Who’s Right, Who’s wrong – Should COVID-19 Vaccines be Mandatory?

Following speculation and reports that the Secretary of State has decided to mandate Covid 19 vaccination for NHS workers, Professor Martin Marshall, Chair of the Royal College of GPs, said the following:

“The Covid vaccination programme has been a huge success with almost 45 million over 16s fully vaccinated In the UK, showing that overall take up has been very high. The vaccine is our most important tool in protecting people from the virus. All vaccines that were currently using in the UK have undergone rigorous testing to ensure they are safe and effective – as such, we’d urge anyone who is offered a jab to have one.”

A rumoured deadline is expected to be set for 1st April next year to give unvaccinated staff time to get both doses Sajid Javid, Health Secretary, told the Commons. This follows on from the mandatory vaccination of social care workers who have been set a deadline of Thursday 11th November to be double jabbed.

The government’s decision follows a consultation which began in September and considered whether both the Covid and flu jabs should be compulsory for frontline NHS and care workers. It is estimated that currently 103,000 NHS workers in England remain unvaccinated. There will be exemptions for the Covid vaccine requirement for medical reasons, and for those who do not have face-to-face contact with patients in their work. The rationale behind this decision is to “avoid preventable harm and protect patients in the NHS, protect colleagues in the NHS and, of course, protect the NHS itself.” Subject to parliamentary approval this will be enforced from April with each of the four UK nations making its own decision on the issue. As of yet, Scotland, Wales and Northern Ireland have not made any proposals to make Covid jabs compulsory for NHS workers or care home staff.

Chair of the Royal College of GPs Professor Martin Marshall has criticised the decision stating:

“To hear reports that the decision of the Secretary of State is to ignore the views of the College, and many other representative bodies across healthcare including the Academy of Medical Royal Colleges, to mandate Covid-19 vaccination for NHS workers, is disappointing and sets a concerning precedent… [especially] at a time when we need as many people as possible working in general practice and across the health and care sectors delivering essential patient care and services.”

The RCGP advocates for informed and educated choices about health interventions rather than enforced interventions, because it “risks leading to resentment and mistrust.” Critically, this echoes pushback from the adult social care sector in response to mandatory vaccinations stating that it will increase the pressures that the industry is already facing. According to Professor Martin Marshall:

We can ill afford to risk losing staff with personal objections to the vaccine, however unfounded those objections may be, and we are unlikely to be in a better position with workforce pressures come next April.”               

Despite objections, the government is still pushing forward. Health Secretary Sajid Javid says the requirement would only be enforced 12 weeks after parliamentary approval and that unvaccinated workers should not be “scapegoated or shamed”, but rather should be supported to make a “positive choice.” However, many workers feel like a basic human rights choice is being taken away from them. One worker said, “I’m angry, probably I will just go and get it, what other options have I got?

With the choice being between making a personal health decision and livelihood the NHS could see a collapse in its staffing levels. After the mandatory vaccination was announced for care workers, only two thirds came forward. If this mandate causes staffing shortages in the NHS then risk can be increased in another way, despite it being an effort to provide safe care to those who need it. This is in light of the possibility of losing staff being a real problem since the NHS already relies on many to work extra shifts and many workers putting off retirement to help out during the pandemic.

Johnathan Ashworth, Labour’s shadow health secretary, has suggested that Javid proceed with caution due to long waiting lists – close to six million – and more than 90,000 vacancies across the NHS, stating, “We simply cannot afford to lose thousands of NHS staff overnight.”

As the data stands, 79.8% of people over age 12 are fully vaccinated and 87% have had their first dose, so it appears that uptake will be high. Some even support the government’s decision to mandate the vaccine and deem it the “sensible” move. Douglas Ferguson, a surgeon as Exeter hospital, believes the government’s responsibility it to protect the people and said

“I think, to be honest, if people who don’t want to be vaccinated feel that an injection, which is very well scientifically researched, is something that they decide they’re going to change their entire career for, it seems unwise, I would say.”

Further, Chris Hopson, chief executive of NHS Providers which represents England’s NHS trusts, said, “We understand why people are vaccine-hesitant. We need to win the argument with them rather than beat them around the head.”

It seems that mandating the vaccine is a double edged sword where individual human rights are clashing with the greater public health and safety. Which way is the right way?

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