Sajid Javid ‘leaning towards’ mandatory Covid jab for NHS staff (England)

[Northerner]

NHS staff have been warned they could face a mandatory requirement to be vaccinated against Covid, with the health secretary saying he is “leaning towards” making the jabs compulsory for staff in England.

Sajid Javid said he had not made a final decision, but the move would put NHS staff in England broadly in line with the requirement for care home workers.

It comes as the chancellor is expected to announce £5.9bn for NHS England as part of financial measures this week to clear the backlog of those waiting for tests and scans, which has been worsened by the pandemic, and also to buy equipment and improve IT.

Critics have said that as well as resources, the government must address the fact that there are not enough staff to support services.

“There are around 100,000 that are not [vaccinated in the NHS] at this point but what we saw with the care sector is that when we announced the policy … then we saw many more people come forward and do the right thing and get vaccinated, that’s what I hope, if we can do the same thing with the NHS, we will see,” Javid told Sky News.

Sajid Javid ‘leaning towards’ mandatory Covid jab for NHS staff

Health secretary yet to make final decision on whether to bring NHS in line with care home sector in England

www.theguardian.com

Personally, I think that if you work in a healthcare setting and there is no medical reason for you not to have it, I don't know why you wouldn't 🙄 There's surely enough evidence now that the vaccines work really well and are not dangerous.

 

[trophywench]

I honestly thought it was compulsory, since last December our 16yo grandaughter, working part time as a cleaner at UHCW was the first of our family to have her first Covid jab! She had her second jab not long after we had our first one.

 

[Inka]

Many of those infected at the moment are children in my local area. Obviously the vast majority of them haven’t yet had any vaccine.

I agree that NHS staff should be vaccinated. It would be madness not to. It will also hopefully cut down on time off work and benefit the NHS that way.

 

[Bruce Stephens]

Many of those infected at the moment are children in my local area. Obviously the vast majority of them haven’t yet had any vaccine.

The ONS survey suggests prevalence is (or was, a week or two ago) 0.7%-1.5% in most age groups, with age 2 to 11 (so primary school) at 3.8% and secondary school 7.8%.

Let's hope it really is safer (or no less safe) for children to be infected than for them to be vaccinated.

 

[Bruce Stephens]

The other day the pm was quoted as saying this to reporters.

If I had to choose a source for accurate information (which'll often involve nuance) about this I wouldn't choose the PM. (Especially not filtered through a reporter who's likely a political reporter rather than a science or health reporter.)

A better summary would be something like being vaccinated does significantly reduce the chances of becoming infected and (if infected) becoming seriously ill. But there are signs of waning effectiveness, which means a booster probably makes sense. I'm not sure whether there's good evidence of waning of the protection against serious illness (it doesn't seem impossible to me that those of us who got Pfizer just have waning antibodies which would mean we'd be more likely to be infected, but we'd then have antibodies quickly produced to protect us against serious illness).

Real world evidence from ONS suggests protection against being infected is still pretty good but not great. Does suggest the waning is in people who got Pfizer, with Ox/AZ not waning much (in this respect). So giving the (Pfizer) booster to Ox/AZ recipients too is presumably an attempt at increasing the protection (since while Ox/AZ isn't waning much it's not great (compared to Pfizer) to begin with).

https://twitter.com/x/status/1452630900475314182

 

[Bruce Stephens]

Based on what the p.m said, I don't see how mandating vaccines which as the p.m states "doesn’t protect you against catching the disease, and it doesn’t protect you against passing it on" will help protect patients and visitors at hospitals and....how sacking or moving those from front line NHS duties (who chose not to be vaccinated) will help protect patients either.

I agree it's not at all clear what the effect of such mandates would be.

If they had the effect of persuading the unvaccinated healthcare staff to become vaccinated (apart from the small number who can't have a vaccine for medical reasons), that would help. The vaccines protect the individual against infection and protect everyone else (a vaccinated person is less likely to be infected, and when infected is less likely to infect someone else). (Regular testing as healthcare staff get also protects against infected staff continuing to work, of course.)

If we had more healthcare staff than we really needed, that would be persuasive, I think. After all, do we really want people working in healthcare who don't think they should be vaccinated? But we already have shortages, and there's a significant risk that some will quit and make that worse.

I don't know what the optimal strategy would be.

 

[Bruce Stephens]

They definitely need to get the facts straight between them (the p.m and health secretary).

