Nearly 15% of health service workers in England remain unvaccinated, and the numbers coming forward for a jab have decreased sharply in the last two weeks, NHS figures have revealed, prompting concerns that many frontline staff are refusing the vaccine.

But health leaders, patients’ groups and unions have been quick to dismiss any suggestion of mandatory vaccinations after it emerged that Matt Hancock, the health secretary, had embarked on a plan before the pandemic to make flu vaccinations compulsory for NHS staff.

Last week, the government began a consultation on whether or not to mandate vaccinations for care-home workers, and a London NHS trust discussed making the vaccination a condition of employment.

The latest figures show that only 6,259 NHS staff in England had their first dose in the seven days before 11 April, down from 11,483 the previous week and substantially lower than the average of 22,985 per week during March. Now 190,697 workers out of 1,378,502 directly employed by the NHS remain unprotected against the coronavirus, four months after they became eligible for vaccination. The figures do not include agency workers, and will include some under-45s who are not frontline staff and are still waiting their turn.

Some NHS trusts would like to introduce mandatory vaccination because they believe efforts to persuade remaining staff are a distraction from other important tasks such as tackling the enormous waiting lists that have grown during the lockdowns.

Lesley Watts, the chief executive of Chelsea and Westminster hospital foundation trust, wrote to other NHS trusts with a draft letter to staff saying Covid vaccination would be mandatory. After the letter was leaked, Watts said there was “no intention to mandate vaccination of our staff”, but did not explain why the letter was written or distributed.

Hancock was a strident critic of anti-vaxxer movements before the pandemic, and told a fringe meeting at the Conservative party conference in 2019 that he favoured making vaccinations compulsory for all childhood diseases. He then asked civil servants at the Department of Health and Social Care to work out how to make flu vaccines mandatory for NHS staff. The DHSC did not say if the proposal was still being considered.

Opponents of mandatory vaccination believe it could be counterproductive and cause vaccination rates to fall in the future. If a vaccine is mandatory, it is harder for people to voice concerns they may have, and there are fewer opportunities to persuade them to get inoculated.

North Middlesex University hospital trust has drawn up 32 reasons for hesitancy and matched them to clinical advice so that staff can easily find evidence to help counter any concerns.

Saffron Cordery, the deputy chief executive of NHS Providers, said the issue was “incredibly complex” and that the consultation on social care had “inevitably put the spotlight on whether a similar policy should be introduced in the health service or other parts of social care.

“Mandatory vaccinations raise a number of legal and ethical questions and, as expected, there is a wide and diverse range of views on this among trust leaders,” she said. “While we are pleased with the strong uptake of the Covid-19 vaccine among staff groups so far, we know more needs to be done to address vaccine hesitancy within the workforce and throughout society.” One-to-one conversations had been particularly effective, she added.

Dame Donna Kinnair, the general secretary of the Royal College of Nursing, said compulsion might affect future vaccination programmes. Unison’s general secretary, Christina McAnea, said: “Forcing NHS staff to have the Covid vaccine would be premature and counterproductive. Work must be done to understand and address the concerns of hesitant staff. A heavy-handed approach could stoke resentment and further erode morale, already near rock-bottom after the government’s insulting 1% pay rise recommendation.”

The NHS said: “The vaccination programme has successfully vaccinated 19 out 20 people aged 50 and over as well as nearly nine in 10 NHS staff. While the vast majority of staff have been jabbed, local NHS teams are making every effort to ensure staff feel confident in taking up the offer.”

This content first appear on the guardian

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