Last reviewed 3 March 2021

Chris Payne looks at ways in which care managers can encourage care staff who are still undecided to be vaccinated against Covid-19.

It is certainly worrying that up to February 2021 there might be nearly a third of social care workers who have not opted to be vaccinated against Covid-19, when they have been given top priority in the Government’s vaccination programme.

They have been given that priority because social care workers are at high risk of exposure to SARS CoV-2, the virus that causes the serious and life-threatening disease of Covid-19. High risk of exposure also means high risk of spreading the virus to others, not least the people receiving their care, and increases their risk of developing Covid-19. The high death rates of people in care homes and those of people receiving community services have made sobering reading throughout this pandemic.

To date there have been upwards of 500 social care workers alone and not counting colleagues in the health services, who have died from Covid-19, which is double that of other occupations. It is also likely that there is a much higher number of social care workers who have experienced less severe disease, but who might still suffer from the well-known longer-term effects.

All the evidence suggest that being vaccinated will:

  • offer you protection from suffering the more severe forms of Covid-19, though how much it protects against exposure to the SARS CoV-2 virus or from spreading it if infected is still unknown

  • protect others as well as yourself, as it will spread less as more people become immune to the disease.

All the evidence also shows that the vaccines:

  • are safe and effective after carefully conducted trials around the world, involving altogether hundreds of thousands of people

  • that the benefits far outweigh the risks, which no one in vaccine development denies exist, as they do with any other medicine

  • add considerably to the levels of natural immunity that result from exposure to the virus and without the suffering that comes from having had the disease.

The available information seems to have convinced the majority of the social care workforce without added inducements about the personal and collective advantages of being vaccinated.

What about the minority who, for one reason or another, are reluctant to step forward?

The first step is to ask why people should be so reluctant and then to see if the issues they raise can be addressed constructively using the available evidence.

This non-vaccinated remainder can be divided roughly into three types, each having distinct concerns that need different approaches. The first is probably the easiest to resolve.

1. The Vaccine Laggards

Some care workers who are happy in principle to be vaccinated, might be waiting for the right opportunity to get vaccinated, because of lack of time, difficulties in getting to a vaccination centre, etc. It should be relatively easy to offer the practical help that they need by making their being vaccinated a priority and providing them with the time and means.

Others will be waiting to see how early responding colleagues have fared and will make the move in their own good time, which is their right. They might just need a gentle push in the right direction.

However, there will undoubtedly be people whose indecision is more deeply rooted — the vaccine hesitant — and there could be those, the vaccine resistant, who are basically opposed to the principle of vaccination because of their personal beliefs.

How should you respond to people in these groups?

2. The Vaccine Hesitant

The first step is to find out exactly what are the concerns, which are often genuine and reflect healthy critical attitudes. The concerns might occur because of:

  • lack of information, for example, about the science behind the vaccine developments

  • misinformation, for example, by taking hearsay mainstream and social media reports, which can be totally misleading, at face value

  • having medical conditions that suggest being vaccinated is risky

  • fears about the vaccination procedures and the after effects.

The second step is to address the individual concerns by, for example, pointing to the publicly available information from the Government, NHS and Public Health and other reputable sources of which there is no shortage. In many cases this will provide the missing information and help to dispel some of the misinformation. Here are some examples of the more common misunderstandings.

Examples

Concern

Considered Response

I am worried that the quick development of the vaccines might have made them less safe.

It is true that the vaccines have been developed in an amazingly short time, but that is because the scientific groundwork has been carried out over the past twenty to thirty years making it possible.

I think that the new MRNA vaccines have not been used before and have heard they might interfere with our genes.

It is true that MRNA methods are relatively new, but they do not interfere in any way with the body’s genes (in fact the MRNA injected quickly disappears), and they will probably be used in future with other drug developments.

I am worried that I might catch Covid-19 from the vaccine.

Not possible because the vaccine does not have a whole virus which is required for infection.

I am worried about becoming ill from the vaccine, which I have heard people have.

The possible side effects, which are caused by the immune response to the injection will be explained to you. It is highly unlikely that any other illness you develop will be caused by the vaccine. Remember people get sick all the time from many different causes.

What if the vaccine is no good for these variants that keep appearing?

It is true that we need to know more about the effect of some variants, but:

  1. the vaccines offer some protection against most variants

  2. the vaccines can be easily tweaked to cover them if not

  3. never underestimate your own immune system to respond to new challenges!

With the vaccination-hesitant, knowledge — meaning knowledge based on scientific evidence not just on what you read in the newspapers or see on TV — should be the most powerful way of addressing these mainly legitimate concerns. A slightly different approach will of course be needed for those who are simply frightened of jabs. But they too can be reassured and offered the help they need to overcome their fears.

3. The Vaccine Resistant

History has many examples of people preferring untruths to evidence-based truths, and this is as true in the present as the past with the spread of fake news and disinformation. People with fixed beliefs, ideas and delusions about the evils of vaccines and vaccination are unlikely to respond to evidence-based reason.

However, it might be worth pointing out the following.

  • When, at the end of the 18th century, Dr Edward Jenner first tried out his vaccines against smallpox, which killed or disfigured multitudes of people across the world, many people thought that his patients or victims as they saw them would turn into cows and pigs. Now because of vaccine development based on Jenner’s pioneering work, smallpox has now been stamped out entirely.

  • In the developed countries, because of vaccination, there is hardly any polio now, when it used to be common, yet in countries without the vaccine it is still widespread.

  • There is as yet no vaccine for HIV, and deaths from HIV are into the millions.

  • Ebola is if anything more deadly than Covid-19, but its spread is being successfully controlled by vaccines that are similar in design to those for Covid-19.

Many more examples can be found, so when considering the advantages and disadvantages of vaccination for Covid-19 it is always important to look at the bigger picture. However, short of mandatory vaccination, which many employers are now considering through changes of contract, there will always be a small minority who remain unconvinced.

Further Information

More information on the benefits of vaccination can be found in the leaflets produced by the national public health/NHS. On 1 March, Public Health England updated its promotional material Covid-19 Vaccination: guide for healthcare workers with information on why it is important to get the Covid-19 vaccine, whether it will protect people and other concerns staff might have.

NHS England has also produced a Vaccination Guide for Social Care Staff in several languages that could be issued to all staff. The leaflet includes information on the advisability and safety of people with different medical conditions, including pregnancy, on receiving the vaccine.