'audience. L'affirmation de Mme Kimber devant le commissaire et devant nous était à l'effet que le formulaire IVMC signé par le Dr Mackay était suffisant, en soi, pour rendre l'exigence de vaccination inapplicable parce qu'il remplissait la condition de la clause 6(1)(d)(ii) de l'Ordre de juin. À notre avis, l'interprétation appropriée du sous-alinéa 6(1)d)(ii) est que l'exemption de l'obligation de vaccination ne s'applique que lorsqu'un médecin certifie que la personne concernée a réellement ce qui est, en termes objectifs, une contre-indication médicale à la vaccination. Il n'est manifestement pas vrai que le simple fait de remplir le formulaire approuvé sur la base de l'identification d'un état ou d'un épisode médical allégué qui n'est pas, en fait, une contre-indication médicale est suffisant pour satisfaire à la condition de la clause 6(1)( d)(ii).

[50] Cette position est confirmée par le formulaire approuvé lui-même, qui identifie quatre contre-indications médicales particulières acceptées et permet ensuite au médecin certificateur d'identifier tout autre type de contre-indication qui pourrait s'appliquer. Que cette dernière option n'avait pas pour but de donner carte blanche à il suffit de remplir toute condition médicale ou épisode à la discrétion du médecin certificateur est indiqué clairement par la note qui suit immédiatement après. La note est à l'effet qu'une allergie aux œufs non anaphylactique ne « qualifie » pas pour une contre-indication médicale. Cela démontre que tout ce qui est rempli sous la dernière option doit être quelque chose qui se qualifie, objectivement, comme une contre-indication médicale au vaccin antigrippal.

[51] La preuve présentée au commissaire a démontré de façon concluante que la condition décrite dans le formulaire IVMC préparé par le Dr Mackay, à savoir « Gonflement du visage sévère et éruption cutanée durant 10 mois à partir du vaccin » n'est pas une contre-indication médicale pour le vaccin antigrippal qui pourrait satisfaire la condition. d'exemption au sous-alinéa 6(1)d)(ii) du Décret de juin. Il est évident qu'en décidant de licencier Mme Kimber, M. Sierp s'est appuyé dans une large mesure sur les conseils du médecin-chef, comme indiqué dans le communiqué de presse, et le commissaire a estimé que la confiance de M. Sierp à cet égard était « objectivement prudente et approprié". Nous ne partageons pas nécessairement l'avis du commissaire selon lequel le communiqué de presse, en lui-même, constituait une base solide et suffisante pour que M. Sierp conclue que l'affection identifiée dans le formulaire IVMC par le Dr Mackay n'était pas une contre-indication médicale au vaccin antigrippal. Cependant, il est évident que M. Sierp a également tenu compte de l'Australian Immunization Handbook, qui, comme indiqué précédemment, n'étaye pas la proposition selon laquelle l'affection cutanée présumée de Mme Kimber constitue une contre-indication médicale acceptée.

[52] Plus important encore, et conformément aux principes énoncés dans Jetstar Airways Pty Limited v Neeteson-Lemkes 9 et CSL Limited v Papaioannou10, Sapphire a présenté un rapport médical d'expert du professeur Wakefield à l'audience pour étayer sa thèse selon laquelle Mme Kimber n'a pas avoir une contre-indication médicale au vaccin antigrippal au moment du congédiement et que, par conséquent, elle était incapable d'exercer les fonctions inhérentes à son poste. Nous avons exposé plus haut les principales conclusions énoncées par le professeur Wakefield. Plus important encore, il a conclu que l'affection décrite par Mme Kimber était très probablement une dermatite chronique non liée au vaccin antigrippal, mais même s'il s'agissait d'un cas rare d'urticaire/œdème de Quincke causé par le vaccin, il s'agissait d'une affection traitable qui ne constituait pas une raison pour ne pas pour administrer le vaccin antigrippal. Autrement dit, en prenant les affirmations de Mme Kimber au sujet de son état de peau au plus haut, cela ne constituait pas une contre-indication médicale.

[53] Le professeur Wakefield a fait l'objet d'un contre-interrogatoire, mais la plus grande contestation de son témoignage était qu'il n'avait pas procédé à un examen médical de Mme Kimber. Ce défi n'a abouti à rien car, bien sûr, l'état de santé de Mme Kimber s'était résolu il y a des années, ne laissant rien à examiner. L'analyse du professeur Wakefield s'est déroulée sur la base des mêmes informations que le Dr Mackay possédait, pour autant qu'on puisse le vérifier, à savoir la description très limitée de Mme Kimber de son état et les deux photos non datées. Mme Kimber n'a présenté aucune preuve en réponse au témoignage du professeur Wakefield ; en particulier, il est à noter qu'elle n'a pas appelé le Dr Mackay à témoigner. Mme Kimber n'a apporté aucune autre preuve probante qu'elle avait une contre-indication médicale au vaccin contre la grippe. Son opinion selon laquelle son problème de peau était causé par la vaccination n'était pas seulement sans réserve et (en termes de preuve stricte) inadmissible, elle n'a même pas donné la moindre information sur la façon dont elle en était venue à cette opinion.

[54] Le commissaire était donc en droit d'accepter le témoignage du professeur Wakefield, et nous considérons en effet qu'il aurait été légalement déraisonnable de ne pas accept it. The consequence of the acceptance of his evidence was necessarily that Dr Mackay did not, objectively speaking, certify that Ms Kimber had a medical contraindication in the IVMC form, and that Ms Kimber was at the time of her dismissal legally prohibited from working at Imlay House. That plainly made the continuation of her employment untenable. In circumstances where Ms Kimber was given ample opportunity by her employer to get vaccinated or demonstrate that she had a medical contraindication, no other consideration could operate to render her dismissal unfair. In that context, the grant of permission to appeal would be entirely lacking in utility, since even if any of the appeal grounds were upheld, Ms Kimber’s application could never ultimately succeed.

[55] Second, Ms Kimber’s other appeal grounds are in any event lacking in merit. We do not propose to consider these grounds in detail to except to say that:

● We reject the proposition that the Commissioner’s finding that there was a valid reason for the dismissal was not founded on the prohibition in the June Order or that the Commissioner found a valid reason on a basis not advanced by Sapphire or disclosed by the Commissioner. The Commissioner’s finding concerning Mr Sierp’s conduct in effecting the dismissal related directly to the question of whether Ms Kimber had a medical contraindication such that the vaccination requirement in the June Order did not apply to her. Accordingly, Ms Kimber’s contention that she was denied procedural fairness in respect of the Commissioner’s consideration under s 387(a) is entirely misconceived.

● The Commissioner made no adverse finding as to Ms Kimber’s credibility (as to which, see below), so no question of the rule in Browne v Dunn arises. It was Ms Kimber’s contention that she had previously suffered an adverse reaction to the influenza vaccine which constituted a medical contraindication to taking the vaccine in the future, and she bore the onus of satisfying the Commission as to this matter. Ms Kimber was served with Professor Wakefield’s report prior to the hearing, and she was therefore on notice that her contention in this respect was placed in issue. She did not adduce any evidence in response to this report. It was not necessary in those circumstances for counsel for Sapphire to mechanically put the matters in Professor Wakefield’s report to Ms Kimber in cross-examination to obtain her (unqualified) response. It was plainly open for the Commissioner to reject Ms Kimber’s contention as to the existence of a medical contraindication.

● There was no inadequacy in the Commissioner’s reasons. She was not required to specifically address every submission advanced by Ms Kimber. The basis for her acceptance of Professor Wakefield’s evidence was clearly explained.

● The Commissioner did not make any findings in her decision that Mr Sierp made misleading or untruthful statements.

[56] Third, although this was not the subject of any finding by the Commissioner, we have real doubt as to the credibility of the main tenet of Ms Kimber’s case, namely that she objected to taking the influenza vaccine because of an alleged previous allergic reaction to it. Our doubt in this respect arises from the following matters:

● the silence in her evidence as to her seeking any medical treatment in relation to her skin condition in 2016;

● the lack of any reference to a previous adverse reaction to the vaccine in Ms Kleine’s letter of 9 April 2020;

● the fact that Ms Kimber did not report or disclose to anyone in the management of Sapphire that she had suffered an adverse reaction to a vaccination administered by one of Sapphire’s employees as part of Sapphire’s vaccination program in 2016 until she provided Dr Mackay’s first letter of support on 4 May 2020, after she was stood down for refusing to take the vaccine;

● Ms Kimber’s general anti-vaccination position, as revealed in her letter to Mr Sierp of 12 May 2020; and

● the inconsistencies in her accounts of her alleged allergic reaction to the vaccine, including as to its effect on her “internal organs”.

[57] There is also an additional matter which arose in the appeal. The Commonwealth Government, shortly prior to the hearing of the appeal, announced that residential aged care workers would be required from 17 September 2021 to have received as a minimum a first dose of a COVID-19 vaccine as a condition of employment. 11 Given that Ms Kimber sought the remedy of reinstatement upon rehearing of her matter, an inquiry was made at the appeal hearing as to whether she was prepared to comply with this requirement. The response which Ms Kimber gave subsequent to the hearing, in correspondence from her solicitor, was as follows:

“In answer to Vice President Hatcher’s question, if re-instated, the appellant has not come to a concluded position on whether she will have a covid-19 vaccination.

The appellant will consider the terms of the applicable order or law when it is made and or passed.

The appellant will also obtain and consider the advice of her general practitioner.

Then the appellant will make an informed decision.”

[58] The fact that Ms Kimber is unprepared, in the context of the current COVID-19 pandemic and the requirement for her to be vaccinated in order to work in residential aged care, to indicate a willingness to take a vaccine that is different to the influenza vaccine supports the inference that she holds a general anti-vaccination position. It also further points to the lack of utility in granting permission to appeal, since there could be no possibility of granting Ms Kimber’s preferred remedy of reinstatement absent an advance commitment from her to take the COVID-19 vaccine.

[59] Fourth, Ms Kimber does not identify any reason beyond the particular circumstances of her case as to why her appeal would attract the public interest. It is not suggested by her that her grounds of appeal raise any issue of diversity in first-instance decision-making requiring appellate resolution or any question of law or principle that is of wider application.

[60] Fifth, we consider that the public interest weighs entirely against the grant of permission to appeal. We do not intend, in the circumstances of the current pandemic, to give any encouragement to a spurious objection to a lawful workplace vaccination requirement.

Conclusion

[61] Permission to appeal is refused.

DECISION OF DEPUTY PRESIDENT DEAN

Introduction

[62] Ms Jennifer Kimber was dismissed because of her inability to be vaccinated against influenza in 2020.

