Unvaccinated health staff are irresponsible but it’s our failure if we can’t reach them
On Monday, Sajid Javid axed plans to require health and care staff to have had a Covid-19 vaccine. In the context of an incredibly fragile NHS workforce, already groaning under the weight of staff shortages, emotional strain and self-isolation requirements, this was sensible. But by invoking a sense of “proportion” as rationale for removing the mandate, the Health Secretary risked downplaying the scale of the threat the unvaccinated pose to our health system.
It is deeply irresponsible for anyone working in a healthcare setting to refuse a vaccine; even against a less severe variant in the form of Omicron, an unvaccinated person is 7.1 times more likely to be admitted to ICU. Widespread vaccination is essential to severing the link between cases and hospitalizations, and in turn reducing the now six million strong NHS waiting list.
Getting the unvaccinated vaccinated should be the top public health objective. In a unique study of the motivations behind those reticent to get the jab, we spoke with 1,500 people about the vaccine rollout, of which 650 had refused the inoculation. This was just a representative sample of a wider problem; currently, there are 550,000 people over the age of 50 who are unvaccinated. This group poses the greatest risk to the NHS.
The unvaccinated over-50s aren’t fundamentalist antivaxxers. Three quarters have been vaccinated before and aren’t opposed in principle. For a fifth the only real barriers were practical ones. In a pandemic where low-hanging fruit has been scarce, this can be harvested immediately by offering free transport to vaccine sites and mobile clinics, along with paid time off for appointments. Some places, like Birmingham, have already offered free taxi services to anyone struggling to get to a vaccine appointment. This should be easily accessible, nationwide.
For the remainder things get trickier. They’re scared and louder voices drown out the facts that vaccines are both safe and effective. Compared to younger cohorts, those over 50 feel there “are too many unknowns” and are more worried about side effects. In the early stages of the vaccine rollout, several European leaders lost their heads over the Astrazeneca jab, causing unnecessary alarm which took hold of people long after we understood the true proportion of the risk.
There needs to be a message of reassurance as well as a campaign to show the importance of the vaccine even after Covid-19 infection. A quarter of unvaccinated over-50s believe this negates the need for a vaccine, seemingly unaware that three to six months after infection, they are five times more likely to test positive for the virus than vaccinated adults.
The vaccine rollout has been incredibly successful. But in order to convince those still reluctant, it needs to be tailored specifically to their most pressing concerns.
The right message needs the right messenger. Friends and family are the most trusted and influential in an unvaccinated person’s life and want them to get vaccinated. Many of our respondents were in the minority when it came to jab status among their loved ones. The government should establish a friends and family hotline, helping them to help those closest to them by arming them with facts and providing practical support to book appointments.
It will come as little surprise that the least trusted messenger right now, according to the polling, is the Prime Minister himself. This needs to be a concerted effort led from Westminster, but it needs to reach to a hyper-local level. Our enduring economic and social recovery is threatened by the unvaccinated population and the risk they pose to a health service struggling to keep its head above water.