I'm pretty sure that if questioned under oath by someone competent, they'd be giving the same information.

Which is that yes, it is possible for vaccinated people to become infected (and to get sick, and die), and to pass on the infection to others, but the vaccines make all those things significantly less likely.

So there is significant value in trying to get healthcare staff to get vaccinated. There are also costs to that (staff may refuse and leave, and in the UK we generally don't mandate vaccinations, believing that having them voluntary has value), and I'm not sure how the costs and benefits measure out.

 

[Bruce Stephens]

Why do you think the p.m keeps saying it's not the vaccines but the lockdowns that keep cases down?

When did he last say that? I presume he said it earlier in the year because that's what the modelling suggested: not that many people had received both doses. It would probably be true now if we were successfully keeping cases down, because while many more people have been vaccinated, the delta variant is much more infectious.

Having said that, all the predictions seem to be that cases will be falling shortly. A combination of vaccination and infection, I assume, with infection especially significant in children.

 

[nonethewiser]

Should have been compulsory long before now, what's took so long?

 

[Bruce Stephens]

So I'd say again, if this is the case and it's not the vaccines cutting the spread of infections (only reducing early deaths from covid19), then how will mandating front line NHS staff with threats of dismissal help?

Nobody is claiming (well, I'm not) that the vaccines aren't reducing the spread of infections. It's just a question of numbers. The modelling suggested that earlier in the year (in April we were about 15% vaccinated) the numbers of vaccinated people just wasn't making a significant impact on the infections. They were having some effect, just an insignificant one compared with physical distancing.

In a population like healthcare staff you could reasonably hope to get very high vaccination rates (no children to worry about) so within healthcare settings that really could be significant.

(I'm not saying it would be bad to try and get the rest of the population vaccinated. Historically we've tried to do that with persuasion rather than broader mandates and felt that's better overall. No signs that's likely to change, though I think there are some employers who are at least considering requiring vaccination.)

 

[Bruce Stephens]

but the pm is

I think he (or a spokesdroid) would argue that he's technically not saying that. He's saying things like the bulk of the work to reduce cases is being done by restrictions, and that vaccines to not prevent transmission. Which is all true, but at other times I'm sure he wants to say that the vaccines are really effective and particularly that they are effective at reducing transmission. (So if only everyone was vaccinated, that really would help reduce infections.)

I think he (and his government) have locked themselves into a mindset that the public are liable to panic and won't follow advice unless it's conveyed in simple three word slogans.

I think with the original story about mandates, given front line NHS staff have selflessly worked through a risky time dealing directly with patients, they are more than likely to have caught the virus at some point and for me, they are probably the least people of concern to anyone and I wouldn't want to see the NHS go down the pan (resignations, sacking and moving etc) for the wrong reasons.

As discussed in Dr John Campbells video "Natural versus vaccine immunity" based on his evidence it's established that natural infection / immunity (for those unlucky enough to have caught the virus e.g NHS staff)) will likely give them long lasting protection.

As far as I understand it, immunity is really complex and varied. Nobody (that I've seen) suggests that vaccines don't also generate memory B cells, for example.

The strongest immunity (that's known about so far) is seen from people who were infected in the first wave and have now been vaccinated. https://www.nature.com/articles/d41586-021-02795-x

Should we count prior infection for something? As I understand it that can happen in France, where infection followed by a single dose of vaccine is counted as full vaccination. Doesn't seem a crazy idea.

I think the worry about treating people who've recovered from infection the same as those who've been vaccinated is that the level of immune response can vary quite a bit. Even if you can be sure that the person actually was infected. It's a lot easier just to require vaccination, which is a great idea even if you were infected earlier.

 

[Bruce Stephens]

See on page 17 Figure 2a.

It shows a bar graph showing covid cases for those "vaccinated" against those "unvaccinated" in all age groups. This is the only thing I can find that indicates why the comment was made. What do you make if it? Seems to be indicating that there are double the number of covid cases in those vaccinated (per 100,000 people) either that, or it's completley wrong or an error?

People think it's an error. See the footnotes on Table 2 (Page 13). The problem is nobody knows what our population is. They know exactly how many people they plan to vaccinate (it's just the number of people registered) and of course how many have been vaccinated, but there's some unknown number who aren't registered.

 

[Bruce Stephens]

People think it's an error.