[63] In a decision dated 29 April 2021, Commissioner McKenna determined that Ms Kimber’s dismissal was not unfair and dismissed her application for an unfair dismissal remedy against Sapphire Coast Community Aged Care Ltd (Sapphire) (the Decision) 12.

[64] Ms Kimber has lodged an appeal, for which permission to appeal is required, against the Decision. Permission to appeal has been refused by my colleagues in the majority (the Majority Decision).

[65] Never have I more strenuously disagreed with an outcome in an unfair dismissal application. The Decision manifest a serious injustice to Ms Kimber that required remedy. More egregious, however, is that the Majority Decision has denied Ms Kimber the protections afforded by the Fair Work Act in part because of “an inference that she holds a general anti-vaccination position” 13.

[66] Had I been able to do so, I would have granted permission to appeal, upheld the appeal and quashed the Decision. In re-determining the application, I would have found that Ms Kimber was unfairly dismissed and would have reinstated her to her former position.

[67] This decision is in two parts. First, I will explain the reasons why Ms Kimber was unfairly dismissed. Second, I will address the Majority Decision as it relates to COVID-19 and vaccine requirements.

PART 1 – MS KIMBER

[68] The background of this matter was set out in detail in the Decision and the key facts are as follows:

a) Sapphire operates an aged care residential facility in Pambula on the south coast of NSW.

b) Ms Kimber was employed to perform general receptionist-type duties on a part time basis on four days per week.

c) Ms Kimber received the influenza vaccine (flu shot) administered by Sapphire in April 2015 and April 2016.

d) After receiving the flu shot in 2016, Ms Kimber developed a severe skin inflammation over parts of her body, including her face, and her internal organs were also affected (the Condition). The Condition persisted for ten months. Ms Kimber considered the Condition to be a reaction to the 2016 flu shot.

e) Ms Kimber chose not to avail herself of an employer provided flu-shot in 2017, 2018 and 2019. She was not asked why she did not have flu shots and no issue was taken by Sapphire in this regard.

f) In 2020, the Australian Government and the governments of the States and Territories took a range of steps in an attempt to address the COVID-19 global pandemic.

g) Relevantly, on 24 March 2020 the NSW Government determined to make a Public Health Order (PHO) about matters related to requirements for flu shots concerning persons who worked within, or otherwise attended, NSW residential aged care facilities (the March PHO).

h) The March PHO reads, in part:

“4 Direction—entering and remaining on premises of residential aged care facility

(1) The Minister directs that a person must not enter or remain on the premises of a residential aged care facility during the relevant period unless—

…….

(d) the person is on the premises in accordance with an exemption given by the Minister, in writing, and complying with any conditions of the exemption.

(2) Subclause (1) is subject to clauses 5 and 6.

5 Direction—persons not to enter or remain on premises of residential aged care facility in certain circumstances

The Minister directs that a person mentioned in clause 4(a)—(c) must not enter or remain on the premises of a residential aged care facility during the relevant period if—

…..

(d) the person does not have an up-to-date vaccination against influenza, if the vaccination is available to the person.

6 Direction—persons aged under 16 years

…

7 Direction—responsibility of operator of residential aged care facility

The Minister directs that the operator of a residential aged care facility must take all reasonable steps to ensure that a person does not enter or remain on the premises of the facility in contravention of clause 4, 5 or 6.

8 Exemption

The Minister may, in writing and subject to any conditions the Minister considers appropriate, exempt a person from the operation of this Order if the Minister is satisfied it is necessary to protect the health and well-being of the residents or staff of a residential aged care facility.”

a) On 3 April 2020 the Australian Government’s Minister for Aged Care issued a media release (the Media Release) in the following terms:

“Aged care workers must get flu vaccination

Aged Care workers are being urged to get their flu vaccination now ahead of the season in a bid to protect themselves and the Senior Australians they care for.

Date published:

3 April 2020

Media type:

Media release

Audience:

General public

Aged Care workers are being urged to get their flu vaccination now ahead of the season in a bid to protect themselves and the Senior Australians they care for.

Minister for Aged Care Richard Colbeck said while every flu season is serious, the spread of COVID-19 means it’s critical every worker is vaccinated.

‘Our Aged Care workers are doing an exceptional job caring for our most vulnerable Australians in very challenging circumstances,’ Minister Colbeck said.

Senior Australians are the most at risk from serious illness from the flu, which is why it is essential that care workers are vaccinated.

“We need our aged care workforce to be fit and healthy as we face this health emergency.

‘This year it is even more important to be vigilant about the flu because of the COVID -19 pandemic.

‘While flu vaccination does not prevent COVID-19, a flu vaccination is critical to protecting the health of Senior Australians, who are more susceptible to contracting influenza.

‘I am urging all care workers who work with older Australians, whether through residential facilities or in-home care, to heed this advice and get vaccinated against the flu.

‘The more people caring for this vulnerable group who have a vaccination will result in less demand on our health care system.’

Every year, Residential Aged Care Providers are required to a free flu vaccination program to their staff.”

Due to the COVID-19 pandemic, the Australian Health Protection Principal Committee (AHPPC), the key medical decision-making committee for health emergencies, has advised that all residential aged care staff and visiting workers should be vaccinated by 1 May 2020.

State and Territories have issued directions to give effect to these requirements. These directions will be enforced and persons who fail to comply could face penalties including fines for individuals and for bodies corporate. Providers should consult their State or Territory Government.

Minister Colbeck said he has received the following advice from the Australian Government's Chief Medical Officer Professor Brendan Murphy:

‘The only absolute contraindication to flu vaccination is a history of previous anaphylaxis following vaccination, those who have had Guillain-Barré Syndrome following previous flu vaccination and people on check point inhibitor drugs for cancer treatment.’

Prof. Murphy said people who suffer from egg allergies - unless they have anaphylaxis - can be safely immunised.

Minister Colbeck said that we need to do everything we can to reduce the risk of Senior Australians getting other illnesses while COVID-19 remains in our community.

‘Vaccinated people of all ages are less likely to get the flu and if they do, are less likely to have a severe case,’ Minister Colbeck said.

‘It’s critical for our older Australians to reduce their risk of getting other illnesses while COVID-19 remains in our community.

‘Together we can work to protect older Australians and our community,’

Flu vaccinations are free for anyone aged 65 and over.

The latest advice released by the National Cabinet is Australians should self- isolate at home to the maximum extent practicable if they are:

• over 70 years of age;

• over 65 years of age with a chronic medical condition;

• an Indigenous Australian over the age of 50 with a chronic medical condition; and

• somebody with a compromised immune system.

These groups should limit contact with others as much as possible when they travel outside. For more information:

• Residential Aged Care

• Flu vaccination advice for all Australians.”

b) Sapphire wrote to its employees on 3 April 2020 stating that the flu shot was now mandatory unless a person had a contraindication to the vaccine, which was specified as anaphylaxis after a previous dose of influenza vaccine or any component of an influenza vaccine.

c) On 9 April 2020, Ms Kimber provided a letter from a Chinese medicine professional confirming that she had been treating Ms Kimber since the end of 2016, and Ms Kimber had had concerns regarding the flu shot and would prefer not to receive it.

d) On 21 April 2020, Sapphire wrote again to its employees, and in reliance on the Media Release noted that the only exception for staff was “a history of previous anaphylaxis following vaccination, those who have Guillian-Barre Syndrome following previous flu vaccination, and people on check point inhibitor drugs for cancer treatment”.

e) Sapphire took the view, in light of the March PHO and the Media Release, that there was nothing in the letter provided by Ms Kimber’s Chinese medicine practitioner that would support her refusal to have the flu shot.

f) Ms Kimber was stood down from her employment by letter dated 30 April 2020 (the stand down letter), because she had been “unable to produce a medical certificate which confirms you are unable to have the flu vaccination” in accordance with the contraindications set out in the Media Release. The stand down letter requested that she provide a medical certificate which referenced the contraindications identified in the Media Release, and further stated once the certificate was received, she would be able to return to her position. She was asked to attend a meeting with the Facility Manager on 4 May 2020, and informed that she may be dismissed if she did not follow what was said to be a lawful and reasonable direction.

g) Ms Kimber, at the meeting on 4 May, confirmed she was not prepared to have the flu shot in circumstances where the March PHO was a temporary measure, and she wanted to wait to see if the requirements would change.

h) Ms Kimber provided two letters from medical practitioners at this time, one being from Dr Neil Mackay MBBS, general practitioner, from Pambula Medical Centre. Dr Mackay’s letter is in the following terms:

“Letter of Support

I have attended Ms Jennifer Kimber on 27/4/2020.

Jennifer has a medical contraindication to the Influena [sic] Immunization. She has had a severe allergic reaction to the flu shot in the past and has been advised not to have it again.

Dr. Neil Mackay M.B.B.S.”

i) The second letter from a different doctor supported an application for carers leave for Ms Kimber until 1 June 2020.

j) Ms Kimber wrote to the CEO of Sapphire on 12 May 2020 and received a reply on 18 May 2020. These letters are set out in the Decision and not repeated here.

k) On 22 June a second PHO was made (the June PHO) which was in slightly different terms to the March PHO which it replaced. Relevantly, clause 6(1)(d) reads:

“6 Direction—persons not to enter or remain on premises of residential aged care facility in certain circumstances

The Minister directs that a person mentioned in clause 5(1)(a)-(d) must not enter or remain on the premises of a residential aged care facility if:

…….

(d) the person does not have an up-to-date vaccination against influenza unless-

(i) the vaccination is not available to the person, or

(ii) the person presents to the operator of the residential aged care facility a certificate in the approved form, issued by a medical practitioner, certifying that the person has a medical contraindication to the vaccination against influenza.” (emphasis added)

a) On 29 June 2020, being the last day of Ms Kimber’s carers leave, Sapphire wrote to Ms Kimber directing her to attend a meeting in order that she show cause as to why she should not be dismissed. The letter is set out in the Decision and not repeated here.

b) On 1 July Ms Kimber attended an appointment with Dr Mackay, who provided her with a letter (the second letter) in the following terms:

“1/7/2020

Letter of Support

(Patients without current clinical evidence of an illness)

I have attended Ms Jennifer Kimber on 1/7/2020.

The patient suffered a severe allergic reaction to the influenza vaccine 4 years ago. This resulted in severe facial and neck swelling with a wide spread erythematous over her face, chest and arms. This rash lasted 10 months and required oral prednisolone to resolve it. Jennifer has supplied photos of the rash which I have attached as supporting evidence.

In my opinion the history as stated is consistent with the above, and therefore is a medical contraindication to having the influenza vaccine.

I have completed the Influenza Vaccine Medical Contraindication Form from the NSW public health website.

[signature]

Dr. Neil Mackay

M.B.B.S.

