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The Guardian - UK
The Guardian - UK
World
Robin McKie

Covid vaccines for care home staff: why ‘no jab, no job’ is controversial

A care home resident holding hands with her daughter. The government is being warned of widespread closures of care homes unless it scraps the “no jab, no job” law in England.
A care home resident holding hands with her daughter. The government is being warned of widespread closures of care homes unless it scraps the “no jab, no job” law in England. Photograph: Andrew Matthews/PA

Why is there controversy about giving Covid-19 vaccinations to care home staff?

Ministers have decreed all care home staff in England must be vaccinated against Covid-19 by 11 November. However, it is estimated – by the government – that about 7% of the 570,000 people employed in English care homes will refuse the vaccine. That represents some 40,000 staff who will no longer be able work in them and care for the elderly.

The union Unison says ministers are leading the country towards a social care disaster and has urged that the “no jab, no job” rule be revoked. For its part, the government says the move is needed to protect the elderly – who are particularly vulnerable to Covid – from being infected by staff. The British Medical Association (BMA) has described the move as “a blunt instrument”.

Just how important is it to vaccinate care home staff?

The government says it is vital. Others disagree. Some critics claim that although vaccines are highly effective at preventing admissions to hospital or death, they do not block transmission. Vaccinated care staff could still pass on Covid-19, it is argued. This claim is dismissed by Peter English, past chair of the BMA’s public health medicine committee. “It is not correct to say that ‘we now know vaccination doesn’t prevent transmission.’ On the contrary it does significantly reduce the odds of infection, and if you are not infected you cannot infect others,” he told the Observer.

English said vaccination roughly halves the probability of infection and those who are vaccinated are likely to be infectious for a much shorter period. “So the odds of being infected and infecting others are likely well below 50% compared to an unvaccinated person – I would guess they’re of the order of 10% or less. The rationale is therefore straightforward. People who are particularly susceptible to death or severe disease should be protected as much as possible, by vaccination – and by reducing their odds of being exposed to disease.”

Are there precedents for imposing vaccinations on staff?

Some NHS trusts make it a condition of employment that staff are willing to have the flu vaccine, while doctors and other healthcare workers who have not had a hep B vaccine are not allowed to undertake certain procedures where there is a risk of hepatitis B infection.

“Care home staff are not being forced to be vaccinated against Covid-19. All that is being said is that they cannot do a particular job unless they are vaccinated,” says English.

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