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Vaccination is a medical procedure that irrevocably alters the patient's body. The ethical considerations of mandating medical procedures have been discussed in this journal in 2009 during the swine flu pandemic. (1) Then and now justification of vaccinism was to reduce spread, however there is a considerable conflict of interest in the reduction of absenteeism and therefore staff cost, which applies even more now with self-quarantine. Should the beneficiaries of the potential staff cost savings be the decision makers relating to mandating medical procedures? If a vaccine is mandated would it be ethical to offer one that has negligible protection against known variants, like AZ ((AZD1222)) on the SA (B.1.351) variant? (2) Would it be ethical to deploy staff to carry out medical procedures under coercion? (3)
Of all vaccines I have had, including yellow fever, hepatitis, BCG, influenza, and swine flu, none have given me the side effects of the AZ vaccine and booster lasting 6 and 2 weeks respectively. Just like my serum was accepted to prove my childhood diseases of measles, mumps, rubella, varicella and my antibody titers to hepatitis* not requiring further boosters I would expect not to be mandated to expose myself to further side effects unnecessarily.
* Requirement of PCSE for entry on the performers list for GPs to be cleared for exposure prone procedures "where the worker’s gloved hands may be in contact with sharp instruments, needle tips or sharp tissues inside a patient’s open body cavity, wound or confined anatomical space, where the hands or fingertips may not be completely visible at all times", presumably for the next wave of hospital work to be transferred to primary care as current guidelines do not list GPs as such. (4)
(3) 69. Many factors influence patients’ decision making, but it’s important that nothing influences a patient to such an extent that they can’t exercise free will. If a patient can’t make a decision freely, they won’t be able to consent. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/dec...
Coercion for care home staff and could extend to NHS
Dear Editor
Vaccination is a medical procedure that irrevocably alters the patient's body. The ethical considerations of mandating medical procedures have been discussed in this journal in 2009 during the swine flu pandemic. (1) Then and now justification of vaccinism was to reduce spread, however there is a considerable conflict of interest in the reduction of absenteeism and therefore staff cost, which applies even more now with self-quarantine. Should the beneficiaries of the potential staff cost savings be the decision makers relating to mandating medical procedures? If a vaccine is mandated would it be ethical to offer one that has negligible protection against known variants, like AZ ((AZD1222)) on the SA (B.1.351) variant? (2) Would it be ethical to deploy staff to carry out medical procedures under coercion? (3)
Of all vaccines I have had, including yellow fever, hepatitis, BCG, influenza, and swine flu, none have given me the side effects of the AZ vaccine and booster lasting 6 and 2 weeks respectively. Just like my serum was accepted to prove my childhood diseases of measles, mumps, rubella, varicella and my antibody titers to hepatitis* not requiring further boosters I would expect not to be mandated to expose myself to further side effects unnecessarily.
* Requirement of PCSE for entry on the performers list for GPs to be cleared for exposure prone procedures "where the worker’s gloved hands may be in contact with sharp instruments, needle tips or sharp tissues inside a patient’s open body cavity, wound or confined anatomical space, where the hands or fingertips may not be completely visible at all times", presumably for the next wave of hospital work to be transferred to primary care as current guidelines do not list GPs as such. (4)
(1) Jordan R, Hayward A. Should healthcare workers have the swine flu vaccine? https://www.bmj.com/content/339/bmj.b3398
(2) https://www.nejm.org/doi/full/10.1056/nejmoa2102214
(3) 69. Many factors influence patients’ decision making, but it’s important that nothing influences a patient to such an extent that they can’t exercise free will. If a patient can’t make a decision freely, they won’t be able to consent. https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/dec...
(4) https://assets.publishing.service.gov.uk/government/uploads/system/uploa...
Competing interests: No competing interests