4748848T”

c) This letter was accompanied by a completed pro forma NSW Government Influenza Vaccine Medical Contraindication Form (the IVMC form). The IVMC form relevantly read as follows:

“Date 1/7/2020

To whom it may concern

Request for access to a Residential Aged Care Facility (RACF) for reasons permitted under the NSW Public Health (COVID-19 Aged Care Facilities) Order (No 2) 2020 (the Order).

I am a registered medical practitioner.

I certify that, Jennifer Anne Kimber … has the following medical contraindication to this season’s influenza vaccine:

[ ] anaphylaxis after a previous dose of any influenza vaccine

[ ] anaphylaxis after any component of an influenza vaccine

[ ] history of Guillain-Barré Syndrome whose first episode occurred within 6 weeks of receiving an influenza vaccine

[ ] cancer immuno-oncology therapies (checkpoint inhibitors) – The patient has been advised to consult with their treating oncologist about the risks and benefits of influenza vaccination

[X] other medical contraindication; being Severe Facial Swelling and rash lasting 10 months from vaccine

*Note - Fluad Quad and Afluria Quad state that people with egg allergy (non-anaphylaxis) can receive an age-appropriate dose and therefore will not qualify for a medical contraindication

I certify that the above mentioned person has a medical contraindication and is not required to have an up-to-date vaccination against influenza prior to entry into a RACF.” (emphasis added)

d) Ms Kimber gave the second letter and the IVMC form to Sapphire prior to a telephone meeting between the parties on 2 July 2020.

e) On 6 July Ms Kimber was advised by telephone that her employment was terminated because she had refused to have a flu shot and would receive a letter to that effect (the Dismissal letter). The Dismissal letter reads:

“Dear Jenny

Re: TERMINATION OF YOUR EMPLOYMENT

We write to inform you that, as of 6/7/20, Sapphire Coast Community Aged Care Ltd has terminated your employment as Clerk Grade 3 Employee.

Despite multiple lawful and reasonable directions to be vaccinated against influenza as per NSW Public Health (COVID-19 Residential Aged Care Facilities) Order 2020 (No 1), clause 5(d) and NSW Public Health (COVID-19 Residential Aged Care Facilities) Order 2020 (No 2) clause 6(1)(d), you have refused to be vaccinated and, as such, you are unable to fulfil the inherent requirements of your role.

The Public Health Order prescribes that a person, including an employee, is not to remain on premises of a residential aged care facility if the person does not have an up- to-date vaccination against influenza.

You attended a meeting with Anne Main on 4/5/20 during which you were offered an opportunity to discuss your refusal to comply with the Public Health Order. During that meeting, you stated words to the effect of “I will await to see if legislation becomes permanent and would consult an immunologist to see if you would likely have another debilitation reaction if you had the flu vaccination”. You were advised at the time and by way of letter (please see attached) that should you choose not to be vaccinated against influenza, you could not lawfully return to work and your employment would be terminated.

You participated in a ‘show cause’ meeting with Anne Main on 2/7/20 via telephone in order to “show cause as to why your employment with Sapphire Coast Aged Care should not be terminated”. This was outlined in a letter sent to you 29/6/20 in relation to inability to fulfil inherent requirements of role of Clerk Grade 3. You advised during the meeting with Anne that “your opinion on having the vaccine has not changed, you would like to know if CEO Matt is seeking an exemption for me”.

Further, we note we received a medical letter of support from you dated 27 April 2020 stating that you have a severe allergic reaction to the flu shot. We advised you that a severe allergic reaction does not qualify as a medical contraindication under the order and therefore the flu vaccination was still available to you. We also requested further information from you [sic] treating doctor. We have now received another medical letter of support from you [Dr MacKay’s Letter of Support dated 1 July 2020] with more information stating that the medical contraindications are severe facial swelling and rash lasting 10mths from vaccine. After considering the advice from the Chief Medical Officer we take the view that your medical contraindication is NOT a qualifiable medical contraindication and therefore Clause 6(1) (a)-(c) of the Order still applies.

Sapphire Coast Community Aged Care Ltd will pay you an amount in lieu of notice in accordance with your entitlements. You will also be paid out any accrued entitlements owed to you which will be detailed in writing under a separate letter. Other documents such as your Group Certificate, Statement of Service and Employment Separation Certificate will also be forwarded to you. Please return all property belonging to Sapphire Coast Community Aged Care Ltd to your supervisor immediately.

Do not hesitate to contact the undersigned, if you have any queries regarding this letter.

Yours sincerely,

[signature]

Matt Sierp

Chief Executive Officer

Sapphire Coast Community Aged Care Ltd”

f) The CEO of Sapphire, in his evidence, said that he had formed the view that the medical contraindication specified by Dr Mackay in the IVMC form did not constitute a medical contraindication in accordance with the Media Release and other information such as the Australian Immunisation Handbook. 14

The Decision

[69] After confirming that Ms Kimber was a person protected from unfair dismissal, the Commissioner turned in the decision to whether the dismissal was unfair, and in doing so, addressed the matters required to be taken into account under s.387 of the Act.

[70] In relation to s.387(a), that being whether there was a valid reason for the dismissal, the Commissioner found as follows:

“[52] Lawful and reasonable direction to have a 2020 flu shot: The dismissal letter identified that the termination of employment occurred because the applicant had “refused to be vaccinated” despite “multiple lawful and reasonable directions to be vaccinated against influenza” as per clause 5(d) of the March PHO and clause 6(1)(d) of the June PHO.

[53] I find the respondent did not, at any time, give any within-terms “directions” to the applicant to have a flu shot. The evidence simply does not support a conclusion there was any written or verbal direction given to the applicant in such respects by Mr Sierp, Ms Main or anyone else associated with the management of the respondent (let alone “multiple directions”) and this is so notwithstanding, for example, what the applicant wrote in her letter dated 12 May 2020 to Mr Sierp asserting she had been given such a direction. That is, the applicant wrote in the letter dated 12 May 2020: “I refer to your letter dated 30th April 2020 regarding the recent direction for me to have a mandatory influenza vaccination, …”.

[54] Although no directions were given by the respondent to the applicant to have a flu shot, equally, the respondent nonetheless firmly communicated to the applicant (and to its employees generally) that having an up-to-date flu shot was necessary for attendance for work at Imlay House. The communications from Mr Sierp referred, for example, to the directions given by the NSW Minister for Health in the PHOs rather than the respondent itself giving directions to have a flu shot. That is, the PHOs, within terms, refer to various directions, i.e. “The Minister directs that …”. The expectation or implicit requirement of the respondent that the applicant (and other employees) should receive the 2020 flu shot was couched in terms which referred (initially) to the NSW Government’s March PHO and (subsequently) to the June PHO; and (after 3 April 2020) to the CMO Advice as set out in the Media Release.

[55] Given the respondent did not, in fact, give any direction to the applicant to have a 2020 flu shot, I find the respondent’s reliance in the dismissal letter upon its purported “multiple lawful and reasonable directions to be vaccinated against influenza” was a misstatement. Nonetheless, the practical import of the communications was effectively to indicate that the respondent expected or required the applicant (and other employees) to have a flu shot unless there was a medical contraindication as described in the CMO Advice.

[56] Putting aside my finding that the respondent did not give any directions to the applicant to have a flu shot, there was sharp contest in the proceedings about whether the respondent could give a lawful and reasonable direction to the applicant to have a flu shot - relevantly in the context of the applicant’s attendance at work and/or continuation of employment at the Imlay House residential aged care facility at a time when the PHOs were in place. Certainly, the respondent could not physically compel the applicant to have a flu shot against her own personal wishes. Regardless of any direction by an employer (whether described in terms of being lawful and reasonable, or described in other similarly-pitched terms), an employee is entitled to make his or her own personal choice about whether to have a flu shot. Be that as it may, that is not the end of the matter. If an employee makes a personal choice not to have a flu shot, then an employer which provides residential aged care services and which is subject to a PHO has its own obligations under that PHO. Here, specific obligations were imposed upon the respondent by the March PHO and then the June PHO. In the complexity of NSW Government and Australian Government interactions, requirements and pronouncements about aged care facilities that were occurring in 2020, the respondent was not only trying to adhere as best it could to the NSW Government’s PHOs, it also was trying to listen to, and apply, what was being communicated at an Australian Government level (and by Mr Sierp’s reading of the Australian Immunisation Handbook). The approach adopted by the respondent was to apply the CMO Advice as to absolute contraindications rather than allow for other categories of contraindications, as appears to be contemplated in the IVMC Form.

[57] It seems to me that if a direction in fact had been given by the respondent to the applicant to have a flu shot, any such direction would not only have been lawful it would have effectively reflected what in fact was the law as it applied in 2020 concerning employees working within NSW residential aged care facilities (subject to the exemptions within the PHOs); as a corollary, any such direction would not only have been lawful, but also reasonable.

[58] Inability to perform the inherent requirements of the job: The dismissal letter indicated that, as the applicant had not received a 2020 flu shot, the applicant was “unable to fulfil the inherent requirements” of her role.

[59] The applicant was unable to perform the inherent requirements of her job if she was not properly permitted to enter or remain at Imlay House absent having an up-to-date flu shot. That is, if the applicant could not enter Imlay House, she could not perform the (principally) receptionist role and other clerical inherent requirements of her position. Moreover, although the applicant mentioned in her cross-examination that she could have worked from home, there was no evidence the applicant made any application to the respondent to perform from home any of the other clerical and/or administrative aspects of her job (and nor was there any evidence the respondent considered non-receptionist duties on a work-from-home basis as an option). The applicant’s case was that she could attend work at Imlay House to perform the inherent requirements of her job but was prevented from doing so by the respondent - and later unfairly dismissed by the respondent - based upon the erroneous failure of the respondent to accept Dr Mackay’s first Letter of Support, Dr Mackay’s second Letter of Support and, particularly, the IVMC Form with Dr Mackay’s certification. The applicant’s case contended for a conclusion by the Commission that as the applicant had provided to the respondent the IVMC Form the exclusion of the applicant from her Imlay House workplace was without a proper foundation and the dismissal lacked a valid reason – but I have accepted the submissions for the respondent in such respects in preference to those for the applicant.

[60] Flu shot requirement: I find that the respondent, principally through Mr Sierp, acted in an objectively prudent and reasonable way in not permitting the applicant to work within Imaly House absent an up-to-date flu shot. I accept the submissions for the applicant that Mr Sierp did not have a detailed knowledge of the Australian Immunisation Handbook (indeed, Mr Sierp himself professed only to be “familiar” with it), but I find he acted on his best understanding of it, conditioned particularly in the context of the CMO’s Advice as set out in the Media Release. To recap, the Media Release identified matters including the following:

• “While flu vaccination does not prevent COVID-19, a flu vaccination is critical to protecting the health of Senior Australians, who are more susceptible to contracting influenza.”

