Media reports today (16 June 2021) suggest that the UK government is likely to make Covid vaccination mandatory for care home staff, and possibly directly employed NHS staff. I think this would be a mistake.
I continue to thank God for the quick development of such apparently effective vaccines against COVID-19. I’ve welcomed the chance to be protected myself, and most of the patients I look after have felt the same. I’ve been keen to persuade those not so keen on vaccines to take up the offer. Many have done so; a few have not.
Notwithstanding my enthusiasm for vaccines, I believe that forcing these vaccines upon care home staff would be wrong in principle, and possibly counter-productive.
Two concerns of principle are consent, and freedom of conscience.
Medical treatment is usually based on consent. Rare exceptions are heavily safeguarded in law such as the Mental Health Act (1983). Consent is only real if it is freely given. How can consent for a vaccine be valid if someone is told they will lose their job if they do not accept it?
CMF is aware of some healthcare professionals who feel that they cannot accept current COVID-19 vaccines on conscientious grounds. Of course, such a decision must be carefully weighed against any risk to patients. Evidence is increasingly pointing towards vaccination reducing transmission of COVID-19, although is not yet conclusive. Yet the rest of government policy is still set as if vaccines have no effect at all on transmission. Fully vaccinated people are still threatened with prosecution if they do not self-isolate after close contact with a confirmed case and are still unable to travel abroad freely even to many countries with low infection rates. Such inconsistency doesn’t help someone with conscience concerns to weigh their decision.
Some reasons for conscientious objection, for example, those around vaccine production methods, are likely to remain whatever the statistics. Even if many Christians don’t share this objection, the principles outlined in Romans 14 would suggest that other believers should bear with them, which surely includes protecting their right to object.
I worry that coercion over this vaccination becomes a thin end of a very large wedge, with a principle established that is used to drive through government mandates in healthcare to which many more people of any faith or none will object.
Beyond the principles, there are many pragmatic concerns.
A small number of people genuinely cannot receive COVID-19 vaccines for medical reasons. How will this be managed?
It is not easy to recruit care home staff. Given that many have probably already been pressured by managers to be vaccinated, those who have not may well leave this often poorly paid sector rather than take a vaccine. Who would replace them?
Vaccine hesitancy is still a problem in the UK, although seemingly less so than in many nearby countries. Could compulsion worsen this? It might suggest that ministers have given up on being able to persuade people that vaccines are safe and effective. This could worsen vaccine hesitancy in the wider population. Trust will not be helped by the fact that the Prime Minister appeared to categorically rule out compulsory vaccination in a press conference in November 2020.
I also wonder whether distrust of the state in general, often linked with vaccine hesitancy, will worsen if some groups feel singled out for having not been vaccinated, particularly in areas like Bolton that have seen large recent outbreaks. Frustration at low uptake in the minds of ministers and many health professionals is quite understandable, but it is important that our response doesn’t worsen the problem.
Differential vaccine take-up by ethnicity is well-documented in the UK already. So those who would lose their jobs after refusing vaccination will be disproportionately black, which could well lead the government open to action under the Equality Act, not to mention the wider impression of discrimination.
BMA Law has a helpful legal summary, which outlines a considerable number of potential legal pitfalls.
So, in conclusion, I think the government needs to tread very cautiously on this issue. It is quite understandable (and commendable) that they want to see vaccine uptake at the highest level possible. But compelling any group of the population to be vaccinated risks unintended consequences and has worrying implications for consent and conscience.
Laurence Crutchlow is CMF’s Associate Head of Student Ministries and a GP near London