Was the NHS mandatory vaccination policy the answer to boost uptake?

Was the NHS mandatory vaccination policy the answer to boost uptake?
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A new survey found only one in six healthcare workers thought mandatory vaccination was the answer to encourage staff to have the Covid jab.

University College London and the University of Leicester joined forces to survey over 3,200 NHS healthcare workers to understand how they felt about the mandatory vaccination policy and what resolutions they would have proposed to address the under-vaccination of frontline staff.

The research followed the UK Governments’ decision to make it a legal requirement for all NHS workers in face-to-face patient roles to be double vaccinated by April 1st, 2022, or risk losing their job. The mandatory vaccination policy has since been abandoned.

The study can be found in the Lancet’s eClinicalMedicine.

Utilising the UK-Reach study data

To obtain the data, the research team called upon the UK-Reach study, which focuses on ethnicity and Covid outcomes within healthcare workers. It is the largest and most comprehensive research project outlining the risk of Covid for 18,000 clinical and non-clinical staff. It was initially launched after growing evidence highlighted those individuals from ethnic minority backgrounds had an increased risk of severe Covid infection compared to that of the White population.

The latest sub-study found healthcare workers who were hesitant about vaccination and/or were not vaccinated against the flu, were found to be less likely to favour mandatory vaccination, as were female staff, staff from Black ethnic groups, and staff in allied health professions.

Professor Woolf, Co-Investigator for the UK-REACH study, added: “Our research shows that had a mandatory vaccination policy been implemented, it would have been viewed especially negatively by the people it most targeted; those who are hesitant about getting vaccinated.

“Staff who are forced to get vaccinated when they don’t want to are unlikely to tell patients and their communities that vaccination is a good idea.

“Furthermore, an increase in mistrust among staff from ethnic minority groups, who are most likely to be hesitant about vaccines, could exacerbate existing health and social inequalities in those groups.

“However, if we encourage and support them, so they believe that vaccination is safe, effective and worthwhile, they will pass this message on. This matters because healthcare staff are an important source of information and advice about vaccination for patients.”

Mandatory vaccinations: what did NHS staff think?

The research found that 77% of healthcare workers surveyed preferred an alternative solution to mandatory vaccinations, and the remaining 5% did not know what the best solution would be.

The preferred solution to mandatory vaccinations noted by healthcare workers was ‘education and support’; this was proposed by 32% of those surveyed. This group thought people should be helped to understand the benefits of vaccination and encouraged to get the Covid vaccine.

Another one in six felt it was up to the individuals to decide whether to get vaccinated. Some of this group specifically stated that it was against human rights to force them to get vaccinated.

Lead author, Katherine Woolf, Professor of Medical Education Research at UCL Medical School, said: “Our survey provides the only available data and insight about what healthcare workers think about mandatory Covid-19 vaccinations.

“It shows that engaging and educating the NHS workforce is essential to building more trust in vaccination, which remains the most important tool we have to combat Covid-19 infection.

“But forcing frontline staff, particularly those who are hesitant, could cause serious mistrust and backfire, lowering morale and leading to thousands of great doctors and nurses leaving the profession.”

‘Vaccination as a condition of deployment’ policy

The UK Government proposed ‘vaccination as a condition of deployment’ (VCOD) requirements were highly controversial and was criticised heavily by several Royal Colleges, medical and nursing groups.

It was estimated around 5% (80,000) of health care workers would have remained unvaccinated and NHS Trusts stood to lose thousands of frontline staff.

Thousands of care home staff left the profession in November last year when rules changes meant that only those fully vaccinated could enter care homes.

The researchers noted that the findings do not state that 82% of NHS staff are against mandatory vaccination, but most respondents preferred an alternative solution.


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