• “Due to the COVID-19 pandemic, the Australian Health Protection Principal Committee (AHPPC), the key medical decision-making committee for health emergencies, has advised that all residential aged care staff and visiting workers should be vaccinated by 1 May 2020.”

• “State and Territories have issued directions to give effect to these requirements. These directions will be enforced and persons who fail to comply could face penalties including fines for individuals and for bodies corporate.”

• “Minister Colbeck said he has received the following advice from the Australian Government’s Chief Medical Officer Professor Brendan Murphy:

Prof. Murphy said people who suffer from egg allergies – unless they have anaphylaxis – can be safely immunised.”

[61] True it is, as the applicant submitted, the Media Release had “absolutely no force at law”, but it would have been foolhardy indeed for Mr Sierp to purport to put his own gloss on, or ignore, what was said by the CMO and, for example, to substitute his own opinion/s for those of the CMO as to matters concerning contraindications to influenza vaccination - whether based on his own reading of the Australian Immunisation Handbook, or based on the reading for which the applicant contended in the hearing, or otherwise. Counsel for the applicant described Mr Sierp’s adherence to the CMO Advice within the Media Release as “pig-headed”. I reject that regrettable characterisation of Mr Sierp, a CEO who was making his best endeavours in relation to the operations of the residential aged care facility in what was undoubtedly a very difficult period of time within the aged care sector, for example, in relation to the multiple deaths at Sydney’s Newmarch House. An extract of the transcript of the cross-examination of Mr Sierp is illustrative as to the cautious approach in his reliance on the CMO Advice. The questions posed by counsel for the applicant are reproduced in plain text and Mr Sierp’s answers are in italicised text in the following extract:

“That is Dr Mackay’s influenza vaccine medical contraindication form? Do you - you received that on or about 1 July 2020? Yes.

You saw that it was an official New South Wales government form? Yes.

And you saw on that form that there were other medical contraindications written on that form apart from anaphylaxis - did you see that? Yes.

Did that cause you to doubt the completeness of the Minister’s attribution to Professor Murphy about that being the only genuine contraindication? No.

Why not? Because we had always followed what the Minister and Professor Murphy utilized as their definitions.

So I don’t want to be rude but did you think the department and the state minister were just waffling in the air when they added all those other boxes to be ticked? No.

What did you think they were doing? I didn’t write the form.

Doesn’t - can I just put to you that that form indicates that the narrow advice or part of advice from - that was quoted in the Minister’s press release is just that narrow and only part of the advice about what are accepted medical contraindications to the influenza vaccine? Did that cause you to think that? It didn’t tie in with Professor Murphy or the Minister’s - - -

Yes, precisely, so it didn’t tie in with what you understood Professor Murphy to be saying through the Minister’s press release and did that cause you to doubt what - what was the appropriate definition of a medical contraindicator to the influenza vaccine for the purposes of Ms Kimber's case? It wasn’t challenging the contraindications.

Sorry? Did it cause you to doubt that Professor Murphy's statement was complete? No.

You just thought those extra boxes about the cancer and those things were - they were just there for no reason, did you? Did you? No.

What reason did you think they were there for? Like a number of forms that are produced it did not tie in with this contraindication. As the provider, we’re allowed to challenge the information that we receive.

It didn’t tie in with what Professor Murphy had said, did it? That’s your evidence? In which question?

The matters on the form didn't tie in with what Professor Murphy had said about medical contraindications to influenza vaccine, did it? It didn’t tie in with the public health order and the fact that the exemption - - -

Sorry, I’m asking you it didn’t tie in with what Professor Murphy had said, did it - or what you understood him to have said? The other box didn’t coincide with Professor Murphy’s.

But that didn’t cause you to doubt what Professor Murphy had to say, did it? No.”

[62] The respondent did not accept what was put forward by the applicant in relation to her refusal to have a flu shot and, in such respects, I find Mr Sierp took an objectively prudent and appropriate approach in his reliance on what was said by the CMO as identified by the federal Minister for Aged Care in the Media Release titled “Aged care workers must get flu vaccination”. Although the applicant submitted that the CMO Advice as set out within the Media Release amounted only to “hearsay” and that “the minister’s press release is really just some sort of throw-away”, it seems to me it carried greater weight than that; I did not find the submissions as to hearsay persuasive in as much as those submissions sought to diminish the significance of the advice of the CMO, albeit as set out in a media release. The March PHO was succeeded by the June PHO, which operated from 23 June 2020 (with an anticipated cessation on 21 September 2020). There was no evidence of any change in the associated advice from the CMO on the matter of contraindications in the time following the Media Release to the date the applicant was dismissed.

[63] Given my acceptance of Mr Sierp’s reliance on the CMO Advice as being objectively reasonable, I find there was a valid capacity-related reason for the dismissal given the applicant chose not to have an up-to-date flu shot in 2020. The respondent determined, appropriately I consider, not to allow the applicant to enter Imlay House to work without an up-to-date flu shot. As I found earlier, if the applicant could not enter Imlay House, she could not perform the inherent requirements of her job.

[64] Although the submissions for the applicant proceeded, in part, to suggest the applicant’s dismissal may have involved a contention about serious misconduct, it is unnecessary to consider those submissions. No aspect of the respondent’s case contended the applicant had misconducted herself or had been dismissed for misconduct, let alone serious misconduct, in not having a flu shot.”

[71] In summary, the Commissioner found that it was ‘objectively reasonable’ for Sapphire to rely on the ‘advice’ in the Media Release, and accordingly found that there was a valid capacity-related reason for Ms Kimber’s dismissal given she “chose not to have an up-to-date flu shot in 2020”. The Commissioner went on to find that “the respondent determined, appropriately I consider, not to allow the applicant to enter Imlay House to work without an up-to-date flu shot. As I found earlier, if the applicant could not enter Imlay House, she could not perform the inherent requirements of her job”.

[72] The findings made by the Commissioner in relation to s.387(b)-(g) do not need to be recited.

[73] In relation to s.387(h), the Commissioner considered a number of matters including that there was “a paucity of medical evidence about a connection between the 2016 flu shot and the Condition”. 15 As a result of the lack of evidence, the Commissioner was not satisfied that the Condition resulted from the 2016 flu shot, notwithstanding the two letters from Dr Mackay and the IVMC form completed by him 16.

[74] The Commissioner at paragraphs 77 and 78 of the Decision said the following in relation to Dr Mackay:

“[77] As to Dr Mackay’s two Letters of Support and the IVMC form, it is reasonably clear that Dr Mackay did not personally examine the applicant in 2016-17. Rather, Dr Mackay appears to have proceeded only on what the applicant stated to him as having occurred in 2016-17 – as indicated in the signed certification by the applicant at the foot of each Letter of Support. It is unclear on the evidence what actually was before Dr Mackay, other than two undated photographs of the applicant and what the applicant recounted to him (i.e., see the applicant’s own certification as recorded within each of Dr Mackay’s two Letters of Support). There is nothing arising from Dr Mackay’s two Letters of Support to indicate he had access to and/or reviewed any medical records relevant to 2016-17. The basis upon which Dr Mackay determined to certify in the IVMC Form that the applicant had a medical contraindication to the (“up-to-date”) 2020 vaccination against influenza is also unclear on the evidence. For instance, the evidence in the respondent’s case indicated there are presently six types of influenza vaccines and there was no evidence of any referral of the applicant by Dr Mackay to a specialist, such as an immunologist, for consultation before Dr Mackay completed the IVMC Form with his certification concerning the applicant. Rather, the applicant attended an appointment with Dr Mackay on 1 July 2020 and that was the same date on the second Letter of Support and the IVMC Form.

[78] The certification by a medical practitioner in an IVMC Form concerns a serious public health matter. It is also a matter with serious legal significance - given that, absent such certification (or an exemption from the NSW Minister for Health), it would have been an offence under the June PHO (with associated penalties of potential imprisonment and fines) to fail to comply with the ministerial direction not to enter an aged care facility without having had an up-to-date vaccination for influenza if it was available to the person.”

[75] The Commissioner also accepted the evidence and opinions of Professor Wakefield, a specialist immunologist, who was called by Sapphire to give expert evidence. She noted in particular the following evidence in his report:

“Based on the information available to me it is not on the balance of probability likely that the rash that Mrs Kimber suffered from was related to prior influenza vaccination and there was no other evidence of a contraindication to her having influenza immunisation. The presence of an allergic reaction to the influenza vaccine could be tested by skin prick testing using the influenza vaccine and/or challenge with the vaccine in a hospital environment to ascertain if the subject has an allergic or severe reaction to the influenza vaccine.” 17

[76] The Commissioner stated that her conclusion that Ms Kimber did not establish the Condition was a reaction to the 2016 flu shot favoured the correctness of the stance taken by Sapphire and its adherence to the ‘advice’ in the Media Release concerning contraindications to the vaccine.

Why is the Decision wrong?

[77] In answering this question it is only necessary to consider the finding that there was a valid reason for Ms Kimber’s dismissal.

[78] The Commissioner’s findings in relation to valid reason are set out earlier. Essentially, she found that:

a) Despite what was stated in the Dismissal letter, Sapphire did not give a lawful and reasonable direction to have a 2020 flu shot to Ms Kimber. However if such a direction were given, the Commissioner found that it would have been both lawful and reasonable;

b) Ms Kimber was unable to fulfil the inherent requirements of her role because she was not properly permitted to enter or remain at Imlay House without having had an up-to-date flu shot; and

c) Sapphire acted in an objectively prudent and reasonable way in not permitting the applicant to work within Imaly House absent an up-to-date flu shot.

Lawful and reasonable direction

[79] I agree with the Commissioner’s findings that Sapphire did not actually give a direction to Ms Kimber to have the flu shot in 2020. To this extent, the reasons provided in the Dismissal letter were both wrong and misleading.

[80] To the extent that the Commissioner found that Sapphire could direct Ms Kimber to be vaccinated and this would have been a reasonable and lawful direction, I fundamentally disagree. As set out in more detail below, Ms Kimber had a valid exemption from the requirement that arose under the June PHO to have the flu shot. This was evident from the second letter from Dr Mackay and the properly completed IVMC form. There was no basis in which a lawful and reasonable direction could have been given to Ms Kimber to have the flu shot in these circumstances, and such a direction would have been contrary to her medical advice. The Commissioner erred in so finding.

