Mandatory vaccines for healthcare workers should be last step says Hiqa

Mandatory vaccines for healthcare workers should be last step says Hiqa

Hiqa has advised that the mandatory vaccination of healthcare workers would be considered the last step on a 'ladder' of increasingly strict interventions.

The Health Information and Quality Authority (Hiqa) has advised vaccinations for healthcare workers should be covered by a ‘ladder’ of increasingly strict interventions as encouragement.

This advice was sent to the National Public Health Emergency Team (Nphet) on Wednesday.

Under this system, mandatory vaccination would be considered last as “a most intrusive step”. The system should include moving staff from areas of care with a high risk of catching Covid-19 to low-risk areas.

Other steps on the ladder should include providing evidence-based information followed by one-to-one conversations about evidence for use of vaccines.

Policies should also be developed, Hiqa advised, for vaccine-hesitant staff to avail of more frequent testing for Covid-19. They should also be advised to wear more PPE items than compared to their colleagues.

Hiqa Deputy CEO and Director of Health Technology Assessment, Dr Máirín Ryan said: “We are encouraging all healthcare personnel to avail of Covid-19 vaccination as soon as they are eligible.” 

And she said:

 “The past year has been very challenging for healthcare personnel and we have advised Nphet that any policy introduced regarding Covid-19 vaccination should be built on a model of encouragement support.” 

The Hiqa review notes the HSE introduced a policy on March 29 requiring some student nurses to be vaccinated or miss out on certain clinical placements. This did not apply to fourth year students in the workforce.

However, this contentious policy was quickly reversed. A spokesman for the Irish Nurses and Midwives Organisation said on Wednesday: “The INMO had an issue with this, and made representations to the HSE. The policy was removed on April 12.”

Hiqa reviewed policies around Europe, and note the NHS policy in the United Kingdom also focuses on encouragement and education.

Italy, which has been seriously affected by the virus, has introduced a mandatory vaccination policy for all healthcare workers, but so far they are alone in the EU in doing this.

Dr Ryan said: “As Covid-19 vaccination programmes progress, we expect that more countries will bring out policy and guidance regarding unvaccinated healthcare personnel.” 

On Wednesday, Hiqa also confirmed to Nphet that evidence continues to show a six-month duration of immunity — protection from reinfection — following a Covid-19 infection.

They said: “However, as the body of evidence is rapidly expanding, Hiqa advises continued review of the data.” 

The Hiqa advice on mask-wearing for children also remains at 13 as the starting point, meaning primary-school-age children can continue to go to school without masks.

“The package of mitigation measures currently in place in primary schools has been effective at minimising transmission,” Hiqa said.

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