The Rationale for the UK Vaccine Mandate for Caregivers in Nursing Homes
The recent move by the UK government making vaccinations mandatory for caregivers in nursing homes was shocking to a majority of the populace.[1] This shock is understandable given the government’s success in inoculating an impressive 87% of the citizens against COVID-19, with 60% having received two dosages.[2] Furthermore, vaccine hesitancy rates are minimal, with the government even managing to halve the hesitancy among the youth.[3] Therefore, the unexpected policy seems irrational, especially considering its role in increasing hesitancy and causing healthcare personnel shortages.[4] These concerns are further aggravated by the government’s failure to satisfactorily explain the rationale for the policy. Given the mandate’s potential damage to vaccine uptake, this discussion identifies the reasons for the policy such as the high threat posed by the delta variant, the higher efficiency in attaining herd immunity, the economical nature of the mandate, and the confidence in vaccine safety.
The high threat to public health caused by the delta variant is arguably the core explanation for the vaccines mandatory for caregivers by the UK government. The threat is evident in the a study conducted by Public Health England and University of Cambridge showing that patients infected with the delta variant were twice as likely to be hospitalised and receive intensive care attendance compared to those with the original infection and Alpha variant.[5] This threat even prompted the US to issue travel advisories against the UK due to its high rate of infections, increasing the threat to public health to level four after a spike in infections following the lifting of restrictions by PM Johnson.[6] With such a high threat to public health coupled with the return to normalcy, the government resorted to mandatory vaccinations for caregivers since they attend to those at the greatest risk of succumbing to the virus. Furthermore, the variants were shown to pose the least effect to those who had received both dosages,[7] which intimates a higher efficiency in attaining herd immunity.
The higher efficiency in attaining herd immunity further cements the mandating of the vaccine for the caregivers in nursing homes since they increase vaccine uptake. This increase in uptake occurs as the people try to avoid the repercussions associated with the mandate.[8] For instance, Australia increased its vaccine coverage to 95% after the No Jab No Pay legislation.[9] Regarding the COVID-19, the possibility of herd immunity is evident in the higher resilience of people who have received both dosages against the deadly delta variant, which would effectively eliminate the virus if replicated across the entire UK population.[10]As such, the mandate, also suggested for nightclubs, would enable the attainment of herd immunity by closing the 27% gap between those with double and single dosages. The mandate would further cover the 13% of people yet to receive their first vaccination.[11] This undoubtedly explains the choice by the government to mandate them for the caregivers, with preparations to apply them to nightclubs currently underway. Furthermore, the mandates are economical.
The economical nature of the mandate as a rationale for the policy is evident in that mandating vaccines is cheaper than other alternatives. For instance, mandating vaccines is cheaper to the families involved since they save on the potential costs of healthcare incurred during hospitalisation and treatment. This is evident in the studies showing that the preventable measles 1980s outbreak in the US created direct medical costs of up to $100 million.[12] As such, instituting mandates saves on these costs since medical attention will not be necessary, making them more economical. Mandates are also less consuming than other alternatives like civic education, as evident in the U.S.’s prolonged and increasing vaccine hesitance rates despite civic education.[13] The economical nature of the vaccines mandates explains the decision by the government to adopt them for caregivers in nursing homes. Furthermore, the public confidence in them reduces the severity of the adverse reactions to them.
The high confidence in the safety of the vaccines further explains the government’s adoption of the mandate policy. Notably, confidence in vaccine safety and handling is critical to their uptake, with studies showing that trust, rather than the infodemic, is responsible for vaccine hesitancy.[14] The importance of trust and confidence is evident in the abandonment of AstraZeneca in favour of Moderna and the Pfizer vaccine after causing blood clots.[15] In the UK, the decision to mandate illustrates confidence by the UK citizens and government in their safety. This is evident in that 87% of the population has at least one dosage, unlike in the US, where only 53% are vaccinated.[16] Given such confidence in the vaccines, the decision by the government to adopt the mandate was not irregular since its public acceptance and trust is already high. Such would have been problematic if the vaccine’s confidence were low since it would aggravate the hesitancy rates.
The preceding establish the issues taken into account by the government in mandating the vaccines for healthcare providers in nursing homes, where the most susceptible demographic is. The factors that possibly persuaded the government are the need to redress the high threat posed by the coronavirus delta mutation, the trust in the vaccine’s safety even to the most vulnerable members, efficiency of vaccine mandates in attaining herd immunity, and their economical nature over other alternatives. These considerations are undoubtedly critical to curbing the acceleration of the pandemic despite the existence of a vaccine. To prevent further acceleration due to the negative impact of the vaccine, continuous civic education on vaccine safety and their importance to supplement the mandates is necessary. Such supplements will instill more trust in the people, especially among those wary of the government’s intentions like racial minorities who believe that the vaccines are meant to under populate them.
References
Department of Health and Social Care. “Vaccination of People Working or Deployed in Care Homes: Operational Guidance.” GOV.UK. Last modified August 4, 2021. https://www.gov.uk/government/publications/vaccination-of-people-working-or-deployed-in-care-homes-operational-guidance
Howard, Jacqueline. “COVID-19 Hospitalization Risk Doubles with Delta, UK Study Suggests.” CNN. Last modified August 27, 2021. https://edition.cnn.com/2021/08/27/health/delta-COVID-19-hospital-risk-study-wellness/index.html.