Unable to fulfil inherent requirements because unable to enter workplace

[81] It was not open for the Commissioner to find that Ms Kimber was unable to perform the inherent requirements of her role because she was not permitted to enter her place of work without having an up-to-date flu shot. There was no legal impediment to Ms Kimber entering her workplace by operation of the June PHO. This is because she had a valid exemption under clause 6(d)(ii) of the June PHO.

[82] The exemption provision contained within the June PHO is clear, in that all that is required to be satisfied is that:

“the person presents to the operator of the residential aged care facility a certificate in the approved form, issued by a medical practitioner, certifying that the person has a medical contraindication to the vaccination against influenza.” 18

[83] This is exactly what Ms Kimber did, prior to her dismissal. There is no dispute that the approved form was used, that being the IVMC form. It was issued by a medical practitioner, that being Dr Mackay. He certified that Ms Kimber had “a medical contraindication” as was required by the exemption provision. Dr Mackay specified what the medical contraindication was.

[84] The IVMC form, set out earlier in this decision, does not limit the possible contraindications to those mentioned in the Media Release. In this regard I note the following:

a) The Media Release references only the ‘absolute’ contraindications to the flu shot. Given the employment background of the CEO, he ought to have been aware that contraindications can be absolute or relative.

b) The Media Release, issued by the Commonwealth Minister for Aged Care, acknowledges that it is the responsibility for States and Territories to give effect to the requirements of the Australian Health Protection Principal Committee (AHPPC).

c) In NSW, the NSW Government relevantly made the June PHO which provided the exemption provisions and provided the template IVMC form.

d) The IVMC form clearly and unambiguously gives power to a registered medical practitioner, of which Dr Mackay is one, to certify that a person has a medical contraindication.

e) In addition to the specific (and absolute) contraindications listed, the IVMC form recognises and allows for the medical practitioner to certify a different contraindication (ie. ‘other’) and specify what that contraindication is.

f) The IVMC form then provides for the medical practitioner to certify that the person is not required to have an up-to-date vaccination against influenza prior to entry into a residential aged care facility, which is exactly what Dr Mackay did.

g) There is no basis for reading into the exemption provisions of the June PHO requirements (such as a requirement to consult a specialist immunologist for example) that are not there.

[85] The Dismissal letter clearly relies on the June PHO and the Media Release to decide that Ms Kimber was unable to fulfil the inherent requirements of her role. The reference to ‘advice’ from the CMO is only a reference to the Media Release, not actual medical advice.

[86] The Dismissal letter also makes clear that despite the second letter from Dr Mackay and the completed IVMC form, Sapphire took the view that her medical contraindication did not qualify as a contraindicator based on the Media Release, and as such the exemption provisions did not apply. In doing so, Sapphire disregarded the medical opinion of a registered medical practitioner and instead replaced it with its own opinion based on the Media Release.

[87] The Commissioner endorsed the approach adopted by Sapphire to apply the ‘advice’ in the Media Release as to absolute contraindications rather than accept other categories of contraindications, as was clearly contemplated in the IVMC Form. To rely on a Media Release as medical ‘advice’ to base a decision to dismiss an employee in these circumstances is simply wrong. The Commissioner, having acknowledged that the Media Release had “absolutely no force at law”, went on to find that “it would have been foolhardy indeed for Mr Sierp to purport to put his own gloss on, or ignore, what was said by the CMO and, for example, to substitute his own opinion/s for those of the CMO as to matters concerning contraindications to influenza vaccination - whether based on his own reading of the Australian Immunisation Handbook, or based on the reading for which the applicant contended in the hearing, or otherwise”. However this is exactly what the CEO of Sapphire did with respect to the medical advice provided by Dr Mackay. He ignored the medical advice he had been provided with and instead substituted his own opinion based on a Media Release.

[88] If this approach were to be correct, the effect is that it is open for employers to simply disregard the professional opinion of a medical practitioner and instead make their own unqualified medical diagnoses, or form their own views about circumstances in which medical conditions may or may not be contraindications to a vaccine. Sapphire did not act in accordance with the medical advice that was provided by Ms Kimber, nor did it obtain any medical advice to counter what was provided by Dr Mackay. The result of the Majority Decision in part is that it undermines the validity and reliability of medical advice received from a medical practitioner.

[89] It is also relevant to highlight that Professor Wakefield confirmed that patients should follow the advice of their medical practitioner, which is exactly what Ms Kimber did. She was advised by Dr Mackay that she had a medical contraindication to the flu shot and should not have the flu shot. She prudently and appropriately followed his advice.

[90] The Commissioner was critical of the lack of evidence as to the basis for Dr Mackay’s professional opinion that Ms Kimber had a medical contraindication. With respect, it is not for the Commission to decide whether a medical practitioner has a reasonable basis for forming a medical opinion, particularly where was no suggestion that the letters from Dr Mackay or the IVMC form were either a sham or fraudulent. There was no evidence to suggest that Dr Mackay was not fit or qualified to arrive at the opinion he reached. The Commissioner erred in deciding to reject the IVMC form.

[91] Further, the Commissioner erred in finding that Ms Kimber was required to establish that the Condition (ie the medical condition she said she suffered after the 2016 flu shot) was caused by the 2016 flu shot. Again, all that was required of Ms Kimber to be exempt from the June PHO was a properly completed IVMC form. In any event, Dr Mackay provided a clear and unequivocal medical opinion that her allergic reaction was a reaction to the vaccine in the second letter when he said:

“The patient suffered a severe allergic reaction to the influenza vaccine 4 years ago. This resulted in severe facial and neck swelling with a wide spread erythematous over her face, chest and arms. This rash lasted 10 months and required oral prednisolone to resolve it. Jennifer has supplied photos of the rash which I have attached as supporting evidence.

In my opinion the history as stated is consistent with the above, and therefore is a medical contraindication to having the influenza vaccine.”

[92] The Majority Decision is critical of Ms Kimber because of what she did not do, in that she did not take time off work in 2016 when the Condition commenced, did not inform Sapphire at that time that she had had an adverse reaction to the flu shot, and did not provide evidence that she sought medical treatment at that time. With respect, this criticism misses the point. There was no requirement for her to do any of these things because the flu shot was not mandatory at the time, and whether she had the flu shot was not relevant to her ongoing employment. All Ms Kimber had to do was to decline to have the flu shot, which is what she did, and there was no issue taken by Sapphire in this regard.

[93] Further, Ms Kimber’s opinion of whether she had a medical contraindication is, on one view, completely irrelevant. It was for a medical practitioner to form an opinion as to whether she had a medical contraindication, which is what Dr Mackay had done.

[94] The Majority Decision also expressed criticism of Dr Mackay. At paragraph 14 the inference is drawn that “the entire basis for Dr Mackay’s assertion that Ms Kimber had previously suffered an adverse reaction to the influenza vaccination was what Ms Kimber had told him”. With respect, this inference is properly able to be drawn. There was photographic evidence of the Condition which Dr Mackay had before him. There is no basis to conclude that he did not have access to her medical records, given medical records are normally able to be accessed by all doctors who practise in a particular medical centre. If any inference can be drawn, it is that she did attend a medical practitioner at the time because she was treated with a prescription-only medication, being prednisolone. Dr Mackay was not required to justify his medical opinion in either the IVMC form or the first and second letters, and so this criticism of him is unfounded and inappropriate.

[95] Finally, in my view it is extremely unlikely that any medical practitioner would certify that a patient had a medical contraindication by completing an IVMC form and providing the letters if they did not genuinely believe that the patient actually had a medical contraindication, as doing so would be fraudulent and would jeopardise the practitioner’s ability to practise medicine.

[96] The Majority Decision is critical of the contents of Ms Kimber’s letter dated 12 May 2020, which is extracted in part at paragraph 16 of the Majority Decision. I consider that Ms Kimber is correct in saying that the flu shot is not completely safe for everyone. So much is abundantly clear by the undeniable fact that there are medical contraindications to the flu shot, as there is with most medications. I disagree with the Majority Decision that the letter demonstrates that Ms Kimber “held a broader anti-vaccination position”. It is not in dispute that Ms Kimber did have the flu shot prior to the Condition. It is also not in dispute that an appropriately qualified medical practitioner advised her that she did in fact have a medical contraindication and that she should not have the flu shot. To label her an anti-vaxxer in these circumstances is highly inappropriate.

[97] Both the Decision and the Majority Decision relied heavily on the evidence of Professor Wakefield, however his evidence was by no means definitive. He considered that the Condition would have been an uncommon reaction and ‘more likely than not’ unrelated to the flu shot, but he did not rule it out as an option. He also gave evidence in cross examination that it is appropriate that a patient follow the advice of their medical practitioner, which is what Ms Kimber did.

[98] In summary, it was not reasonably open on the facts for the Commissioner to find that Ms Kimber was unable to perform the inherent requirements of her role, because she was able to enter her workplace as a result of her valid exemption from the June PHO. In doing so, the Commissioner made a significant error of fact by finding that Sapphire “acted in an objectively prudent and reasonable way in not permitting the applicant to work within Imlay House absent an up-to-date flu shot, in reliance on the Media Release.” 19

[99] The Majority Decision also raises the question of Ms Kimber’s willingness or otherwise to have the COVID vaccine, and this is relied on as a reason for refusing to grant permission to appeal. During the appeal hearing, the Vice President asked Ms Kimber whether she would comply with a requirement to have the COVID vaccine. Ms Kimber’s response was that she would consider the terms of any PHO that might be made (given at the time no such PHO had been made) and obtain the advice of her medical practitioner. It is hard to see what criticism could reasonably be levelled at Ms Kimber for this response, but the Majority Decision states that this response “supports the inference that she holds a general anti-vaccination position”.

[100] Finally, the last paragraph of the Majority Decision cannot pass without comment. To suggest that Ms Kimber had a “spurious objection to a lawful workplace vaccination requirement” in circumstances where she had been advised by her medical practitioner that she did indeed have a medical contraindication to the flu shot, advised she should not have a flu shot, and had provided a properly completed IVMC form, is a terrible mischaracterisation of her and the circumstances in this case.

PART 2 –VACCINE REQUIREMENTS IN RELATION TO COVID

[101] The Majority Decision raises the issue of COVID vaccinations and their requirement in workplaces. It forms part of the reasoning for refusing to grant permission to appeal and accordingly provides the opportunity in this decision to deal with this important issue.

[102] There can be absolutely no doubt that vaccines are a highly effective tool for protection against a variety of diseases. The focus of this decision, however, is not the pros and cons of vaccination. It is about the extent to which mandatory COVID vaccinations can be justified, as to do so impinges on other laws, liberties and rights that exist in Australia.

Vaccinations should be voluntary

[103] It has been widely accepted that for the overwhelming majority of Australians, vaccination should be voluntary.

