Covid-Vaccination scrapped for NHS Staff: How did we get here?
Fever, chills and sniffles, autumn has been one long respiratory illness for one GP who asks 'Why are NHS staff no longer eligible for the covid vaccination?"
As I sip on the coffee I can’t taste again this morning I realise I’ve had back to back respiratory illnesses since September. Perks of the job. As all GPs know, flu season is well and truly upon us. I’m pretty sure I’ve achieved the trifecta of flu, covid and the common cold, contracted from patients enthusiastically demonstrating their coughs to me, as they seek relief from the same misery.
And what is the best relief we can offer as GPs? (other than excluding serious illness, then signposting to over-the-counter symptom control measures) – I’d argue the best relief we can give is providing prevention advice via vaccination, mask use and improving indoor air quality.
We know that both flu and covid-19 can lead to serious illness in vulnerable groups, with thousands of hospitalisations each winter – last winter there were around 8000 deaths associated with flu. Getting vaccinated has a significant impact on reducing the severity of illness (it may not stop you catching it, but it shouldn’t be as severe). Flu vaccination for frontline NHS staff is still considered a national priority for NHS leaders. Seeing colleagues taken out of action with illness already, is there a reason that the NHS is no longer offering Covid boosters to its own staff this winter?
Evolution of Covid vaccines for NHS workers
Cast your mind back to the end of 2020, when the covid-19 vaccine was first rolled out - urgent protection of frontline health workers was a top priority. Pre-vaccination - hundreds of NHS staff died from covid-19, and many, many more were struck down with long-covid.
By spring 2021 nearly all NHS staff had received a first dose, and many also got boosters in 2021–22. This campaign helped break transmission, and seemed so crucial, that in the same year, mandates for staff vaccination were contemplated (then reversed). By 2023, with most people vaccinated or previously infected, the calculus changed. The government shifted to “autumn booster” campaigns for the elderly and clinically vulnerable, gradually dropping younger age groups and eventually for the first time this year - frontline workers.
The Joint Committee on Vaccination and Immunisation’s (JCVI) guidance this season, assumes that the NHS workforce already has decent protection against covid-19. For most people, covid-19 is now a relatively mild disease, with rates of hospitalisation and death now significantly reduced. Instead of a mass staff booster campaign (which they feel will not reduce staff absences), their focus is concentrating resources on the frail and immunosuppressed – those who are at highest risk of serious disease.
Staff sickness and the value of vaccination
Even if most NHS staff have some immunity from past infection or vaccination this doesn’t equate to zero illness. Seasonal respiratory viruses can still knock people out of work. Multiple studies (mostly about flu vaccines) show that vaccinating health workers reduces sick days. Stephen Griffin, professor of cancer virology at the University of Leeds told the BMJ last month that vaccinating healthcare workers against both SARS-CoV2 (covid) and influenza “is an absolute no brainer.” saying:
“We can ill afford unnecessary staff absences either over the short or longer term. Failing to maintain population immunity in the face of a fast evolving virus is well understood for influenza, so I cannot understand why this does not apply to [covid-19]. It is critical to recognise that vaccines also protect against long covid and other latent sequelae which continue to blight keyworker occupations and the public in general.”
What can we do?
We have very short memories when it comes to the Covid pandemic - we don’t want to remember, and understandably so. But when it comes to minimising the damage of new covid waves, and indeed any new diseases that come along in the future, we need to look at what did make a difference and implement that within our organisations:
Vaccination – for those who can afford it – covid-19 vaccinations are available privately for around £99. Seasoned campaigner Samantha Wathen, submitted a parliamentary petition at the start of October, calling for the covid-19 vaccine to be available to NHS staff. The petition has not yet been approved by the government. DAUK will share this when available if you wish to add your signature.
Mask wearing – The Independent Sage has shown that good quality masks work (when worn correctly and consistently) reduce transmission of respiratory diseases, and we should be normalising their wearing within hospitals and health care settings.
Ventilation - Evidence shows that increasing ventilation to clean indoor air reduces airborne contaminants.Optimising air quality and ventilation within healthcare settings should be a priority.
Sick Leave – Take the time off. We are terrible as medics – and as a society for encouraging presenteeism. Working when sick is bad for our own health and risks the health of others.
I’ve taken 1 day off during this bout of illness – and that was because I couldn’t speak. Perhaps if I’d taken more time, I would’ve felt better quicker. I missed the staff flu jab clinic at work, as my clinic overran, and I haven’t been wearing a mask when patients cough all over me. I’m clearly a terrible patient and need to start taking my own advice. Book the vaccines in and arm myself with a mask and some kleenex– there’s still a long winter ahead of us. Stay Safe!