Public Health England. “Confirmed Cases of COVID-19 Variants Identified in UK.” GOV.UK. Last modified December 23, 2020. https://www.gov.uk/government/news/confirmed-cases-of-COVID-19-variants-identified-in-uk.
Public Health England. “Vaccines Highly Effective against Hospitalization from Delta Variant.” GOV.UK. Last modified June 14, 2021. https://www.gov.uk/government/news/vaccines-highly-effective-against-hospitalisation-from-delta-variant
Rezza, Giovanni, and Walter Ricciardi. “No jab, no pay and vaccine mandates: Do compulsory policies increase vaccination coverage? The Italian experience.” Vaccines, vol.38, no. 33 (2020), 5089. doi:10.1016/j.vaccine.2020.05.043.
Robinson, Maye W. “COVID Vaccine Hesitancy Halves among Young People in Great Britain.” The Guardian. Last modified August 10, 2021. https://www.theguardian.com/world/2021/aug/09/COVID-vaccine-hesitancy-halves-young-people-great-britain.
Rodgers, Lucy, and Dominic Bailey. “COVID Vaccine: How Many People in the UK Have Been Vaccinated So Far?” BBC News. Last modified February 5, 2021. https://www.bbc.com/news/health-55274833.
Sharma, Susan S., Badri N. Rath, and Neluka Devpura. “Pandemics and their impact on global economic and financial systems.” MethodsX, vol,8, no. 2 (2021), 101274. doi:10.1016/j.mex.2021.101274.
[1] Department of Health and Social Care. “Vaccination of People Working or Deployed in Care Homes: Operational Guidance.” GOV.UK. Last modified August 4, 2021. https://www.gov.uk/government/publications/vaccination-of-people-working-or-deployed-in-care-homes-operational-guidance
[2]Lucy Rodgers and Dominic Bailey, “COVID Vaccine: How Many People in the UK Have Been Vaccinated So Far?,” BBC News, last modified February 5, 2021, https://www.bbc.com/news/health-55274833.
[3] Maye Robinson. “COVID Vaccine Hesitancy Halves Among Young People in Great Britain.” The Guardian. Last modified August 10, 2021. https://www.theguardian.com/world/2021/aug/09/COVID-vaccine-hesitancy-halves-young-people-great-britain.
[4]Giovanni Rezza and Walter Ricciardi, “No jab, no pay and vaccine mandates: Do compulsory policies increase vaccination coverage? The Italian experience,” Vaccine 38, no. 33 (2020): 5089.
[5] Jacqueline Howard. “COVID-19 Hospitalization Risk Doubles with Delta, UK Study Suggests.” CNN. Last modified August 27, 2021. https://edition.cnn.com/2021/08/27/health/delta-COVID-19-hospital-risk-study-wellness/index.html.
[6] Centers for Disease Control and Prevention. “COVID-19 in the United Kingdom.” Last modified February 2, 2021. https://wwwnc.cdc.gov/travel/notices/COVID-4/coronavirus-united-kingdom.
[7] Public Health England. “Vaccines Highly Effective Against Hospitalisation from Delta Variant.” GOV.UK. Last modified June 14, 2021. https://www.gov.uk/government/news/vaccines-highly-effective-against-hospitalisation-from-delta-variant
[8] Rezza and Ricciardi, “No jab, no pay and vaccine mandates: Do compulsory policies increase vaccination coverage? The Italian experience,” 5089.
[9] Ibid.
[10]Public Health England. “Vaccines Highly Effective Against Hospitalisation from Delta Variant.”
[11] Rodgers and Bailey, “COVID Vaccine: How Many People in the UK Have Been Vaccinated So Far?,” BBC News, last modified February 5, 2021, https://www.bbc.com/news/health-55274833.
[12]Susan S. Sharma, Badri N. Rath, and Neluka Devpura, “Pandemics and their impact on global economic and financial systems,” MethodsX 8, no. 2 (2021): xx, doi:10.1016/j.mex.2021.101274.
[13]Centers for Disease Control and Prevention. “Vaccine Hesitancy for COVID-19.” Accessed August 29, 2021. https://data.cdc.gov/stories/s/Vaccine-Hesitancy-for-COVID-19/cnd2-a6zw/.
[14]Thomas, Liji. “Study Suggests COVID-19 Vaccine Confidence and Hesitancy in the UK Driven by Trust, Not Misinformation.” News-Medical.net. Last modified July 20, 2021. https://www.news-medical.net/news/20210720/Study-suggests-COVID-19-vaccine-confidence-and-hesitancy-in-the-UK-driven-by-trust-not-misinformation.aspx.
[15] New York Times. “European Countries Suspend Use of AstraZeneca Shots Over Worries About Blood Clots.” Last modified March 24, 2021. https://www.nytimes.com/2021/03/11/business/astrazeneca-vaccine-denmark-blood-clots.html
[16] Centers for Disease Control and Prevention. “Vaccine Hesitancy for COVID-19.”