John Greenall

Vaccine Mandates: A defining justice issue for our professions?

John is CMF's Associate CEO, and a practising paediatrician
The views expressed do not necessarily reflect those of CMF.

“I’ve worked for two years throughout this pandemic…with inadequate PPE…overtime…seeing many die in front of me. And now I’m going to lose my job”.

This is just one story of many I have heard from colleagues who stand to lose their jobs when the government’s vaccination mandate for healthcare workers in England comes into force on 1st April. In practice, those who haven’t had the first dose by 3rd February are at risk.

I am vaccinated and believe Covid vaccines have supported our route out of lockdowns. Whilst some people may qualify for a medical exemption, others might have deeply held medical, religious or philosophical concerns which should be understood and respected. Indeed, none of those I have spoken to are refusing vaccines because of a crazy conspiracy theory, but instead for deeply held convictions and, in some cases, fears. Why and how should we respond and act to stand alongside colleagues?

I propose that such a mandate is potentially harmful, is mistimed and is discriminatory and unjust. It may cause more harm than good: with 7% of our NHS workforce currently unvaccinated, this could mean as many as 100,000 staff leaving the NHS, further exacerbating the tens of thousands of vacancies that already exist in the NHS and social care system. With a large backlog of patients still to be seen, as well as the increase in stress-related medical conditions caused by the pandemic, this is a time when we can least afford to lose large numbers of staff. If on the other hand, only a handful of people lose their jobs, then why mandate vaccinations in the first place? Not only this, but it is a quick way to lose goodwill. One Consultant has told me ‘I am getting vaccinated purely not to lose my job and I am extremely upset about it, and I have started thinking and working on leaving my job. They need to know that even if they make NHS workers get vaccinated, they are losing our loyalty’. In sum, mandating vaccines may well be a lose-lose situation.

It is mistimed because the emergence of Omicron means a new set of data on the disease’s virulence and transmissibility. A pause to consider the benefits against the risks would be helpful as well as to explain how often staff will need to be vaccinated. If immunity dips every three months, is this what we are asking of healthcare staff? It would be an even greater shame to lose staff when the evolving scientific picture is so obviously unclear.

Finally, it may be discriminatory. The government’s own Equality Impact Assessment indicates that there are higher levels of vaccine hesitancy among some ethnic minority groups and groups that observe particular religions. Compelling vaccination risks deepening historical suspicion and penalising staff who have risked their lives during the pandemic. One staff member told me: ‘Several people depend on my paycheque. If I had money I would have left immediately. How ethical is that? The rich get away with things but people who need the money will have to do as they are told even if it is against what they believe in.’

Harm, evidence-base, and injustice are things that should get us listening. We should be deeply disturbed at the impact on our colleagues, the vast majority under threat being those from an ethnic minority background. We have seen thousands of care home staff leave in the last year, many due to the mandate for them to be fully vaccinated, effective from last November. This deadline passed with barely a whimper, and yet within hours of speaking up about this issue, I was on Sky News alongside the white, British-trained ITU doctor at King’s who got top billing on the evening news.

Many of those contacting me feel they have no voice. I believe we are called to stand with those who need support. Let’s not be those who say, ‘oh I’m fine, it’ll all blow over. Hopefully, people will get jabbed and get on with it’. Whether we agree with unvaccinated colleagues or not, let’s stand with them.

We are calling on the government to pause the implementation of this decision and rather than use coercion and threat, to use persuasion and encouragement; to understand more the deeply held reasons that many of our colleagues have, and to respect the right of people to choose. If you would like to support this, you are welcome to sign an open letter to the Health and Social Care Secretary Sajid Javid HERE.


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