Photo Credit – CDC PHIL
#16,174
Nine months after the first COVID vaccines became available there remain a large number of healthcare workers - both in the UK, and around the world - who have been offered a vaccine, but have declined. We've seen similar reluctance among HCWs when it comes to the yearly flu vaccine (see 2011's Flu Shot Ethics).
In the 5 years following the 1957 H2N2 pandemic, however, we saw two robust waves; one in 1960, and another in 1963.
Proving that if you've seen one pandemic, you've seen one pandemic.
Eighteen months into COVID-19 we are on our third major variant, and it could be argued that the COVID-19 pandemic of 2020 has been supplanted by the Delta pandemic of 2021. With several variants potentially poised to take over after Delta exhausts itself, there are no guarantees we'll see a respite anytime soon.
Since running out the clock may not be an option, many countries are thinking more about the long game. How do we return to some semblance of normalcy - and save lives - if COVID remains an active, and evolving, threat?
We basically have only two ways to protect people. Non pharmaceutical interventions (NPIs) like face masks and social distancing, and a vaccine. Compliance with face masks has dropped dramatically, and most social distancing mandates have been abandoned.
Leaving vaccines - which while initially remarkably effective - have gradually become less so over time and with the emergence of the Delta variant. Vaccines, however, do still reduce the severity of COVID infection, and significantly reduce (but don't eliminate) the risk of infection.
Facing another potentially catastrophic winter - one where influenza may well return to cocirculate with COVID - the UK is considering mandating the COVID vaccine for all front line medical personnel.
While a similar measure has already been enacted for personnel working in Adult Care facilities (see Making vaccination a condition of deployment in older adult care homes), this move would expand this vaccine mandate to all HCWs with patient contact.
As with the Adult Care mandate, the process begins with getting public input on the potential rule change, a process which is outlined in the following statement published today on the UK's Department of Health & Social Care website.
Making vaccination a condition of deployment in the health and wider social care sectorPublished 9 September 2021
Applies to: EnglandSummary
The government is seeking views on whether or not to extend vaccination requirements to other health and care settings for COVID-19 and also for flu.
This consultation closes at11:45pm on 22 October 2021
Consultation description
Vaccines are the best way to protect people from COVID-19 and latest estimates suggest that 105,900 deaths and 24,088,000 infections have been prevented as a result of the COVID-19 vaccination programme (up to 20 August). Vaccinated people are less likely to get seriously ill, be admitted to hospital, or die from COVID-19 and there is evidence that they are less likely to pass the virus on to others.
Following a public consultation on making COVID-19 vaccination a condition of deployment for those working in adult care homes, the government recently announced COVID-19 vaccination would be required of people entering a CQC registered adult care home, unless exempt, to protect vulnerable residents.
While residents in care homes are some of the most at risk from COVID-19, the responses to this initial consultation made a clear case for extending this policy beyond care homes to other settings where vulnerable people receive care and treatment.
The government, therefore, is now seeking views on whether or not to extend vaccination requirements to other health and care settings for COVID-19 and also for flu. Recent research has shown people infected with both flu and COVID-19 are more than twice as likely to die as someone with COVID-19 alone and nearly six times more likely than those with neither flu nor COVID-19, so it is right that both are considered within the consultation.
The consultation proposes that, if introduced, requirements would apply to frontline health and care workers– those with face-to face contact with patients and clients though the delivery of services as part of a CQC regulated activity. It would mean only those workers that are vaccinated could be deployed (or those with a legitimate medical exemption) to deliver those services.
These are complex and important issues and the consultation seeks to gather a wide range of perspectives from the public and across the health and care sectors about whether such requirements should be introduced and how they could be implemented.
The easiest way to participate is by completing the survey
The consultation document has been translated into Albanian, Arabic, Bengali, Chinese, Farsi, French, Gujarati, Hindi, Kurdish, Nepali, Polish, Punjabi, Romanian, Somali, Spanish, Tagalog, Turkish, Ukrainian and Urdu.
The UK isn't alone in this dilemma, and while mandating vaccines for HCWs isn't the perfect solution, it is one of the few available options in our limited armamentarium against COVID.
Having all HCWs vaccinated - even when it isn't 100% protective - would help to prevent doing unintentional harm to patients, and for that matter, to their overworked, and overstressed coworkers.
The first tenant of medicine has long been Primum non nocere : First, do no harm. Which is why, when a safe and reasonably effective vaccine is available for a deadly pandemic virus, HCWs should be more willing to take it. Alas, not everyone feels that way.
Those with adamant objections against getting the vaccine are likely to find that existing loopholes and exemptions will be squeezed out of existence in the months ahead - and not just in the healthcare sector - as COVID slugs inexorably towards its 2nd anniversary.
A year ago, mandating the vaccine was deemed `unthinkable' by many politicians and policy makers, who recognised how incendiary such a proclamation would be. Today, with no end to the pandemic in sight, it is no longer unthinkable - and for many employees - may well be inevitable.
And as if on cue, as I'm wrapping up this blog post, CNN has recently published:
Biden to announce that all federal workers must be vaccinated, with no option for testing
