Covid-19: Should vaccination be compulsory in health and care?


TO shield vulnerable patients from Covid-19, few people who work in health and long-term care would disagree with the ambition to vaccinate as many of their colleagues as possible.

But there remain deep divisions over whether vaccination should be compulsory for staff who are not medically exempt.

In a special issue of the BMJ, academics and a transplant patient debate the pros and cons of mandatory vaccination.

“If hospital chefs refuse to comply with new safe food preparation guidance, they have no good reason to expect to continue to be employed,” argues Michael Parker, professor of bioethics at the University of Oxford, United Kingdom, in the BMJTrusted Source.

“So too in frontline healthcare roles, staff are rightly required to modify their practice in the light of evidence about patient safety,” he writes. Prof. Parker believes the same principle should apply to Covid-19 vaccination.

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In the United States, more than 50 medical organizations — including the American Medical Association, the American College of Physicians, the American Nurses Association, and the American Public Health Association — have endorsed a statement that calls for compulsory vaccination of healthcare and long-term care facility staff against Covid-19.

The Department of Veterans Affairs, some university hospitals, and some health systems have already made Covid-19 vaccination compulsory, though many of them allow exemptions on religious or philosophical grounds.

U.S. President Joe Biden has announced that federal workers and contractors must be vaccinated or else comply with new rules on mandatory wearing of masks, weekly testing, and social distancing.

In the U.K., the House of Commons recently approved legislation that would make Covid-19 vaccination compulsory for staff working in care homes in England unless they have a medical exemption.

The U.K. government is consulting on whether to extend the requirement to healthcare workers and other social care staff.

Italy, France, and Greece have already made vaccination mandatory for healthcare workers. Prof. Parker notes that health and social care providers have a duty to recruit staff whose presence does not put patients at unnecessary risk.

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