Expert Comment: Professor Lydia Hayes challenges mandatory Covid-19 vaccinations for care home workers

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Professor Lydia Hayes, Head of Kent Law School, alongside Allyson Pollock, Professor of Public Health at Newcastle University has argued that mandatory vaccination is ‘unnecessary, disproportionate, and misguided.’

The government decision to remove the right of care home staff in England to choose whether or not to be vaccinated against Covid-19 is a profound departure from public health norms. The intended next step is a rapid and massive expansion of compulsory vaccination to legally require covid-19 and flu vaccination of all frontline health and social care workers, subject to consultation.

In an editorial analysis for the BMJ, Professor Hayes and Professor Pollock suggest that vaccination ‘is not a panacea for safety’ and ‘will not remedy the serious shortcomings of the care sector in England.’

They note government consultation documents and subsequent media reports have claimed that mandatory vaccination is necessary because of low vaccination take up rates in some care homes.

Yet, figures show that by 20 June 2021, over 90% of care home residents in England had received two doses of a Covid-19 vaccine, 84% of care workers in England had received a first dose, and 72% of care workers had received a second dose – in line with Scientific Advisory Group recommendations.

The Professors’ closer scrutiny of the data shows that uptake of the first dose of Covid-19 vaccination among care workers is below 80% (68-74%) in only three English local authorities but these numbers are an artefact of very low numbers of staff employed by care homes in these London areas.

Moreover, they highlight that the government’s own methodology note warns that reliable information on vaccination uptake cannot be directly derived from the data the government is using.

According to regulatory law, safety in care homes ‘is achieved through adequate staffing levels, training, equipment, cleanliness, personal protective equipment, risk assessment, and consultation with staff and residents,’ they write.

Vaccination protects individuals from Covid-19 and reduces the risk of transmission of disease to others, but neither duration of protection nor efficacy against new variants are known.

The Professors stress that care workers need paid time in which they can access vaccination and good training, decent wages (including sick pay), personal protective equipment, and strong infection control measures.

Professor Hayes said: ‘I hope the decision will be reconsidered. Vaccination is important, of that there is no doubt. But vaccination is not a silver bullet for safety, it is only one piece in our armour against this virus. Threatening care workers with the loss of their job if they are not double jabbed, on the basis of dodgy data, is not the right way to increase safety and confidence in care homes.

‘Across the care home sector, vaccination take up is very good, higher than SAGE recommended level for threshold protection in care homes. Many care workers have acquired natural immunity through Covid infection, yet this is overlooked. The data on numbers of unvaccinated care workers are not reliable and the government’s own methodology notes say so. Compulsory vaccination is not needed in Wales and Scotland. However, in England the government plans to dismantle the principle of vaccination by consent when what is needed is greater respect for care workers, better education and training, paid time and help to access vaccination and better systems of data collection.’

The article ‘Mandatory covid-19 vaccination for care home workers’ is published by the BMJ. doi: 10.1136/bmj.n1684