A spoonful of honey or a gallon of vinegar? A conditional COVID-19 vaccination policy for frontline healthcare workers

Journal article

Seven COVID-19 vaccines are now being distributed and administered around the world, with more on the horizon. It is widely accepted that healthcare workers should have high priority. However, questions have been raised about what we ought to do if members of priority groups refuse vaccination. Using the case of influenza vaccination as a comparison, we know that coercive approaches to vaccination uptake effectively increase vaccination rates among healthcare workers and reduce patient morbidity if properly implemented. Using the principle of least restrictive alternative, we have developed an intervention ladder for COVID-19 policies vaccination among healthcare workers. We argue that healthcare workers refusing vaccination without a medical reason should be temporarily redeployed and, if their refusal persists after the redeployment period, eventually suspended, in order to reduce the risk to their colleagues and patients. This “conditional” policy is a compromise between entirely voluntary or entirely mandatory policies for healthcare workers, and is consistent with healthcare workers’ established professional, legal and ethical obligations to their patients and to society at large.

Authors: Bradfield, O; Giubilini, A

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: BMJ Publishing Group
• Journal: Journal of Medical Ethics
• Volume: 47
• Issue: 7
• Pages: 467-472
• Publication date: 2021-05-11
• Acceptance date: 2021-03-30
• DOI: 10.1136/medethics-2020-107175
• EISSN: 1473-4257
• ISSN: 0306-6800
• Language: English
• Keywords: FFR