Mandatory Covid-19 vaccination of healthcare workers considered by Nphet

Mandatory Covid-19 vaccination of healthcare workers is being considered by public health officials as a response to high infection levels.

The issue was raised at a meeting of the National Public Health Emergency Team (Nphet) earlier this month, which agreed to examine “relevant ethical, legal and practical issues before any action is considered”.

The Department of Health is to prepare an evidence paper on the topic to be discussed at a future meeting, according to minutes of Nphet's meeting on November 11th.

Up to now, the practice has been to remove an unvaccinated healthcare worker from frontline duties, based on an individual risk assessment. However, other countries, including France, have introduced mandatory vaccination for health staff.

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The meeting discussed communicating the “path to endemicity” of Covid-19 and the role of boosters in this to the public.

“Such messaging could explain that, while it is likely that many people may become infected with SARS-CoV-2 at some point in future, it is vital that as many people as possible are vaccinated and given booster doses where appropriate as quickly as possible.”

“If the situation does not improve, limits on capacity and other restrictions may need to be contemplated in certain sectors,” officials were told.

Members queried where there is a possible correlation between the numbers of vulnerable people presenting to hospital and the primary vaccine received.

"It was noted that the National Immunisation Advisory Committee is considering this matter in the context of the booster vaccination programme with a view to bolstering protection for the most vulnerable."

They also queried whether “more proactive measures” could be taken in hospitals to reduce spread.

It was suggested booster vaccines could be given on admission, and whether the HSE should consider testing all admission to healthcare settings for the virus.

Nphet chairman and chief medical officer Dr Tony Holohan emphasised that when the force of infection is so strong, as it is at present, it is “not reasonable” to assume that our healthcare system can cope by increasing capacity or scaling up testing and tracing.

“There are many layers to our response to Covid-19. The front line of defence must remain the public’s continued adherence to basic public health measures.”

While work is underway to increase the current 300 critical care beds to the target of 321, “this work is challenging,” according to the minutes.

Increased numbers of Covid-19 presentations to hospital and ICU from vulnerable groups and pregnant women who are unvaccinated was “noted with concern”.

An Irish Nurses and Midwives Organisation spokesperson said “the overwhelming majority of healthcare workers” had received their first and second vaccination, and the booster programme which it had campaigned for continues.

On ventilation measures, it said: “Many of our hospitals have issues with air quality and ventilation, this is something that the INMO has raised with both the HSE and the Health and Safety Authority. Hospitals are not just care settings, they are places of work. Our nurses and midwives need every measure available to protect them from Covid and its emerging variants, including proper ventilation.”

The union added it was supportive of the Workplace Ventilation Bill 2021, which was being tabled in the Oireachtas on Wednesday.

Fórsa responded to the news of Nphet’s deliberations, saying no proposals for a mandatory system of vaccination had been proposed to, or discussed with, the union.