Vaccinating healthcare workers against Covid-19

In an article published in the British Medical Journal, we discuss the topic of vaccinating healthcare workers against Covid-19. Our conclusion is that compulsion is unnecessary and inappropriate.

Parliament’s decision to make vaccination against covid-19 a condition of employment for care home workers has fuelled the debate around compulsory vaccination for healthcare workers, which may follow. Compulsory vaccination is not a panacea and may harm the safety of patients and healthcare workers, as well as affecting workload and wellbeing. It is a dilemma familiar to occupational health services in many NHS trusts.

Is there a vaccine hesitancy problem in UK healthcare for which mandatory vaccination is an appropriate solution? Data suggesting pockets of poor uptake of covid-19 vaccination among care home staff led the government to make vaccination compulsory, abandoning a targeted but voluntary approach. The government’s Scientific Advisory Group for Emergencies (SAGE) has not published a recommended minimum acceptable level of staff vaccination for healthcare settings, but over 80% of frontline healthcare workers in NHS trusts have now received two vaccine doses,4 reaching over 90% in some trusts. The level of risk posed by the remaining minority is unlikely to justify policy change at a national level.

Vaccination is already compulsory for staff working in healthcare settings in France and Italy. However, both countries have a history of compulsory vaccinations in response to substantial vaccine hesitancy and outbreaks of vaccine preventable infections such as measles. In Italy, legislation introducing compulsory childhood vaccinations was followed by a decrease in the incidence of measles and rubella. Nevertheless, this policy is under review and may be made more flexible depending on regional vaccine coverage.

The full text of the article is available in the BMJ.