[104] The commonly accepted definition of voluntary includes acting of one’s own free will, optional or non-compulsory. This is the opposite of the definition of mandatory, which is something that is compulsory, obligatory or required. Something that is mandatory must be done.

[105] The stated position of the Australian Government is that the vaccine is voluntary. On 21 July 2021, the Prime Minister in a media conference stated that “people make their own decisions about their own health and their own bodies. That’s why we don’t have mandatory vaccination in relation to the general population”.

[106] On 13 August 2021, the Australian Council of Trade Unions (ACTU) and the Business Council of Australia (BCA) issued a joint statement on mandatory COVID vaccinations in which it acknowledged the Australian Government’s COVID vaccination policy that the vaccine is voluntary, and confirmed the views of the BCA and ACTU that “for the overwhelming majority of Australians, your work or workplace should not fundamentally alter the voluntary nature of vaccination”. (emphasis added)

[107] The Fair Work Ombudsman has publicly stated that employers will need to have a “compelling reason” before requiring vaccinations, and that “the overwhelming majority of employers should assume that they can’t require their employees to be vaccinated against coronavirus”. (emphasis added)

[108] Safe Work Australia has publicly stated that “most employers will not need to make vaccinations mandatory to meet their [health and safety] obligations”. (emphasis added)

[109] Despite this, many employers are declaring they will mandate COVID vaccines for their workers, and PHOs are being made by State Governments, in circumstances where there is no justification for doing so.

Mandatory vaccination cannot be justified

[110] COVID vaccinations, in accordance with the Australian Government’s policy, must be freely available and voluntary for all Australians.

[111] Mandatory COVID vaccinations, however, cannot be justified in almost every workplace in Australia. While there are numerous reasons for this, this decision will focus on:

a) the requirement for freely given and informed consent for medical procedures;

b) denying an unvaccinated person the ability work on health and safety grounds, whether at the initiation of an employer or as part of a PHO; and

c) the requirements to comply with disability discrimination laws.

[112] There is of course a degree of overlap with the reasoning applicable to the inability to justify mandatory vaccination whether at the initiative of employers or as part of a PHO, however I have not repeated the reasons under each separate heading.

[113] Before turning to a consideration of these reasons, it is important to set the context with some information that is publicly available and should be uncontroversial:

a. Unlike many other vaccinations such as those used to stop the spread of tetanus, yellow fever and smallpox, COVID vaccinations are not designed to stop COVID. They are designed to reduce the symptoms of the virus, however a fully vaccinated person can contract and transmit COVID.

b. The science is clear in that COVID is less serious for those who are young and otherwise healthy compared to those who are elderly and/or who have co-morbidities. In other words, the risk of COVID is far greater for those who are elderly or have co-morbidities. Around 87% of those who have died with COVID in Australia are over 80 years old and had other pre-existing illnesses listed on their death certificates.

c. The World Health Organisation has stated that most people diagnosed with COVID will recover without the need for any medical treatment.

d. The vaccines are only provisionally approved for use in Australia and are accordingly still part of a clinical trial 20.

e. There are side effects to the COVID vaccines that are now known. That side effects exist is not a conspiracy theory.

f. The long-term effects of the COVID vaccines are unknown, and this is recognised by the Therapeutic Goods Administration (TGA) in Australia.

Consent is required for participation in clinical trials

[114] Consent is required for all participation in a clinical trial. Consent is necessary because people have a fundamental right to bodily integrity, that being autonomy and self-determination over their own body without unconsented physical intrusion. Voluntary consent for any medical treatment has been a fundamental part of the laws of Australia and internationally for decades.
It is legally, ethically and morally wrong to coerce a person to participate in a clinical trial.

[115] Coercion is not consent. Coercion is the practice of persuading someone to do something using force or threats. Some have suggested that there is no coercion in threatening a person with dismissal and withdrawing their ability to participate in society if that person does not have the COVID vaccine. However, nothing could be further from the truth.

[116] All COVID vaccines in Australia are only provisionally approved, and as such remain part of a clinical trial 21. This is not part of a conspiracy theory. It is a fact easily verifiable from the website of the TGA, Australia’s regulatory authority responsible for assessing and registering/approving all COVID vaccines before they can be used in Australia.

[117] The requirement for consent in this context is not new and should never be controversial. The Nuremburg Code (the Code), formulated in 1947 in response to Nazi doctors performing medical experiments on people during WWII, is one of the most important documents in the history of the ethics of medical research.

[118] The first principle of the Code is that “The voluntary consent of the human subject is absolutely essential”. The Code goes on to say that “This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision….”

[119] Informed and freely given consent is at the heart of the Code and is rightly viewed as a protection of a person’s human rights.

[120] The United Nations, including through the Universal Declaration of Human Rights, first proclaimed in 1948, has long recognised the right to bodily integrity.

[121] The Declaration of Helsinki (the Declaration), made in 1964 by the World Medical Association, is also a statement of ethical principles for medical research involving human subjects. Under the heading of “Informed Consent”, the Declaration starts with the acknowledgement that “Participation by individuals capable of giving informed consent as subjects in medical research must be voluntary”.

[122] Australia is a party to the seven core international human rights treaties, including the International Covenant on Civil and Political Rights.

[123] The Australian Human Right Commission Act 1986 (Cth) gives effect to Australia’s obligations under the International Covenant on Civil and Political Rights, which provides in Article 7 that “…no one shall be subjected without his free consent to medical or scientific experimentation”.

[124] In 1984, the American Association for the International Commission of Jurists (AAICJ) held an international colloquium in Siracusa, Italy, which was co-sponsored by the International Commission of Jurists. The focus of the colloquium was the limitation and derogation provisions of the International Covenant on Civil and Political Rights, and the outcome is a document that is referred to as the Siracusa Principles 22.

[125] The introductory note to the Siracusa Principles commences in the following terms:

“It has long been observed by the American Association for the International Commission of Jurists (AAICJ) that one of the main instruments employed by governments to repress and deny the fundamental rights and freedoms of peoples has been the illegal and unwarranted Declaration of Martial Law or a State of Emergency. Very often these measures are taken under the pretext of the existence of a “public emergency which threatens the life of a nation” or “threats to national security”.

The abuse of applicable provisions allowing governments to limit or derogate from certain rights contained in the International Covenant on Civil and Political Rights has resulted in the need for a closer examination of the conditions and grounds for permissible limitations and derogations in order to achieve an effective implementation of the rule of law. The United Nations General Assembly has frequently emphasised the importance of a uniform interpretation of limitations on rights enunciated in the Covenant.”

[126] Paragraph 58 of the Siracusa Principles under the heading of Non-Derogable Rights provides:

No state party shall, even in time of emergency threatening the life of the nation, derogate from the Covenant’s guarantees of the right to life; freedom from torture, cruel, inhuman or degrading treatment or punishment, and from medical or scientific experimentation without free consent; freedom from slavery or involuntary servitude; the right not be be imprisoned for contractual debt; the right not to be convicted or sentenced to a heavier penalty by virtue of retroactive criminal legislation; the right to recognition as a person before the law; and freedom of thought, conscience and religion. These rights are not derogable under any conditions even for the asserted purpose of preserving the life of the nation. (emphasis added)

[127] This is consistent with Article 4 of the International Covenant on Civil and Political Rights.

[128] Australia’s National Statement on Ethical Conduct in Human Research 23 confirms that consent is a fundamental requirement for participation in any clinical trial, and that “no person should be subject to coercion or pressure in deciding whether to participate” in a clinical trial. Further, the Australian Government’s Consumer Guide to Clinical Trials24 also confirms that participation in a clinical trial is voluntary, and states “it is important that you never feel forced to take part in a trial”.

[129] Freely given consent to any medical treatment, particularly in the context of a clinical trial, is not optional. Coercion is completely incompatible with consent, and denying a person the ability to work and participate in society if the person does not have a COVID vaccine will unquestionably breach this fundamental and internationally recognised human right.

Can COVID vaccinations be mandated by employers on health and safety grounds?

[130] The short answer to this question, in almost every case, is no.

[131] The fundamental starting point here is the answer to the question – what is the risk? All risk controls are (or should be) designed to address an identified risk. The risk needs to be a real risk and not a perceived risk. The real risk for employers is that a person who has COVID will spread COVID to others within the workplace.

[132] The risk of spreading COVID only arises with a person who has COVID. This should be apparent and obvious. There is no risk associated with a person who is unvaccinated and does not have COVID, notwithstanding the misleading statements by politicians that the unvaccinated are a significant threat to the vaccinated, supposedly justifying “locking out the unvaccinated from society” and denying them the ability to work.

[133] The primary duty of care for employers under health and safety law requires the employer to ensure health and safety so far as is reasonably practicable by eliminating risks to health and safety, and if this is not reasonably practicable, risks must be minimised so far as is reasonably practicable.

[134] There is nothing controversial in stating that vaccines do not eliminate the risk of COVID, given that those who are vaccinated can catch and transmit COVID. By way of one example, a report issued by the Centres for Disease Control and Prevention (CDC) in the United States on 6 August 2021 25 looked at an outbreak of COVID in Massachusetts during July 2021. Of the 469 COVID cases identified, 74% were fully vaccinated. Of this group, 79% were symptomatic. In total, 5 people required hospitalisation and of these, 4 were fully vaccinated. This is not an anomaly – the data from many countries and other parts of the United States provides a similar picture, although obtaining similar data from the United States will now be problematic given the decision by the CDC on 1 May 2021 to cease monitoring and recording breakthrough case information unless the person is hospitalised or dies. What is clear, however, is that the vaccine is not an effective control measure to deal with transmission of COVID by itself.

[135] In order for an employer to meet its duties under health and safety laws, it will need to minimise the risk of exposure to COVID in the workplace, which will require employers to apply all reasonably practicable COVID control measures.

[136] As noted earlier, Safe Work Australia, in relation to whether employers need to include mandatory vaccination as a control measure to comply with WHS duties, has advised that “it is unlikely that a requirement for workers to be vaccinated will be ‘reasonably practicable’”.

[137] The Safe Work Australia website also includes the following advice to employers:

“Employers have a duty under the model Work Health and Safety (WHS) laws to eliminate, or if that is not reasonably practicable, minimise the risk of exposure to COVID-19 in the workplace.

……... However, while this is a decision you will need to make taking into account your workplace, most employers will not need to make vaccination mandatory to comply with the model WHS laws.

