Guidance for responding to the Government’s consultation on mandatory vaccines for the health and care sector

Big Brother Watch Team / October 22, 2021

The Government’s consultation on mandatory Covid-19 and flu vaccination for the wider health and care sector is currently open for submissions from the public.

We have made a quick guide to help you fill out the consultation in just a few minutes.

Click here to open the consultation in a new tab…

Making vaccination a condition of deployment in the health and wider social care sector

About you

The first few questions ask you for your name and email address – this is optional. We recommend that you select ‘a current service user/patient or family of a current service user/patient’ – after all, almost everyone uses the NHS or have family who do.

The next questions ask for demographic information such as your gender, age group, ethnicity, and disabilities.

Views on the policy intention

The first question asks your preference about the COVID-19 and flu vaccination status of the people who provide your care, your family member’s care or your friend’s care.

In our view, this is a trick question– it is highly unlikely that anyone would specifically want everyone in a space to be unvaccinated, but if someone mistakenly selects this response to this confusing question, their responses will likely be segmented and dismissed as “anti-vaccination”.

We believe that the majority of people will, and should, select “I don’t mind either way”.

Which persons should be required to be vaccinated?

The following four questions ask whether you support mandatory vaccine for either Covid-19 or flu in a range of setting. We believe those responding should select ‘Not supportive’ for every answer.

For the first question, ‘Which of the following best describes your opinion of the requirement: Those deployed to undertake direct treatment or personal care as part of a CQC regulated activity in a healthcare or social care setting (including in someone’s home) must have a COVID-19 and flu vaccination?’ we recommend you paste in the following text:

I wholly oppose proposals for mandatory vaccinations in any setting in the UK. Mandatory vaccine policies displace fundamental modern British values: individual autonomy, dignity, privacy and equality are subsumed by coercion, state control, monitoring and discrimination. This serious damage to British freedoms provides no public health benefit and damages trust in public health authorities among the groups where trust matters most. Mandatory vaccines were abandoned in Victorian Britain after sparking an anti-vaccination movement, mass protests and social discord. With opposition to mandatory vaccines from unions, civil liberties groups, and hundreds of thousands of members of the public, mandatory vaccine policies, particularly in relation to vaccinations that are new and on emergency approval, are destined to reignite distrust at a time when distrust could cost lives. As unions warned, the vaccine mandate in care homes has contributed to an exodus of care workers. It is likely that extending this mandate to other sectors will see staff shortages in other key areas of health and social care. I strongly believe that the Government should reject mandatory vaccines for all settings and adopts a strategy of support rather than coercion.

For the second question, ‘Must have a COVID-19 vaccination in social care’, we recommend you paste in the following text:

Some individuals receiving social care may be at greater risk of serious illness and death from Covid-19 and flu. I fully support reasonable and evidence-based steps to ensure the protection of vulnerable individuals in these settings. However, I believe that mandatory vaccination of staff not only raises serious ethical issues but would be an unnecessary and ineffective approach to protecting service users. Vaccine uptake is is already very high amongst staff working in social care, but a vaccine mandate could increase distrust amongst the sector and wider public.

For the third question, ‘Must have a Flu vaccination in healthcare’ we recommend you paste in the following text:

The Department of Health and Social Care noted that “last season saw the most successful [flu vaccination] programme ever,” with the highest levels of uptake on record for over 65s and at-risk groups. 77% of all frontline healthcare workers received the seasonal flu vaccine during winter 2020/21, a significant increase from winter 2019/20 (64%), indicating that healthcare workers are conscious of the risks posed by seasonal flu combined with Covid-19. Public Health England stated that this was “the highest ever recorded levels of influenza vaccine uptake” for healthcare workers. It is likely that the “85% ambition” for vaccine uptake for health and social care workers, outlined by the Department of Health and Social Care, NHS and Public Health England in a letter to NHS staff in July 2021, will be met, given that the Government is planning the “biggest flu programme in history”. However, the target could be jeopardised by coercive communications and the prospect of mandated vaccination. The Government should not mandate the flu vaccine for healthcare workers.

