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Do doctors have to have the covid-19 vaccine?

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n810 (Published 29 March 2021) Cite this as: BMJ 2021;372:n810

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Covid-19: Is the UK heading towards mandatory vaccination of healthcare workers?

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Re: Do doctors have to have the covid-19 vaccine? Yes

Dear Editor

I read with interest the views of the experts. I agree with Rob Henry and the quoted sections of the GMC’s Good Medical Practice, which are pretty unambiguous in stating that we should be vaccinated against common communicable diseases. As a profession, we have long accepted mandatory screening, testing, prophylaxis and treatment for other infectious diseases. All doctors in the UK are required to provide an immunisation record (including BCG, MMR and Hepatitis B vaccinations) as part of occupational health screening. There is clear guidance that failure to produce this evidence and/or vaccine refusal results in further investigation and restrictions being placed on a doctor’s practice. This principle may be extended to medical interventions other than vaccination; a doctor who is HIV seropositive must consent to blood tests to check their viral load. It is mandatory that these individuals are on effective combination antiretroviral therapy. Failure to meet these requirements results in restrictions being placed on the doctor’s practice.

While Covid-19 differs from the aforementioned infections, the fundamental principle remains that this is a highly communicable disease and there is a risk that an infected healthcare worker might transmit the infection to vulnerable patients who may then come to significant harm. There is increasing evidence that the available vaccines reduce person-to-person transmission as well as protecting the vaccinated individual. Are those health professionals who are refusing this fairly low risk, low-burden intervention, failing our patients? Some invoke their rights and freedom to choose but this fails to appreciate that a rights-based ethical theory must still strike a balance between the interests of the individual and the wider public interest. Furthermore, our professional rights come with responsibilities too; when we entered the profession, we made an informed choice that we would follow a code of conduct that includes protecting the vulnerable.

This discussion does though raise challenging questions around how personal choices may influence overall trust in the profession. It also explores the issues of probity and liability – is there a duty to disclose vaccination status to our regulators, employers and patients? The answers to these questions will have a significant impact on the future doctor-patient relationship and the debate will likely outlast the pandemic.

Competing interests: No competing interests

10 April 2021
Bhaskar Narayan
ST7 Intensive Care and Acute Medicine
Leila Asfour
Manchester
Manchester