A safe and effective vaccine is only one part of keeping the Australian community safe and healthy. To meet your duties under the model WHS laws and minimise the risk of exposure to COVID-19 in your workplace, you must continue to apply all reasonably practicable COVID-19 control measures including physical distancing, good hygiene and regular cleaning and maintenance and ensuring your workers do not attend work if they are unwell.” 26

[138] It is very clear that a range of control measures will need to be implemented by employers to meet their health and safety obligations. In addition to the measures noted above, controls (based on a proper assessment of the risk in a particular workplace) might include appropriate air ventilation and filters, personal protective equipment including masks, staggered meal breaks, increased use of outdoor areas etc. The simple act of requiring people to stay at home if unwell and symptomatic will no doubt have a significant impact on the spread of all coronaviruses (whether a cold, flu or COVID).

[139] Critically, there is another alternative to vaccines to assist employers in meeting their WHS obligations, that being testing. Given there is no doubt that those who are fully vaccinated can catch and transmit the virus, testing (whether rapid antigen or otherwise) will provide employers with a level of comfort that a worker does not have COVID and therefore will not transmit COVID to others (that being the risk that is to be managed) in the workplace.

[140] Testing is now widely used around the world as a risk control for the spread of COVID. There is absolutely no reason why it cannot be widely used in Australia.

[141] Testing is arguably a better control measure compared to vaccines in meeting health and safety obligations.

[142] Vaccines have not been broadly mandated on health and safety grounds in most countries. For example, despite what has been reported in Australia, most of the European Union (EU) and the Scandinavian countries have not actually mandated vaccinations for travel purposes. EU citizens can travel freely now if any one of three options are satisfied, that being a vaccine, a negative COVID test, or evidence of having recently recovered from COVID (in recognition of the natural immunity that comes with having recovered from having COVID). The EU have provided these options so that people who are not vaccinated will not be discriminated against when travelling across the EU. In other words, all those who are not vaccinated can get tested for COVID and travel freely 27.

[143] In a scientific brief prepared by the World Health Organisation (WHO) dated 10 May 2021 on COVID natural immunity, the WHO found that “within four weeks following infection, 90-99% of individuals infected with [COVID] virus develop detectable neutralising antibodies….”. Further, “available scientific data suggests that in most people immune responses remain robust and protective against reinfection for at least 6-8 months after infection (the longest follow up with strong scientific evidence is currently approximately 8 months)”.

[144] The science is clear that those who have recovered from COVID have at least the same level of protection from COVID as a person who has been vaccinated. There can be absolutely no legitimate basis, then, for mandating vaccination for this group of people.

[145] In short, there is no justifiable basis for employers to mandate COVID vaccinations to meet their health and safety obligations when other options are available to appropriately manage the risk.

[146] Finally, it should be clearly understood that employers who mandate vaccinations will be liable for any adverse reactions their workers may experience, given this is a foreseeable outcome for some people.

Use of Public Health Orders to mandate vaccinations

[147] I will focus on the law as it applies in NSW given that is the jurisdiction applicable to Ms Kimber.

[148] The Public Health Act 2010 (NSW) (PH Act) provides broad powers with respect to protecting the health and safety of the public.

[149] Section 7 of the PH Act, used to make PHO’s in NSW, is in the following terms:

1. This section applies if the Minister considers on reasonable grounds that a situation has arisen that is, or is likely to be, a risk to public health.

2. In those circumstances, the Minister—

a. may take such action, and

b. may by order give such directions,

as the Minister considers necessary to deal with the risk and its possible consequences.

3. Without limiting subsection (2), an order may declare any part of the State to be a public health risk area and, in that event, may contain such directions as the Minister considers necessary—

a. to reduce or remove any risk to public health in the area, and

b. to segregate or isolate inhabitants of the area, and

c. to prevent, or conditionally permit, access to the area.

[150] PHOs have been made in NSW mandating COVID vaccinations for anyone who lives in a local government area of concern and wishes to work, and those who are airport workers, aged care workers or health care workers among others.

[151] In making blanket rules in PHOs which deny people their fundamental right to work or operate to “lock them out of society”, and which denies them freedoms which are a fundamental and essential part of any democracy, concepts of reasonableness, necessity and proportionality arise. In other words, decisions taken to restrict or remove basic liberties must be proportionate and necessary to manage the risk and must be the minimum necessary to achieve the public health aims.

[152] The Australian Health Protection Principal Committee (AHPPC) is Australia’s key decision making body for heath emergencies and public health emergency management. It has issued a number of public statements on minimising the potential risk of COVID 28, the purpose of which is to provide advice on the appropriate management of COVID in certain industries or occupation groups.

[153] A statement on COVID vaccination requirements for aged care workers it issued on 4 June 2021 29 commences with the following:

“AHPPC does not recommend compulsory COVID-19 vaccines for aged care workers” (emphasis added)

[154] Notwithstanding this advice, a PHO has been made mandating COVID vaccinations for aged care workers.

[155] The AHPPC statement on minimising the potential risk of COVID transmission in schools, made on 26 July 2021, does not recommend compulsory COVID vaccines for school staff either.

[156] Notwithstanding there is no advice from the AHPPC to mandate vaccinations for school staff, the NSW Government has also made a PHO requiring that all workers in NSW schools be vaccinated, which extends to volunteers. Those without a COVID vaccine will not be able perform any work at a school after 8 November 2021 (unless a medical exemption applies). On the face of it, this will prevent a parent from attending their child’s school to assist with reading, or prevent a volunteer from occasionally helping out with maintenance or gardening at a school. What risk does a person pose that needs to be controlled by vaccination who mows the lawns of a school on a weekend? Of course, there is no risk that requires a vaccination.

[157] The vaccine mandate for NSW schools is strongly opposed by many, with over 65,000 people recently signing a petition organised by teachers and school staff to record their opposition for such a mandate.

[158] There have now been many studies around the world that have looked at the rate of transmission of COVID in schools. One of the largest studieson COVID transmission in schools in the United States, undertaken by Duke Clinical Research Institute, looked at more than 90,000 students and teachers in North Carolina over a 9 week period 30. Given the rate of transmission in the community at that time, it was expected that there would be around 900 cases in the schools, however when researchers conducted contact tracing to identify school-related transmissions, they identified only 32 cases. This is one of many publicly available studies that have found similar results, that being that transmission in schools is lower than community transmission in the community in which the school is located.

[159] Teachers and school staff more generally continue to work in the EU without a COVID vaccination and can instead participate in regular testing. What, then, is the basis for mandating the vaccine for all school staff? There is no justification for doing so when other measures are available and are widely in use across the world. Such a mandate will not be the ‘minimum necessary’ to achieve public health aims.

[160] Further, the necessity and reasonableness of the denial or restriction on basic liberties must be weighed against a variety of other serious flow on consequences such as the significant increase in mental health issues and domestic violence, and against the serious economic damage that has been caused and will continue to be caused by the existing measures found in the PHO’s.

[161] The Great Barrington Declaration (GB Declaration) 31, a statement by infectious disease epidemiologists and public health scientists, recommended an approach called Focused Protection. The GB Declaration includes the following:

“Current lockdown policies are producing devastating effects on short and long-term public health. The results (to name a few) include lower childhood vaccination rates, worsening cardiovascular disease outcomes, fewer cancer screenings and deteriorating mental health – leading to greater excess mortality in years to come, with the working class and younger members of society carrying the heaviest burden. Keeping students out of school is a grave injustice.

….We know that vulnerability to death from COVID-19 is more than a thousand-fold higher in the old and infirm than the young. Indeed, for children, COVID-19 is less dangerous than many other harms, including influenza.

As immunity builds in the population, the risk of infection to all – including the vulnerable – falls. We know that all populations will eventually reach herd immunity – i.e. the point at which the rate of new infections is stable – and that this can be assisted by (but is not dependent upon) a vaccine. Our goal should therefore be to minimize mortality and social harm until we reach herd immunity.

The most compassionate approach that balances the risks and benefits of reaching herd immunity, is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk. We call this Focused Protection.

Adopting measures to protect the vulnerable should be the central aim of public health responses to COVID-19. By way of example, nursing homes should use staff with acquired immunity and perform frequent testing of other staff and all visitors. Staff rotation should be minimized. Retired people living at home should have groceries and other essentials delivered to their home. When possible, they should meet family members outside rather than inside. A comprehensive and detailed list of measures, including approaches to multi-generational households, can be implemented, and is well within the scope and capability of public health professionals.

Those who are not vulnerable should immediately be allowed to resume life as normal. Simple hygiene measures, such as hand washing and staying home when sick should be practiced by everyone to reduce the herd immunity threshold. Schools and universities should be open for in-person teaching. Extracurricular activities, such as sports, should be resumed. Young low-risk adults should work normally, rather than from home. Restaurants and other businesses should open. Arts, music, sport and other cultural activities should resume. People who are more at risk may participate if they wish, while society as a whole enjoys the protection conferred upon the vulnerable by those who have built up herd immunity.” (emphasis added)

[162] The authors and first signatories to the GB Declaration were Dr. Martin Kulldorff, professor of medicine at Harvard University, a biostatistician, and epidemiologist with expertise in detecting and monitoring infectious disease outbreaks and vaccine safety evaluations, Dr. Sunetra Gupta, professor at Oxford University, an epidemiologist with expertise in immunology, vaccine development, and mathematical modelling of infectious diseases, and Dr. Jay Bhattacharya, professor at Stanford University Medical School, a physician, epidemiologist, health economist, and public health policy expert focusing on infectious diseases and vulnerable populations.

[163] The qualifications held by the list of 44 co-signatories to the GB Declaration is impressive 32, and since the GB Declaration was first made, over 860,000 scientists and health professionals have signed the GB Declaration.

[164] It should be abundantly clear that there are other, far less restrictive and less intrusive ways in which we can ensure public health and appropriately address the risk of COVID without resorting to the extreme measures currently in place.

[165] In an article published by Monash University’s Castan Centre for Human Rights Law, the author, Professor the Hon Kevin Bell AM QC 33, considered the COVID guidance issued by the United Nations Office of the High Commissioner for Human Rights for introducing COVID response measures consistent with human rights. He provided the following summary:

• “Governments have to take difficult decisions in response to COVID-19. International law allows emergency measures in response to significant threats – but measures that restrict human rights should be proportionate to the evaluated risk, necessary and applied in a non-discriminatory way. This means having a specific focus and duration, and taking the least intrusive approach possible to protect public health.

• With regard to COVID-19, emergency powers must only be used for legitimate public health goals, not used as a basis to quash dissent, silence the work of human rights defenders or journalists, deny other human rights or take any other steps that are not strictly necessary to address the health situation.

• Governments should inform the affected population of what the emergency measures are, where they apply and for how long they are intended to remain in effect, and should update this information regularly and make it widely available.

• As soon as feasible, it will be important for Governments to ensure a return to life as normal and not use emergency powers to indefinitely regulate day-to-day life, recognising that the response must match the needs of different phases of the crisis”.

