As vaccine hesitancy continues to be a challenge for many home health agencies, some medical ethicists say getting a COVID-19 shot should be a condition of employment.
In the Journal of Medical Ethics, ethicists argue the ramifications for not getting vaccinated and the seriousness of COVID-19 justify making the vaccine mandatory for staff working directly with patients.
The idea is being floated in the United Kingdom where a public debate is under way on whether to require all older adult home care providers to get vaccinated as a condition of employment.
The authors of the article said coercive approaches to seasonal flu vaccinations, when properly implemented, have increased the uptake of those vaccines among healthcare workers and have reduced illness among patients.
At the same time, the authors concede overly coercive regulation could undermine goodwill between frontline healthcare staff and their employers. It could also promote resentment, opposition and mistrust, especially if workers are already experiencing higher rates of depression, anxiety and burn-out from the pandemic.
U.S. home healthcare agencies have told McKnight’s Home Care Daily in recent weeks that between 75% and 85% of their workers have been vaccinated, while the rest still haven’t gotten shots or refuse to get them.
The leader of a major home care provider group has stopped short of calling for an industrywide vaccination requirement.
“The issues involved with mandatory vaccines are very complicated, including a variety of legal issues. While we have encouraged staff vaccinations, it is up to the individual company on how it handles the matter,” National Association for Home Care & Hospice President William Dombi told McKnight’s Home Care Daily.
The authors of the Journal of Medical Ethics report designed a COVID-19 intervention ladder for healthcare workers. Less coercive actions include educational programs on the vaccines and opt-out policies which redeploy unvaccinated staff to jobs that don’t put them in contact with patients. More coercive actions include suspension, termination of employment and possible suspension of professional licenses.