References

Ahmed W, Vidal-Alaball J, Downing J, López Seguí F. COVID-19 and the 5G conspiracy theory: social network analysis of Twitter data. Journal of Medical Internet Research. 2020; 22:(5) https://doi.org/10.2196/19458

Measuring the four principles of Beauchamp and Childress. 2012. https://tinyurl.com/y5afa6j3 (accessed 13 January 2021)

Amnesty International UK. UK among highest COVID-19 health worker deaths in the world. 2020a. https://tinyurl.com/y4psd4k6 (accessed 13 January 2021)

Amnesty International UK. More than 7,000 health worker deaths from COVID-19 globally - UK deaths third-highest. 2020b. https://www.amnesty.org.uk/press-releases/more-7000-health-worker-deaths-covid-19-globally-uk-deaths-third-highest (accessed 13 January 2021)

Anderson RM, Hollingsworth TD, Baggaley RF, Maddren R, Vegvari C. COVID-19 spread in the UK: the end of the beginning?. Lancet. 2020; 396:(10251)587-590 https://doi.org/10.1016/S0140-6736(20)31689-5

Avery G. An introduction to healthcare ethics, 2nd edn. London: SAGE Publications; 2017

Aziz AM. The case for flu vaccination for health professionals. Br J Nurs. 2014; 23:(2) https://doi.org/10.12968/bjon.2014.23.2.74

Baden LR, Sahly H, Essink B Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020; 383:(27)2603-2615 https://doi.org/10.1056/NEJMoa2034577

BBC News. Coronavirus: chancellor Rishi Sunak warns of ‘significant recession’. 2020a. https://www.bbc.co.uk/news/business-52641807 (accessed 13 January 2021)

BBC News. Coronavirus: greatest test since world war two, says UN chief. 2020b. https://www.bbc.co.uk/news/world-52114829 (accessed 13 January 2021)

BBC News. Coronavirus: sending untested patients to care homes ‘reckless’—MPs. 2020c. https://www.bbc.co.uk/news/uk-politics-53574265 (accessed 13 January 2021)

Beauchamp TL, Childress JF. Principles of biomedical ethics.Oxford: Oxford University Press; 2009

Behrman A, Offley W. Should the influenza vaccine be mandatory for healthcare workers?. BMJ. 2013; 347 https://doi.org/10.1136/bmj.f6705

Benecke O, DeYoung SE. Anti-vaccine decision-making and measles resurgence in the United States. Glob Pediatr Health. 2019; 6 https://doi.org/10.1177/2333794X19862949

Blackmore NCV. Flu vaccination: an opt-out system for healthcare workers. BMJ. 2018; 360 https://doi.org/10.1136/bmj.k1143

Bowen RAR. Ethical and organizational considerations for mandatory COVID-19 vaccination of health care workers: a clinical laboratorian's perspective. Clin Chim Acta. 2020; 510:421-422 https://doi.org/10.1016/j.cca.2020.08.003

Callaway E. The race for coronavirus vaccines: a graphical guide. Nature. 2020; 580:(7805)576-577 https://doi.org/10.1038/d41586-020-01221-y

Just 50% of Americans plan to get a COVID-19 vaccine. Here's how to win over the rest. 2020. https://tinyurl.com/ybangbqv (accessed 13 January 2021)

Covid vaccine: NHS must be ready to deploy from early December, Matt Hancock says. 2020. https://tinyurl.com/y4527gr7

Cullen P. Covid-19: booster doses may be needed for vaccine, Nphet told.: Irish Times; 2020

Demicheli V, Jefferson T, Ferroni E, Rivetti A, Di Pietrantonj C. Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev. 2018; 2:(2) https://doi.org/10.1002/14651858.CD001269.pub6

Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020; 20:(5)533-534 https://doi.org/10.1016/S1473-3099(20)30120-1

Fadda M, Albanese E, Suggs LS. When a COVID-19 vaccine is ready, will we all be ready for it?. Int J Public Health. 2020; 65:(6)711-712 https://doi.org/10.1007/s00038-020-01404-4

Covid-19: Oxford-AstraZeneca vaccine approved for use in UK. 2020. https://www.bbc.co.uk/news/health-55280671 (accessed 13 January 2021)

Gilroy R. The anti-vaccination movement: a concern for public health. Practice Nursing. 2019; 30:(5)248-249 https://doi.org/10.12968/pnur.2019.30.5.248