[166] In an article recently published by two Senior Lecturers from the Faculty of Law at Monash University entitled “Wars, Pandemics and Emergencies What can history tell us about executive power and surveillance in times of Crisis?” 34, the authors concluded that “in an emergency, we must be particularly vigilant to protect civil liberties and human rights against incursions that are more than the absolute minimum necessary to combat the crisis…..”

[167] The Australian Financial Review, in an article published on 8 September 2021 entitled “The 17,000 flu linked deaths no one is talking about” 35, notes that modelling by the Doherty Institute says about 600 people die each year of influenza and there are about 200,000 cases annually, but in 2019, influenza and pneumonia were the underlying cause of 4124 deaths in Australia. While the vast majority of these deaths are people over the age of 80, there is an annual average of 5 infants under the age of one, 13 children aged 1-14, and 48 people aged 25-44 that died of flu or pneumonia in 2019.

[168] The article goes on to note that about 17,385 people died with flu and pneumonia in 2019, where flu and pneumonia was either the underlying cause or an associate cause of death, according to the Australian Bureau of Statistics. In Sweden, doctors in one county analysed all their COVID deaths and found that COVID was the chief underlying cause of death in only 15% of cases. In 70% of cases COVID was an associated cause of death, and in the remaining 15% of cases it was irrelevant.

[169] To put all of this further in perspective, Australia is ranked 118^th in the world for COVID deaths. Broadly speaking, Australia has had around 56,000 cases of COVID with around 1,000 deaths. Of the deaths in Australia, only 1% were under the age of 50. In the same time period as the 1,000 COVID deaths, around 200,000 Australians have died for other reasons, including around 70,000 from cancer, 19,000 from heart disease, 17,000 from respiratory illnesses (not COVID), 13,000 from strokes and 4,500 from suicide.

[170] Each and every single day, around 8,000 children die around the world from starvation, which of course is completely preventable.

[171] As at 2019, there were 4,344 paedophiles in NSW on the Child Protection Register. There are no blanket rules which prevent these people from working or participating in society, nor do they have to declare that they are paedophiles before entering a business or a school.

[172] The initial predictions of a 60% infection rate from COVID with a 1% death rate thankfully did not materialise. It is now time to ask whether the ‘cure’ is proportionate to the risk, and the answer should be a resounding no. When deciding now what is actually reasonable, necessary and proportionate in terms of any response to COVID, governments and employers should actively avoid the hysteria and fear-mongering that is now so prevalent in the public discourse, and which will cloud rational, fact based decision making.

[173] In summary, the powers to make PHOs cannot lawfully be used in a way that is punitive, and human rights are not suspended during states of emergency or disaster. The current PHOs have moved well past the minimum necessary to achieve public health aims, and into the realm of depravation. It is not proportionate, reasonable or necessary to “lock out” those who are unvaccinated and remove their ability to work or otherwise contribute to society. PHOs, by their nature, are designed and intended for short term use in the event of an emergency or crisis. They are not intended to be an ongoing vehicle to enforce significant depravations of our civil liberties. The COVID pandemic started over 20 months ago. The time is fast approaching where the reliance on PHO’s will no longer be justified on public health grounds, particularly where there is such a significant intrusion on individual liberties.

Disability Discrimination

[174] It is highly likely that the dismissal of an employee who fails to have the COVID vaccine will breach the Disability Discrimination Act 1992 (DD Act). The DD Act makes it unlawful to discriminate against a person, including in employment and in accessing services, because of a disability.

[175] The definition of disability in s.4 of the DD Act includes “the presence in the body of organisms capable of causing disease or illness”. It includes a disability that presently exists, or previously existed but no longer exists, or may exist in the future, or is imputed to a person.

[176] The Explanatory Memorandum to the DD Act discusses the definition of disability as being:

“…intended to include physical, sensory, intellectual and psychiatric impairment, mental illness or disorder, and provisions relating to the presence in the body of organisms capable of causing disease. These provisions have broad application, for example, they are intended to ensure that persons with HIV/AIDS come within the definition of disability for the purposes of this Bill.”

[177] As a recent article has highlighted, 36 gay men were the prime target for protection under this part of the definition of disability because of a perception they were at a greater risk from HIV. In this situation the DD Act works to prohibit all types of discrimination not only against gay men but everyone who may in future be infected with HIV. The author notes that “for the same legal reason that a publican cannot say ‘gay men are not allowed into my pub because they might be infected with HIV’, a publican also cannot say ‘unvaccinated people are not allowed into my pub because they might be infected with measles. Nor is it valid for a State or Territory to pass a law to that effect – the Act binds them too.”

[178] Section 48 of the DD Act provides an exemption for discrimination that is necessary to protect public health where a person’s disability is an infectious disease, however being unvaccinated is not an infectious disease. What logically follows is that an employer who dismisses a person because they do not have a COVID vaccine will breach the DD Act.

Final comments

[179] Research in the context of COVID-19 has shown that many who are ‘vaccine-hesitant’ are well educated, work in the health care industry and have questions about how effective the vaccines are in stopping transmission, whether they are safe to take during pregnancy, or if they affect fertility. 37 A far safer and more democratic approach to addressing vaccine hesitancy, and therefore increasing voluntary vaccination uptake, lies in better education, addressing specific and often legitimate concerns that people may hold, and promoting genuine informed consent. It does not lie in censoring differing opinions or removing rights and civil liberties that are fundamental in a democratic nation. It certainly does not lie in the use of highly coercive, undemocratic and unethical mandates.

[180] The statements by politicians that those who are not vaccinated are a threat to public health and should be “locked out of society” and denied the ability to work are not measures to protect public health. They are not about public health and not justified because they do not address the actual risk of COVID. These measures can only be about punishing those who choose not to be vaccinated. If the purpose of the PHOs is genuinely to reduce the spread of COVID, there is no basis for locking out people who do not have COVID, which is easily established by a rapid antigen test. Conversely, a vaccinated person who contracts COVID should be required to isolate until such time as they have recovered.

[181] Blanket rules, such as mandating vaccinations for everyone across a whole profession or industry regardless of the actual risk, fail the tests of proportionality, necessity and reasonableness. It is more than the absolute minimum necessary to combat the crisis and cannot be justified on health grounds. It is a lazy and fundamentally flawed approach to risk management and should be soundly rejected by courts when challenged.

[182] All Australians should vigorously oppose the introduction of a system of medical apartheid and segregation in Australia. It is an abhorrent concept and is morally and ethically wrong, and the anthesis of our democratic way of life and everything we value.

[183] Australians should also vigorously oppose the ongoing censorship of any views that question the current policies regarding COVID. Science is no longer science if it a person is not allowed to question it.

[184] Finally, all Australians, including those who hold or are suspected of holding “anti-vaccination sentiments”, are entitled to the protection of our laws, including the protections afforded by the Fair Work Act. In this regard, one can only hope that the Majority Decision is recognised as an anomaly and not followed by others.

SHAPE \* MERGEFORMAT

VICE PRESIDENT

Appearances:

Mr J Pearce of counsel for the Appellant.

Mr R Reitano of counsel for the Respondent.

Hearing details:

2021.

Sydney (via video-link):

29 June.

Printed by authority of the Commonwealth Government Printer

1 [2021] FWC 1818

2 Clauses 4(1), 5(d)

3 Clause 7

4 Clause 8

5 Transcript, 12 February 2021, PN179

6 Ibid, PNs143-147

7 Clause 11

8 In her witness statement, Ms Kimber incorrectly dated this incident as occurring on 1 June 2020.

9 [2013] FWCFB 9075, 239 IR 1

10 [2018] FWCFB 1005, 273 IR 168

11 In New South Wales, this requirement will take effect through the Public Health (COVID-19 Aged Care Facilities) Order 2021, which was made on 26 August 2021 and commences on 17 September 2021. An exemption from the requirement applies if a person is unable, due to a medical contraindication, to be vaccinated against COVID-19 and presents a certificate issued by a medical practitioner specifying the medical contraindication that makes the person unable to be vaccinated (clause 8).

12 [2021] FWC 1818.

13 Paragraph 58 of Majority Decision

14 See [2021] FWC 1818 at [47].

15 [2021] FWC 1818 at [74].

16 Ibid at [76].

17 [2021] FWC 1818 at [79].

18 Clause 6(d)(ii)) of June PHO.

19 [2021] FWC 1818 at [60].

20 https://www.tga.gov.au/covid-19-vaccines-undergoing-evaluation

21 https://www.tga.gov.au/covid-19-vaccines-undergoing-evaluation

22 https://www.icj.org/wp-content/uploads/1984/07/Siracusa-principles-ICCPR-legal-submission-1985-eng.pdf

23 https://www.nhmrc.gov.au/about-us/publications/national-statement-ethical-conduct-human-research-2007-updated-2018#block-views-block-file-attachments-content-block-1

24 https://www.australianclinicaltrials.gov.au/sites/default/files/content/18239%20NHMRC%20-%20CHF%20Fact%20Sheet-v1-0-accessible.pdf

25 https://www.cdc.gov/mmwr/volumes/70/wr/mm7031e2.htm

26 https://www.safeworkaustralia.gov.au/covid-19-information-workplaces/industry-information/general-industry-information/vaccination?tab=tab-toc-employer

27 https://ec.europa.eu/info/live-work-travel-eu/coronavirus-response/safe-covid-19-vaccines-europeans/eu-digital-covid-certificate_en#are-citizens-who-are-not-yet-vaccinated-able-to-travel-to-another-eu-country

28 https://www.health.gov.au/committees-and-groups/australian-health-protection-principal-committee-ahppc

29 https://www.health.gov.au/news/australian-health-protection-principal-committee-ahppc-statement-on-covid-19-vaccination-requirements-for-aged-care-workers

30 https://pediatrics.aappublications.org/content/147/4/e2020048090

31 https://gbdeclaration.org/

32 Co signatories to the GB Declaration: - https://gbdeclaration.org/

33 https://www.monash.edu/law/research/centres/castancentre/our-areas-of-work/covid19/policy/covid19-and-human-rights-in-australia/covid19-and-human-rights-in-australia-part-2

34 Ng, Yee-Fui; Gray, Stephen; [2021] UNSWLawJl 9; (2021) 44(1) UNSW Law Journal 227.

35 https://www.afr.com/politics/federal/the-17-000-flu-linked-deaths-no-one-is-talking-about-20210903-p58oqq

36 https://spectator.com.au/2021/09/limiting-access-for-the-unvaxed-to-public-places-will-likely-breach-the-disability-discrimination-act/

37 Maya Goldenberg, Vaccine Hesitancy: Public Trust, Expertise, and the War on Science, 2021