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The U.K. government is preparing to push ahead with mandatory coronavirus vaccinations for care home workers by the summer, in what could be a worldwide first.
Prime Minister Boris Johnson is expected to make a statement around April 5, coinciding with the launch of a detailed consultation on making jabs a condition of employment for those working in care homes, according to an internal civil service memo seen by POLITICO.
The consultation, set to run until May 21, will explore “how rather than if” a compulsory inoculation scheme should be set up, the memo said. The requirement would apply to all on-site staff unless they have a medical exemption, and would depend on a change in the law that ministers are hoping to complete by mid-June.
SAGE, a body that provides scientific advice to the government, was consulted on the move and concluded that “ensuring very high levels of vaccination in vulnerable residents and people who care for them in these settings is an appropriate public health intervention for a serious vaccine-preventable disease.”
Internal briefings, however, have highlighted the risk that people could quit the over-stretched care workforce as a result of the new rule. There’s also the chance that government ministers could be held responsible for potential side effects following “compelled” vaccinations.
The idea could also hit resistance among some Tories and civil liberties campaigners who are already unhappy over draft proposals for a U.K. vaccine-certification regime. Most recently, reports this past week suggesting that people could be asked to prove their COVID-19 status to go to pubs caused an uproar.
Health Secretary Matt Hancock said he was considering the mandatory jabs for care homes after reports emerged in the Daily Telegraph earlier this week, but Friday’s leak provides the clearest indication yet that the government is determined to go down this route.
Ministers are especially concerned at the low take-up of vaccines among care workers, which has reached the level of immunization thought safe by government scientists in only half of England’s care homes.
Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, sees an ethical case for such an effort, noting that it’s important to distinguish between making vaccines compulsory for the public and doing so for health and care workers.
“Given that health and care professionals have an ethical duty to protect patients from harm, I think there is a case to be made for this,” he said. “I also think that, in future, it may be extended to flu vaccines.”
A U.K. government spokesman said: “The review into Covid status certification is considering a range of issues. No final decisions have been made.”
Health policy is devolved in the U.K. and the rule change is likely to apply to England only.
The U.K. doesn’t currently have a mandatory policy in place for any types of vaccinations for the general population. But health care staff working with sharp instruments may be required to have a hepatitis B vaccine, or else be moved to other work if they refuse.
More broadly, support for mandatory coronavirus vaccination varies across Europe. A February survey from Ipsos of five European countries found that a majority of people in the U.K., Spain and Italy supported making the vaccine compulsory for people over 18. In France and Germany, most people opposed such a move.
While other countries have yet to mandate the coronavirus jab, the idea could gain traction as the pandemic grinds on. In France, for example, a government adviser told the Senate earlier this month that if the pace of vaccinations of health care workers doesn’t double in the next 15 days, the state would need to consider mandating the vaccine for health staff.
Mandatory vaccinations for other diseases are relatively commonplace, with some European countries such as Italy and France writing these provisions into law. While most are targeted at childhood vaccination, there are some cases, such as in Finland, where health care workers are required to receive seasonal flu vaccines as a condition of employment.
The evidence for mandatory vaccination isn’t clear cut, however. In response to a question in European Parliament in 2017, the European Commission cited data suggesting there “are no striking differences in vaccination coverage between countries that recommend certain vaccinations and countries that make vaccinations mandatory for the general public.”
But the Commission also pointed to evidence specific to health care workers suggesting that mandatory policies have had a positive impact on uptake in that group, whereas voluntary schemes have not.
Update: This article was updated to include a U.K. government comment.
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