Graham BS. Rapid COVID-19 vaccine development. Science. 2020; 368:(6494)945-946 https://doi.org/10.1126/science.abb8923

Isaacs D. Vaccine hesitancy and anti-vaccination movements. J Paediatr Child Health. 2019; 55:(11)1293-1294 https://doi.org/10.1111/jpc.14581

Jahn WT. The 4 basic ethical principles that apply to forensic activities are respect for autonomy, beneficence, nonmaleficence, and justice. J Chiropr Med. 2011; 10:(3)225-6 https://doi.org/10.1016/j.jcm.2011.08.004

John Hopkins University of Medicine. COVID-19 dashboard by the Center for Systems Science and Engineering (CSSE). 2021. https://coronavirus.jhu.edu/map.html (accessed 13 January 2021)

Joint Formulary Committee. Influenza vaccine. Side effects. British National Formulary (online). 2020. https://bnf.nice.org.uk/drug/influenza-vaccine.html#sideEffects (accessed 13 January 2021)

Jones-Berry S. Compulsory flu jab for staff—is it a moral duty, or a morale wrecker?. Nursing Standard. 2018; 33:(3)8-10 https://doi.org/10.7748/ns.33.3.8.s5

Kinsinger FS. Beneficence and the professional's moral imperative. J Chiropr Humanit. 2009; 16:(1)44-46 https://doi.org/10.1016/j.echu.2010.02.006

Lamb D. Therapy abatement, autonomy and futility.Aldershot: Avebury; 1995

Coronavirus: deaths of hundreds of frontline NHS and care workers to be investigated. 2020. https://tinyurl.com/y4htw8j3 (accessed 13 January 2021)

MacDonald NE Vaccine hesitancy: definition, scope and determinants. Vaccine. 2015; 33:(34)4161-4 https://doi.org/10.1016/j.vaccine.2015.04.036

Mahase E. Covid-19: vaccine candidate may be more than 90% effective, interim results indicate. BMJ. 2020; 371 https://doi.org/10.1136/bmj.m4347

National Institute for Health and Care Excellence. Flu vaccination: increasing uptake. NICE guideline NG103. 2018a. https://www.nice.org.uk/guidance/ng103 (accessed 13 January 2021)

National Institute for Health and Care Excellence. Flu vaccination: increasing uptake. NICE guideline NG103. The committee's discussion. 2018b. https://tinyurl.com/yxnldr4c (accessed 13 January 2021)

National Institute for Health and Care Excellence. Coronavirus—Covid 19: background information. 2020. https://cks.nice.org.uk/coronavirus-covid-19#!background (accessed 13 January 2021)

NHS website. Ruling on doctor in MMR scare. 2010. https://tinyurl.com/y6tjjk6y (accessed 14 January 2021)

NHS website. Symptoms of coronavirus. 2021. https://tinyurl.com/yamja5m8 (accessed 13 January 2021)

Noddings N. Caring.Los Angeles (CA): University of California Press; 1982

Nordhaug M, Nortvedt P. Justice and proximity: problems for an ethics of care. Health Care Anal. 2011; 19:(1)3-14 https://doi.org/10.1007/s10728-010-0159-3

Nursing and Midwifery Council. The code. Professional standards of practice and behaviour for nurses, midwives and nursing associates. 2018. https://tinyurl.com/zy7syuo (accessed 13 January 2021)

Nursing and Midwifery Council. Suspension orders. 2020. https://tinyurl.com/y2gh2u6r (accessed 13 January 2021)

Page K. The four principles: can they be measured and do they predict ethical decision making?. BMC Med Ethics. 2012; 13 https://doi.org/10.1186/1472-6939-13-10

Polack FP, Thomas SJ, Kitchin N Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020; 383:(27)2603-2615 https://doi.org/10.1056/NEJMoa2034577

Public Health England. Seasonal flu vaccine uptake in healthcare workers: monthly data, 2019 to 2020. 2020. https://www.gov.uk/government/statistics/seasonal-flu-vaccine-uptake-in-healthcare-workers-monthly-data-2019-to-2020 (accessed on 19 January 2021)

Public Health England. Coronavirus (COVID-19) in the UK. Cases. Deaths. 2021. https://coronavirus.data.gov.uk/ (accessed 13 January 2021)

