Compulsory Vaccination: Context and Ethical Guidance - BASW UK statement 

  • Date of adoption: 27 October 2021
  • Review date: By 31 October 2022
  • Statement owner: Policy Ethics and Human Rights Committee

Context 

The government in Westminster has adopted a policy of requiring workers in care homes in England to be double vaccinated. This includes a timetable by which workers in care homes must be vaccinated. Care workers who are not double vaccinated will be no longer be able to work in residential homes. 

The government in Westminster has also recently announced its intention to consult on all health and social care staff (which would include social workers) being required to be double vaccinated. However, the Secretary of State for Health has already informed the Commons that he anticipates that double vaccination will become a requirement.

While this is the current situation in England, it seems quite possible that one, or both, of these possibilities is also floated by government in Scotland, Northern Ireland or Wales.

This is because all four governments of the UK have vigorously promoted vaccination to break the cycle of rising infection, rising death rates, lockdown and then a repeat of this cycle.

There are real challenges in requiring vaccination for such large staff groups. Existing recruitment shortfalls may be made worse. This may arise because some people are still concerned about vaccine safety. But it may also arise directly from workers’ anger at vaccination no longer being a choice and being made a requirement of their employment. Workers in the health and social care sector have experienced greatly increased workloads and significant trauma due to Covid. Many are already contemplating leaving the sector and the introduction of compulsory vaccination may accelerate this process.  

It is also possible that the government in Westminster drops the proposal requiring all health and social care staff to be vaccinated. 

Nevertheless, given the strong possibility of required vaccination for social care staff, including social workers, it is appropriate to issue a statement for England, Scotland, Northern Ireland and Wales.      

Implications 

Under current legislation, to make a substantive change to an existing permanent contract of employment without the employee’s express consent is a breach of employment law. This would include any obligation by the employer to require an employee to be vaccinated.

Agency workers do not have permanent contracts of employment. Agency contracts can be changed or terminated at short notice. Agency workers who are not vaccinated, and plan not to be vaccinated, may therefore be vulnerable, if their employer opts to require vaccination for employment. 

Social workers who are not vaccinated, and plan not to be vaccinated, may wish to seek redeployment with their employer. If this is available, it should not be assumed that any redeployment offer would reflect the preference of the employee.

The reality of staff turnover allows employers to place new employees on a different contract to existing employers so it is possible that new recruits may be required to demonstrate double vaccination even if existing employees do not.

However, it is possible that the government in Westminster changes the law, with the effect of overriding existing employment law. Normally, the legislative process can take up to two years, but the current government is putting legislation through at speed, sometimes in a matter of days.

If vaccination becomes a requirement, there are as yet no clear rules about who is entitled to exemption. It seems likely that any exemption will refer to medical exemption (for example, a life-threatening allergic reaction) rather than exemption on any other grounds (for example, personal choice about vaccination), and that any exemption will have to be medically certified. 

Ethical Guidance

At the time of writing Covid has caused the death of over 134,000 individuals across the UK.

Many others have had significant stays in hospital and/or been subject to many weeks or months of de-habilitating illness – ‘Long Covid’.

While vaccination is no absolute guarantee of freedom from infection or serious illness or death various vaccines in use have been shown to have high rates of effectiveness against Covid.

Therefore, the benefits of having the vaccination greatly outweigh the risks.

BASW has consistently encouraged the take-up of vaccination whilst supporting the principle of individual responsibility and acknowledging the concerns over the vaccine in some sections of the population. [1]

Over the last year, a growing body of evidence has added weight to the effectiveness of the vaccine generally, and as a result it has been extended to other groups within society (for example, pregnant women) who were not initially included. 

As the professional association for social work and social workers, BASW’s first priority is the health and safety of social workers.

BASW therefore calls for all social workers to take the vaccination, if they have not already done so and are able to do so.

All four of the governments in the UK, which have very different political complexions, have vigorously promoted vaccination as a way of breaking out of the cycle of rising infection rates, rising death rates and lockdown. Lockdown is profoundly damaging to the economy, the education and development of children and young people and many people’s mental health. Already vulnerable groups (for example, those subjected to domestic violence) have faced worsening circumstances.

The BASW Code of Ethics states that social workers ‘should work towards promoting the best interests of individuals and groups in society and the avoidance of harm’ (p. 6). In this light being vaccinated not only protects one’s own health it is a contribution to the overall wellbeing of society. 

Vaccine take-up varies within the population. This may be for economic reasons (lower-paid workers may not be released to attend vaccination appointments), cultural reasons, or other reasons. Further, there is limited evidence that compulsory vaccination is the best way forward. Any variations in vaccination take-up are best addressed by improved information and communication.

The BASW Code of Ethics states that ‘social workers should respect, promote and support people’s dignity and rights to make their own choices and decisions’ (p. 6) BASW is therefore opposed to the use of coercion, including through employment contracts, for individuals who have decided not to be vaccinated. 

BASW therefore opposes making vaccination compulsory. BASW advocates for better education and improved persuasion on the benefits of vaccination and continuing safeguarding practices against Covid. 

BASW will continue to advocate for social workers to have access to PPE and other means of Covid risk reduction.

If there is to be required vaccination, there must be clarity over who is exempt, and a process set in place for rapid, robust assessment for exemption that is independent of employers. BASW members have already expressed concerns about the lack of clarity over the exemption process in England for professional visitors to care homes. These concerns must be addressed if other staff groups are required to be vaccinated.

BASW will keep this policy under review particularly if new, or more damaging variants of Covid emerge.

In line with the BASW Code of Ethics which states that ‘social workers should respect, promote and support people’s dignity and rights to make their own choices and decisions’ (p. 6) BASW will support any member in an employment setting who is not and does not wish to be vaccinated. However, advocacy for individuals works within the constraints of existing law, and depending on individual’s contracts, existing legal protections may not be sufficient or, as set out above, may be over-ridden.

[1] https://www.basw.co.uk/media/news/2021/jan/covid-19-and-vaccination-basw...