Thursday is supposedly the day when everyone who works in a healthcare setting MUST have had their first Covid-19 vaccination dose. If not, they can no longer work in a patient facing role and will either be redeployed or made redundant according to UK Government policy. Mandatory vaccination is not the usual policy for the UK; in my opinion, forcing anyone to have a medical procedure against their will is highly unethical.
You can be forgiven for missing this abuse of Government power over the NHS and social care workforce… something more important keeps hogging the headlines, apparently the resident of No.11 has complained about the noise from the parties at No.10… or maybe No.11 just wasn’t invited to the party(s)… who knows…?
Various professional bodies are lining up to ask the UK Government to reverse its mandatory vaccination policy, including the Royal College of GPs, the Royal College of Nursing and the National Care Association. Do we think the Government will change its mind? Well, protests and pleading hasn’t worked before, and the Government seems more worried that scrapping mandatory vaccination would be latched onto by opposition parties and news channels as showing another Government policy U-turn… something no politician will do willingly.
How the heck did we come to this sorry situation?!
Was there a burning desire from the general public for health and social care workers to be vaccinated? Who thought this was a good idea?
Public Consultation
Did you take part in the Governments public consultation on mandatory Covid-19 vaccination for healthcare workers that took place between 9th September and 22nd October last year? Did you even know about it?
It makes for fascinating reading….
Did you know that ONLY 29% of the 35,000 responses were supportive of mandatory vaccination of health and social care workers? It’s even more curious how this figure breaks down further:
- ONLY 13% of the public (service users or relatives of service users) supported or slightly supported mandatory vaccination (FACT: 81% were dead against it!)
- ONLY 35% of the health and social care workforce supported or slightly supported mandatory vaccination
- BUT 56% of health and social care managers supported or slightly supported mandatory vaccination
Even with this support of NHS managers - of all the 35,000 responses - 71% DID NOT SUPPORT MANDATORY VACCINATION. Let me say that again, in the public consultation staff and the public didn’t support mandatory vaccination….
So, it doesn’t look like a mandatory vaccination policy had the democratic mandate of the general public, and yet on the 14th December 385 versus 100 MPs voted for the law to change making Covid-19 vaccinations mandatory in the UK for health and social care workers. Politicians are not on the list for mandatory vaccination, would they agree to a medical procedure against their will if it was deemed in the benefit of the greater good? But who is this greater good? I believe in the good of vaccination and I am double AstraZeneca vaccinated, but I will not take a Pfizer vaccine 3rd dose booster.
Vaccinations protect the individual from severe disease associated with Covid-19; vaccines do not prevent the spread of the disease (evidenced by asymptomatic disease) nor stop the disease occurring in the vaccinated. “Protecting the greater good” is not the role of vaccines, the role of the vaccine is to break the link between severe disease and infection. The aim was never to eradicate the disease. 100% vaccination rates were never the goal; there are NO vaccines that are 100% or mandatory in the UK. Gosh, can you imagine stating all childhood vaccinations (including the MMR vaccine) are to be mandatory!!! All hell would break loose with “this is an outrageous abuse of power” statements left, right and centre. Or what if the right to NHS treatment is withdrawn from the unvaccinated? Or access to a supermarket or cinema denied unless you are a non-smoker… How free are people’s liberties feeling now? Public health laws are incredibly powerful, and should not be misused.
Maybe I missed something? Did I “miss” PubMed and the .gov.uk website publishing the strong scientific evidence to support mandatory vaccination?
Is the mandatory vaccination policy scientifically justified?
I have my doubts about this. The UK Government, in its response to the public consultation, says “there is clear public health rationale for ensuring that people who provide health and care services only deploy those people who have been vaccinated in order to protect those who are most at risk”.
But where is the “clear public health rationale”? Have you seen it? Has anyone seen it? They mention it several times in the document, but I cannot find any publication of data or information to show that mandatory vaccination will protect patients or other healthcare workers.
In fact, how many times have we been told by the UK Government that vaccination doesn’t prevent carriage or transmission but rather it protects from disease. Well, it can’t be both… can it? It can’t protect patients if vaccinated healthcare workers are still able to carry it and transmit it. In fact, the immunity to Covid-19 from 2 doses of vaccine tends to wane by 20 weeks, and the 3rd “booster” dose only seems to add another 10 weeks or so.
So, to me the “clear public health rationale” is really just a political statement with no obvious scientific backing… at all!
I question if coercing people (…or lose your job and career) into having vaccinations is even legal?
Is the mandatory vaccination policy legal?