For the fourth question, ‘Must have a Flu vaccination in social care’, we recommend you paste in the following text:

There is very significant concern that a Covid-19 and flu vaccine mandate for social care workers will lead to dangerous staffing shortages during a difficult winter for the health and social care sector. Prior to the introduction of mandatory vaccinations for care home workers, unions, care homes and parliamentarians warned that this approach could backfire dangerously and lead to staffing shortages for an already stretched industry. This was also acknowledged by the Government in its operational guidance to care homes: “[w]herever possible, we would expect the registered person to take reasonable steps to cover the staff shortfalls themselves in the short term through the use of bank or agency staff.” However, given that the National Care Association has warned that there could be 170,000 vacancies due to the new requirement, it seems unlikely that care providers will be able to fill the gap. Unison General Secretary Christina McAnea warned that Ministers are “sleepwalking into a disaster”.
Charity Skills for Care’s annual report into the state of the care sector in England found that vacancies in the care sector had increased since Covid-19 and that employers are “struggling to recruit and retain their staff.” It notes that if unvaccinated staff “were to leave and replacements were not found it would push the staff vacancy rate up to its highest level on record.” Widening vaccination requirements to cover all health and social care workers, and adding the seasonal flu vaccine to the mandate, would only exacerbate these serious staffing issues and endanger public health as a result.

The next screen asks about mandatory vaccination for those under the age of 18 working in the health and social care sector. For all four questions we recommend you answer ‘Not supportive’ of the requirement’ and write: ‘Vaccinations should not be mandated for individuals of any age.’

Considerations of potential impacts

The next page asks about the impact of mandatory vaccine on protected groups (i.e. groups protected by equality laws).

The first question asks if any protected groups will benefit from vaccine mandates. We said ‘no’ as staff shortages will make everyone less staff.


After this it asks if any protected groups will be negatively affected. We said ‘yes’.

We recommend you paste the following text into the answer box:

Mandating vaccination (either directly or indirectly) poses a serious threat to the principle of personal and bodily autonomy and would likely lead to discrimination and the widening of inequalities.

Many people will not receive a coronavirus vaccine, whether for health reasons, due to concerns around pregnancy (even if misplaced), or due to religious, philosophical or other personal beliefs. There is also evidence that Covid-19 vaccine hesitancy is higher in black and minority ethnic groups and in more deprived areas. Flu vaccine uptake is also lower in black and mixed ethnic groups compared to white and Asian ethnic groups and in areas with higher social deprivation. Penalising communities where there may already be deprivation and unemployment would lead to further marginalisation and distrust among these communities.

The consultation then asks what the Government could do to increase vaccine uptake. We answered with the following:

The National Institute for Health and Care Excellence’s guidance for increasing flu vaccine uptake recommends a range of measures to drive vaccine uptake amongst health and social care staff, including assigning dedicated staff to increase awareness and uptake, training peers to vaccinate their co-workers, extending on-site vaccination clinic hours to fit in with staff work patterns, and significantly, “a full participation vaccination strategy” whereby NHS staff are “able to opt out if they wish.” It does not recommend mandating vaccination.

Unions have highlighted a range of measures that they believe would be more effective than vaccine mandates, such as allowing appointments during working hours, increasing statutory sick pay so those suffering from side-effects will not lose out, further education, opportunities to ask questions of colleagues who have been vaccinated, taking vaccinations into communities and workplaces, and campaigns that debunk vaccine misinformation.

Given widespread high vaccination uptake, the Department of Health and Social Care should consider a targeted response, that focuses on the small number of areas where vaccination uptake is below the national average.

The consultation then asks for any comments relating to the code of practise, we answered the following:

I support the new requirement within the Code of Practice for providers to ensure that“there is appropriate support and education of those deployed in relation to the vaccine” and that “those deployed are provided with the appropriate support to access vaccination.” However, I have significant concerns about mandating vaccination for any form of employment. The necessity and proportionality of such a step should be carefully considered and balanced against the rights of employees. I am also concerned by the requirement to verify and store the vaccination status of employees, which as well as engaging data protection issues, will normalise health surveillance by employers.

Final screen

Lastly, the consultation asks you for any additional comments. We recommend the following:

Mandating vaccination for health and social care workers would be a heavy-handed, invasive and discriminatory approach. It poses unacceptable risks to rights and individual liberties and could jeopardise national trust in the safety of vaccinations. The Government should continue its successful approach of educating and explaining the benefits of the Covid-19 and flu vaccination, whilst intervening in NHS trusts with support and education where necessary.


Please share this consultation submission guidance widely.