Expert advice

Could coronavirus vaccination become compulsory for nurses?

Mandatory vaccination and the rights of individuals and employers

COVID-19 throws focus on the sometimes fraught issue of mandatory vaccination of healthcare professionals and the rights of individuals and employers

Is the government planning to make the COVID-19 vaccination compulsory for nurses?

Nurses who work in care homes for older residents in England could be legally required to be vaccinated against COVID-19 under plans being considered by the government.

In April, the government began a consultation into these plans, which are intended to drive up vaccination rates.

Ministers want to amend the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which would mean older adult care home providers can only use those staff who have received the COVID-19 vaccination (or those with a

COVID-19 throws focus on the sometimes fraught issue of mandatory vaccination of healthcare professionals and the rights of individuals and employers

Picture: Alamy

Is the government planning to make the COVID-19 vaccination compulsory for nurses?

Nurses who work in care homes for older residents in England could be legally required to be vaccinated against COVID-19 under plans being considered by the government.

In April, the government began a consultation into these plans, which are intended to drive up vaccination rates.

Ministers want to amend the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which would mean older adult care home providers can only use those staff who have received the COVID-19 vaccination (or those with a legitimate medical exemption).

The consultation closes on 21 May, with a decision expected in the summer.

Health and social care secretary Matt Hancock said that making vaccination a condition of deployment is something ‘many care homes have called for’.

‘Older people living in care homes are most at risk of suffering serious consequences of COVID-19 and we have seen the grave effects the virus has had on this group,’ he said.

‘The vaccine is already preventing deaths and is our route out of this pandemic.’

Picture: Alamy

What about nurses working elsewhere in the NHS and social care?

While the government says it is not currently consulting on plans for mandatory vaccination of NHS staff, a national newspaper report suggests at least one NHS trust is considering making COVID-19 vaccination part of employment contracts.

Are any vaccinations currently mandatory for NHS staff?

According to media interviews in March, Mr Hancock has claimed a precedent was set when doctors were required to have hepatitis B vaccination.

But while this vaccine is strongly recommended for healthcare staff by the General Medical Council and the Public Health England Green Book, it is not mandatory. The Green Book states: ‘Hepatitis B vaccination is recommended for healthcare workers who may have direct contact with patients’ blood or blood-stained body fluids.’

But some employers appear to insist that employees at risk of exposure-prone procedures have the jab before being offered employment.

Are COVID-19 vaccines mandatory for healthcare staff anywhere else in the world?

Italy has become the first country in Europe to make vaccination against coronavirus mandatory for healthcare workers.

Health professionals who refuse to have the vaccine will have the option to be transferred to duties that do not risk transmission of the virus, otherwise be suspended without pay for as much as a year.

The move was backed by the Order of Doctors, Surgeons and Orthodontists at a time when Italy, which was severely affected by the virus, faced its third wave.

What does NHS England say about nurses who decline the COVID-19 vaccine?

Guidance from NHS England in March says that staff who refuse the vaccine could be redeployed to a less exposure-prone setting.

The guidance suggests conversations about vaccine hesitancy could be undertaken with a line manager or another ‘person of trust’ such as a vaccinator, peer or chaplain.

What does the RCN say?

While the RCN does not support mandatory vaccination for nurses, it does strongly encourage all healthcare staff to get the injection.

‘Professionals … should take all reasonable personal precautions to avoid potential health risks to colleagues and people receiving care’

Nursing and Midwifery Council

Vaccination should not be a condition of employment or part of employment contracts and nurses should not be coerced into receiving the jab, the college says.

It supports the principle of employers taking a proactive approach and ensuring there is easy access for staff to get the vaccine at work.

‘If RCN members decide they do not want the vaccine the reasons should be explored. If they remain anxious about having the vaccine, the RCN would support their decision,’ the RCN says.

‘There are serious concerns around mandating vaccines. Like the wider population, health and care staff are a diverse group and there are both physical and societal barriers for some on the take up for the vaccine.’

What do nurses think about mandatory vaccines in general?

Surveys by Nursing Standard have found that a significant minority would not support mandatory vaccination.

Picture: Alamy

More than a third (36%) of more than 2,000 nurses said they would not support a move to make the flu vaccine mandatory, in a 2019 survey that revealed the strong feelings healthcare professionals hold on this issue.

It is a deeply polarising issue for nurses, with many saying being vaccinated is a fundamental part of protecting vulnerable patients. But some said they would quit if forced to have a vaccine, and others said while they always received the flu jab, they did not agree with it being made mandatory.

What does the Nursing and Midwifery Council (NMC) say?

The NMC says it would expect the majority of registrants to be vaccinated because of the risk of inadvertently spreading coronavirus to vulnerable people.

‘Although there aren’t any mandatory vaccines in the UK, the code and our standards make clear that professionals have a responsibility to maintain their own level of health. And that they should take all reasonable personal precautions to avoid potential health risks to colleagues and people receiving care,’ the regulator says.

What do legal experts think?

The current approach with hepatitis B vaccination and the use of employers’ health and safety policies has not been tested legally, and does not necessarily represent legally-binding precedent, Isra Black, lecturer in law at the University of York, says.

Mandatory vaccination interferes with the right to private life protected by the European Convention on Human Rights, so the relevant authorities would need to show that the interference is justified, he says.

Public bodies must also show that they have taken into account the Public Sector Equality Duty, including that they eliminate unlawful discrimination, harassment and victimisation and other prohibited conduct.

They must also show that mandatory vaccination policies comply with the requirements of the Equality Act 2010. The situation is more complex for private providers.

‘The human rights and equality dimensions of mandatory vaccination cannot be avoided by the use of health and safety law,’ he says.

‘We might question the wisdom of the government’s proposal to use health and safety regulations, as proposed in consultation, to enact mandatory COVID-19 vaccination, rather than pursue primary legislation that would enable a robust justification for controversial policy to be offered in parliament.’


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