COVID-19 vaccinations – the right for healthcare workers to decide and the impact on social care

Most people who followed the press coverage in the UK following the public announcement of an ambitious national vaccination rollout would have foreseen the possibility for tension to exist between the public drive for everyone to be vaccinated against COVID-19 and the right of autonomy to refuse. The number of “anti-vax” conspiracy theories circulating online is simply staggering and some of the farcical claims really do beggar belief, notwithstanding the government’s attempts to allay these concerns. However, whilst many are content for individuals to make their own informed (or otherwise) decision, it becomes a far more emotive subject when the workers concerned are in the healthcare sector. Chances are, the majority of people reading this will have been affected directly or indirectly by COVID-19 and many more will have vulnerable or elderly relatives who rely upon the care and unwavering dedication of healthcare workers but it may not be a particularly comforting thought if the person providing that care to a vulnerable loved one were to refuse the vaccine.

The UK does not have a mandatory national vaccination programme but some countries  have adopted a more authoritarian approach by requiring vaccination before being permitted to return to work. In June, the government announced that vaccinations would become mandatory for all care home workers and, despite the often strongly held opposing views on the subject, the rationale behind such a move is fairly obvious and is intended to protect the most vulnerable group in society. Of course, if one group is in the mandatory class, it may not take long before others are added to that list such as all front line NHS workers which would no doubt bring its own insurmountable political maelstrom.

Although the national take up for vaccinations in the UK is breath taking, it is easy to overlook those who refuse to engage with the programme for whatever reason. Are we heading towards an increasing programme of mandatory vaccinations for particular groups and what might the impact be if a cohort of the national workforce was told you must have the vaccine if you wish to keep your job?

Although the UK has not publicly announced any plans for mandatory vaccinations for all front line NHS staff, care home workers are very much in the government’s sights. Clearly, despite an emotive plea for care home workers to be vaccinated to protect those around them and the patients they treat, recent data has shown care workers have a worryingly far lower vaccination uptake than in the general population. What is the impact of this? Recent press coverage from the BBC reports one care home manager stating that he will lose staff over the government’s mandatory vaccination plans and that trying to persuade staff members to take up the vaccine puts care home managers in an unenviable and difficult position. Although the plans currently in mind may mean workers either face being redeployed away from front-line care or potentially losing their job, it remains to be seen how a sizeable workforce will respond to this with reports of bullying tactics already being mentioned. If that were not enough to fluster most care home managers, there would then be a frantic search to recruit from an already depleted pool of candidates (it is reported that there are currently more than 100,000 care home staff vacancies in England). The National Care Association has stated that vaccinations should not be compulsory at this stage and one would expect there to be a flurry of legal challenges to dismissals on the grounds of not accepting a vaccine, due to unique or particular circumstances or on the grounds of protected characteristics such as religion and beliefs.

If the currently trajectory of vaccine refusal amongst care staff is maintained, despite the government’s efforts and the mandatory programme, it is not unimaginable for care homes to potentially find themselves dangerously understaffed prompting questions about the sustainability of the sector and the impact this could have on those who are most vulnerable.

Lee Biddle, Associate, BLM

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