I have to say, I wondered this; can the UK Government insist that someone is vaccinated against Covid-19, or they are out of a job? Where is the BMA on this? Publically very quiet!! They strongly support vaccination for healthcare staff but challenge the mandatory nature. They will advise staff at risk of dismissal. However, they state “having reviewed existing case law, the BMA does not believe there is a reasonable prospect of successfully challenging a requirement that doctors/healthcare staff involved in face-to-face treatment of patients are appropriately vaccinated”.
So, it turns out the Governments mandatory vaccination policy is legal. Really!?! Yes…it seems so…
Firstly, mandatory vaccination for health and social care workers has been introduced as an Act of Parliament... it has been introduced as a new law.
Secondly, there is strong legal case law to support mandatory vaccination. The High Court ruled that care homes requiring visitors to be double vaccinated against Covid-19 did not breach human rights as they found in favour of protecting the residents of the care homes right to life above the rights of the visitors not to be vaccinated (Peters & Findlay vs. Secretary of State for Health). In addition, there is legal precedent where someone can be “punished” for not getting vaccinated e.g., refusal to allow unvaccinated children to go to school, as long as the punishment is proportionate to protecting public health (Vavricka & Others vs. The Czech Republic).
So essentially, as long as it’s the law and it is deemed to be for the greater “public health good” then mandatory vaccination trumps personal human rights… I find this very worrying, as it seems like a very slippery slope to me….
So, it’s legal and it’s going to be introduced, but what if the impact on health and social care delivery is deemed to be significant? Is a failed NHS service “in the greater public health good”? Will that stop the introduction of mandatory vaccination?
Impact Assessment
During the public consultation on mandatory vaccination, only 31% of respondents said they had no concerns about the impact on delivery of care. The UK Government published its Impact Assessment on what they believed would be the consequences of introducing mandatory vaccination for health and social care workers. It’s not very long… but it is very worrying.
The Impact Assessment estimates that 73,000 NHS and 38,000 social care workers would not be vaccinated (about 5% of the total work force) and this figure is remarkably accurate considering the numbers who remain unvaccinated with only days to go.
When discussing the impact of the loss of staff on the delivery of healthcare in the UK they go on to say, “we cannot be confident that the system, even with additional funding, will be able to absorb the loss of capacity resulting from the implementation of this policy” and “the impact on workforce levels and health and care services could be significant”.
So, the UK Government knew their mandatory vaccination policy would be an issue and yet they still went ahead with it…!
Huh?! So, there is no public desire for mandatory vaccination, no overwhelming scientific justification and the adverse impact on health and social care delivery is expected to be significant… that all seems to be very bad to me…
Ummm… [Sorry to interrupt the rant] but don’t we already have mandatory vaccination in the NHS with Hepatitis B Virus vaccines? Surely, it’s all been done before, so it must be okay?… Or has it?
Hepatitis B vaccination
Many proponents of mandatory Covid-19 vaccination refer to there being a precedence for mandatory vaccination already within healthcare; anyone carrying out exposure prone procedures (EPP) must be able to show that they are vaccinated, or if they cannot be vaccinated or do not respond to the vaccine, that they do not have Hepatitis B infection.
BUT this is not the same as the Covid-19 vaccination situation.
Hepatitis B Virus (HBV) infection is an uncommon blood-borne virus infection where the risk of transmission is very high from an infected person (1 in 3 needlestick injuries from someone with detectable virus in their blood). The vaccine is very effective at preventing HBV infection (>90%), carriage, and transmission.
The SARS CoV2 vaccine is at best 70% effective, the immunity does not last (months not years), it prevents severe disease in the individual not carriage of infection and therefore vaccination does not prevent transmission… HBV vaccine does provide long term protection from infection and disease both in patients and staff members and does stop transmission.
What can you do if you are one of the 77,000 unvaccinated NHS healthcare workers?
Unless you are vaccinated you cannot work in a patient facing role in the NHS in England… but you can work in Wales and Scotland who don’t have a mandatory vaccination policy for health and social care workers! I know of a number of colleagues who are already moving across the borders.
Alternatively, you can use those years of clinical excellence to sit behind a desk in an administrative role, helping to try and improve services for patients. It might be a waste of all of that experience but maybe having experienced patient centred staff “managing” may improve services!, However you may lose a significant amount of pay as Trusts can “demote” you, stop oncall supplements, etc. (speak to the BMA).
Or maybe wait until Thursday… there could yet be a Government U-turn on this…!
According to Sajid Javid, the UK Health Secretary, it is the “professional duty of every NHS worker to get vaccinated”. I wonder if I should put in a Freedom of Information Request to the UK Government asking how many sitting Members of Parliament have been vaccinated? Surely, they have a “professional duty” to get vaccinated so that we as members of the public are ensured our elective representatives do not pass infection onto other MPs or their constituents… or that they are indeed doing what they are asking of the public? Hmmmmm… Lockdown party anyone?!?