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HIQA: Mandatory vaccination of health staff 'most intrusive' and other steps should be taken first

The finding was contained in a report by the health service watchdog.

Image: Shutterstock/wutzkohphoto

A REPORT BY the health service watchdog has said that making Covid-19 vaccines mandatory for healthcare workers would be the “most intrusive” step and that other interventions should be attempted first.

However, the Covid-19 Expert Advisory Group suggested that consideration may be given to mandatory vaccination of healthcare workers in future if there was low uptake of the vaccine and if all other interventions had been exhausted. 

The recommendations feature in a report given by the Health Information and Quality Authority (HIQA) to the National Public Health Emergency Team (NPHET) about how to manage healthcare workers who do not want to take a vaccine against the virus.

The report was compiled to ensure the safety of healthcare workers and to minimise the risk to patients of contracting Covid-19 in healthcare settings.

It states that all healthcare workers should be encouraged and enabled to take a vaccine as soon as possible, given the challenges experienced by the sector during the pandemic.

It also says that staff should be facilitated to make a decision on whether to be vaccinated “in a supportive environment with the right information” and following a clear explanation of the benefits of taking a vaccine.

However, HIQA noted that healthcare workers may not wish to take a vaccine because of potential contra-indications with other medicines or their refusal to do so.

The watchdog recommended that in such cases, a progressive approach should be taken, using what it describes as an “intervention ladder” where each “rung” would require stronger levels of justification to be actioned.

“The decision to step up the ladder should be influenced by the level of risk to patients from unvaccinated healthcare personnel posed by increased levels of community transmission,” HIQA said.

The report says that the first step should involve providing evidence-based information about the vaccine “in a supportive manner”, followed by further levels of intervention such as ongoing testing, an increased use of PPE and redeployment to a lower risk area.

“Mandatory vaccination would sit at the top of the ladder as the most intrusive step,” it adds.

The report noted that a meeting of the Covid-19 Expert Advisory Group about the issue decided that mandatory vaccination “may not be appropriate” because it could act as a deterrent.

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“Additionally, such a measure may be perceived as being overly harsh on a workforce that have had a particularly traumatic year,” it said.

However, the group also outlined the possibility that mandatory vaccination of healthcare staff could happen in future.

“If all lesser restrictive measures have been exhausted and there is still low uptake, consideration may be given to mandatory vaccination in the future.”

One suggestion by the group was the potential for ‘nudges’ to be used improve vaccine uptake, such as wearing stickers or badges.

However, the group also warned that this should not discriminate or stigmatise those who did not avail of the vaccine.

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