Royal Pharmaceutical Society, Royal College of Nursing. Professional guidance on the administration of medication in a healthcare setting. 2019. https://tinyurl.com/y5y7mzsx (accessed 13 January 2021)

Care ethics. Internet Encyclopedia of Philosophy. 2012. https://iep.utm.edu/care-eth/#SH1b (accessed 13 January 2021)

Sarre S, Maben J, Aldus C The challenges of training, support and assessment of healthcare support workers: a qualitative study of experiences in three English acute hospitals. Int J Nurs Stud. 2018; 79:145-153 https://doi.org/10.1016/j.ijnurstu.2017.11.010

Skår R. The meaning of autonomy in nursing practice. J Clin Nurs. 2010; 19:(15-16)2226-2234 https://doi.org/10.1111/j.1365-2702.2009.02804.x

How I talk to the victims of conspiracy theories. 2020. https://www.bbc.co.uk/news/blogs-trending-54738471 (accessed 13 January 2021)

Sullivan SM, Pierrynowski-Gallant D, Chambers L Influenza vaccination and decisional conflict among regulated and unregulated direct nursing care providers in long-term-care homes. AAOHN J. 2008; 56:(2)77-84 https://doi.org/10.1177/216507990805600204

Thompson J, Thompson H. Bioethical decision making for nurses.East Norwalk (CT): Appleton-Century-Crofts; 1985

Voysey M, Costa Clemens SA, Madhi SA Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2021; 397:(10269)99-111 https://doi.org/10.1016/S0140-6736(20)32661-1

Wadman M. Antivaccine forces gaining online. Science. 2020; 368:(6492) https://doi.org/10.1126/science.368.6492.699

Walker T. What principlism misses. J Med Ethics. 2009; 35:(4)229-233 https://doi.org/10.1136/jme.2008.027227

Welsh L. Ethical issues and accountability in pressure ulcer prevention. Nurs Stand. 2014; 29:(8)56-63 https://doi.org/10.7748/ns.29.8.56.e9262

World Health Organization. The guide to tailoring immunization programmes (TIP). 2013. https://tinyurl.com/y33yxrek (accessed 13 January 2021)

World Health Organization. Influenza. 2019. https://www.who.int/biologicals/vaccines/influenza/en/ (accessed 13 January 2021)

World Health Organization. Transmission of SARS-CoV-2: implications for infection prevention precautions. 2020. https://tinyurl.com/y7hkuanl (accessed on 19 January 2021)

YouGov. Would you be willing to have a COVID-19 vaccine when they become available?. 2020. https://tinyurl.com/y5bmowzk (accessed 13 January 2021)

Should the SARS-CoV-2 vaccine be mandatory for nurses? An ethical debate

28 January 2021

Professional

02 January 2021

Volume 30 · Issue 2

ISSN (print): 0966-0461

ISSN (online): 2052-2819

Abstract

The COVID-19 pandemic has had a devastating impact on the UK, as well as many other countries around the world, affecting all aspects of society. Nurses and other health and care professionals are a group particularly exposed to the virus through their work. Evidence suggests that vaccines form the most promising strategy for fighting this pandemic. Should vaccination against be mandatory for nurses and other health professionals? This article explores this question using an ethical framework.

This article explores the ethical question of whether it should be mandatory for nurses and other health professionals and social care workers to receive the vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and why this is a nursing issue. The term healthcare worker is used throughout to mean anyone who has close contact with patients, be they nurses, doctors, other health professionals, staff such as porters, administrative and catering workers in hospital, health and care staff who work in the community, and all those who work in care homes. The ethical debate will be constructed using the framework provided by Beauchamp and Childress (2009). The article aims to reach a conclusion on whether mandatory vaccination is ethical, and should be implemented in all healthcare settings.

COVID-19 is now at the forefront of everyday life in the UK, and practices such as social distancing, support bubbles, shielding and wearing face masks have become the norm. The pandemic has severely impacted many aspects of society such as health care, social care, education, hospitality, retail, leisure and tourism, not just within the UK, but worldwide. UK Chancellor Rishi Sunak has stated that the country will face a significant recession as a result of COVID-19 (BBC News, 2020a) and UN Secretary General António Guterres has warned that SARS-CoV-2 is the biggest challenge for the world since the Second World War (BBC News, 2020b).

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Coronavirus

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Vaccination ethics