For example,

https://twitter.com/x/status/1451565485150068736

 

[Bruce Stephens]

where is his bar graph showing the real data?

Unfortunately there isn't really "real data" because the problem is we don't know the populations. Some of the replies to that tweet offer some replacement charts using ONS estimates rather than NIMS data, for example.

 

[Bruce Stephens]

So this basically leaves us where? In terms of official statements and data? pm saying about the vaccines "it doesn’t protect you against catching the disease, and it doesn’t protect you against passing it on"

The consensus view is that the vaccines do offer significant protection against both catching and passing on the infection. But not perfect protection.

 

[SueEK]

Irrespective of the differences of opinions above, as an NHS worker I believe we should all be fully vaccinated if we are able to be, some people cannot have the vaccine. Mixing with people who are poorly or vulnerable we should all do what we can to ensure we do not spread the virus. I am not a clinician but nevertheless come into contact with patients and it is our duty to do what we can to keep each other safe. This is just my personal opinion.

 

[Eddy Edson]

Unfortunately there isn't really "real data" because the problem is we don't know the populations. Some of the replies to that tweet offer some replacement charts using ONS estimates rather than NIMS data, for example.

And the FT piece from a couple of weeks ago: https://www.ft.com/content/125fbaf8-175a-4e2e-852a-9995ca5176b2

 

[trophywench]

Lies, damned lies and statistics ....

 

[mikeyB]

To attempt to get this thread back on track, let's get away from the anti-vaxxer arguments and look at at this topic dispassionately.

It is undoubtedly true that vaccinated folk who get Covid, even if it not seriously, can pass on the disease. Many NHS and careworker staff have died from Covid, but the infection rate has dropped as most health workers have been vaccinated. A vaccinated person picking up the disease or coming into close contact with the disease still has to self isolate, but where did the disease arise? Probably, like Kier Starmer, from a child.

With regard to NHS workers, they come into regular close close contact with diseased folk, but use protective clothing and masks. If they are vaccinated, they are extremely unlikely to get ill, and can carry on working. To me it seems that as the NHS is on its knees due to cuts since 2010, we would expect all NHS staff to be vaccinated to be able to carry on working. There are no spare doctors, nurses, porters, cleaners to pick up the slack. Notwithstanding Amity Islands contentions, the vaccines do work at protecting individuals, and society. As do face masks and social distancing, a fact tacitly acknowledged by Boris wearing a face mask in Parliament.

If only 5% of MHS staff aren't vaccinated, you can't depend on herd immunity, because each member of staff may deal with infected people, particularly in reception areas. So making vaccination compulsory seems seems sensible.

With regard to the veracity of Boris Johnson he has long been been known to be a liar,and indeed has been sacked from previous jobs for doing just that. It's a habit. Like he told kids recently that recycling was a waste of time.

And with regard to his performance during the early period of the pandemic, let's compare The UK with Brazil. President Bolsanoro, A Trump-like idiot, left the country wide open - no lockdowns, no social distancing, no masks. The death rate per 100,000 of the population is 286.51. A congressional inquiry into his mishandling of the crisis has concluded he should be charged with crimes against humanity. What is the equivalent death rate in the UK? 208.82 per 100,000. Higher than any country in Europe. I wonder why Boris wants an inquiry next year...

France is still compelling mask wearing in all public places and gatherings, as is social distancing. Has done for months, the people don't object. And their infection rate is far, far lower than in the UK. (I was the only person wearing a mask at the football last week, though only in the refreshment room. There was nobody within 3m of me outside.)

And finally, on the general subject of compulsory vaccination, you cannot enter many tropical countries without a Yellow Fever vaccination certificate. If you haven't got one, you get put on the plane back. People do that without question. For sure, you won't get in by arguing about efficacy. What is the difference? In the NHS, Surgeons are vaccinated against Hepatitis, because they operate on anybody who needs it. And protecting subsequent patients.

It's all about safety, protecting patients and the general public. And the continuing work of NHS England.

 

[nonethewiser]

Irrespective of the differences of opinions above, as an NHS worker I believe we should all be fully vaccinated if we are able to be, some people cannot have the vaccine. Mixing with people who are poorly or vulnerable we should all do what we can to ensure we do not spread the virus. I am not a clinician but nevertheless come into contact with patients and it is our duty to do what we can to keep each other safe. This is just my personal opinion.

Good personal opinion to have.