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COVID-19 and needle phobia: ensuring service users are vaccinated

Trust and consent are key to supporting people to have the vaccine safely 
Illustration of a young woman with learning disabilities who is needle-phobic and afraid of being vaccinated

Trust and consent are key to nurses supporting autistic people and those with learning disabilities to have the vaccine safely  

Illustration of a young woman with learning disabilities who is needle-phobic and scared of vaccinations
Picture: iStock

Unless you’ve been on a desert island for the past year, you’ll know by now that our world-leading scientists have come up with several COVID-19 vaccines, and that ten years of red tape have been removed so they are available for immediate use.

Recognising the importance of this programme as a passport back to normality I now pose this question : how will you ensure your service users, where possible, are vaccinated?

I have tried everything over the years to ensure that my daughter Rachael, who is needle phobic, has vaccinations, but sedation, mindfulness and good old-fashioned parental bribery never worked.

Applying principles of mental capacity for people with learning disabilities 

The answer lies in understanding and applying the principles of the Mental Capacity Act 2005 for all service users over 16 years of age.

You will know to presume capacity unless you have cause to doubt it. If you do doubt it, then an assessment should be carried out and steps taken to support the person make their decision. 

If those steps don’t succeed then you must work out whether the vaccine will be administered on the basis of the consent of an attorney – or a deputy with the relevant power – or on the basis of an agreement that it is deemed to be in the person's best interests

‘Always consider what other steps can be taken short of restraint – just because you can restrain does not mean that you should’ 

Remember the importance of consulting significant others, including family members and others interested in the person’s well-being.

Ask yourself this: if the person could advocate for themselves what would they want? 

Decision rests with the person administering the vaccine 

If you think restraint may be needed to succeed, Section 6 of the Mental Capacity Act 2005 makes it lawful to restrain a person who lacks capacity to consent where the restraint is in their best interests, but only where it is necessary and proportionate to the risk of harm they might otherwise experience.

Always consider what other steps can be taken short of restraint – just because you can restrain does not mean that you should. 

Ultimately, the decision-maker is the person administering the vaccine, but you are the game changer by supporting the process that maximises the opportunity to make it happen.

Make it so.

Further information 


More articles by Wendy Johnson


Wendy JohnsonWendy Johnson, @wendyjo02857016, is associate director of safeguarding, Great Western Hospital NHS Foundation Trust, Swindon. She has written the regular Planet Rachael column, which is about life with her daughter, Rachael, who has autism

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