Healthcare professionals in the UK have a moral duty to get the Covid jab

I t is an irony of the UK vaccine rollout that, as healthcare workers inoculate the public, some are failing to have the jab themselves. By 20 February, more than a fifth of NHS healthcare staff in England had still not received their first dose of Covid vaccine, according to new figures. This follows data that Matt Hancock quoted last month suggesting that at the time only about two-thirds of care workers had taken up the offer of a jab, despite being given priority; in London, only half of staff in care homes for the elderly have been vaccinated.

Many of us are surprised by these figures – we assume that healthcare workers credit science, and always put care for their patients first. But there were always signs there would be a problem; we know from flu jab uptake over the years that many health and care staff don’t have the vaccine, despite flu being potentially deadly or disabling to vulnerable patients. Similarly, healthcare workers were never going to be immune to the ways in which race and class affects vaccine take-up in the general population. Research by the University Hospitals of Leicester NHS trust found that while 71% of white staff had received at least one coronavirus vaccine shot, that figure went down to 59% for south Asian workers, and only 37% of black staff.

We are all too familiar with how social media is spreading vaccine misinformation, but it is harder to imagine medics “liking” such posts. And yet a survey by the Royal College of Nursing found the most common reasons cited by nurses for refusing the vaccine were straight out of the conspiracy textbook: from worry that it was unsafe, or had not been tested enough, to fears about side-effects. Meanwhile, hesitancy among younger healthcare staff is anecdotally partly being put down to the myth that the vaccine damages fertility.

Ministers have made good strides in developing strategies to reassure reluctant communities, but the NHS will now need its own programme. Education to counter misinformation among health and care staff, and outreach to deprived or ethnic minority communities who often have good reason to distrust authority, must be everyone’s priority.

But we must also recognise that low take-up is about more than vaccine hesitancy. There are thousands of workers avoiding the test-and-trace system for fear of lost wages, which shows how precarious and low-paid labour endangers the fight against Covid. This culture in some workplaces is so toxic, it is now even discouraging care workers from taking the vaccine; BBC Newsnight reported that some care staff were refusing the vaccination due to fears that they would need time off due to the side effects (this is highly unlikely). This is an issue that has arisen across Europe. Providing the dignity of sick pay and secure contracts is not only the right thing to do – it could save lives.

Reassurance and education is far better than force, and workers – particularly those who can’t have the jab on medical grounds – need protection. But it is not unreasonable to suggest that in the coming weeks a plan B will be needed for those staff who still hold out. One of the UK’s largest care home operators has already instituted a “no jab, no job” policy for new staff, while another said it would insist that current staff are vaccinated (unless they can’t for medical reasons). The idea of vaccine passports has gained traction in England to get into places such as shops, and though there are valid ethical questions to consider, this is even more pressing issue for medics and care workers expecting access to vulnerable patients. A former chief medical officer for England previously recommended that all healthcare workers who refused the flu jab should wear a lapel badge to warn patients they weren’t protected. Such a solution has its problems – on a crowded ward with few staff, you can’t pick and choose your nurse, and it is outright cruel to expect a care user who needs help to get to the toilet to have to turn away their unvaccinated care worker at their door.

Compulsory vaccinations for all NHS and care staff are surely a valid last resort. Concerns about protecting individual liberties are reasonable, but vaccines for healthcare workers cannot be spun as a matter of personal choice. Your freedom does not include the right to potentially harm others. Besides, if the pandemic has taught us anything, it is that we each have a collective responsibility to protect one another – something that is never more true than for those who have signed up to do so as a professional duty.

These are complex ethical and practical questions to address, but there are lives at stake. For the past year, high-risk people have had to fear every interaction with another person. It is unfathomable that they will be expected to see potentially infected nurses and care workers at a time when they are already at their most vulnerable – not least when the vaccine now offers such an easy solution.

• Frances Ryan is a Guardian columnist