Tens of thousands of care workers across England are facing the sack, after a new law came into force overnight, meaning Covid vaccination is now a condition of employment for all care home staff.

Official NHS figures released today show that over 50,000 staff in care homes have still not had a second vaccine just four days before the deadline, a much higher figure than the 32,000 estimation given by health secretary, Sajid Javid, earlier this week.

The National Care Forum reckons that it will lose around 8% of its staff today. Reports of firings have already begun. Birmingham, Manchester and Nottingham are among the cities which could suffer the biggest losses – with only 80-81% of care home staff in these areas currently vaccinated. 

Under the new government rules, care homes must keep records of who is vaccinated and the Care Quality Commission (CQC) will enforce the rules and carry out checks. 

For now, mandatory vaccination applies only to those in the care sector. But in April, the “no jobs, no jabs” rule will also come into effect in NHS hospitals, where roughly a tenth of the workforce are unvaccinated. 

Compulsory vaccination raises complex ethical issues.

Those in favour argue that pursuing a career in care means doing everything within your power to protect vulnerable, elderly patients, work which now includes getting a jab. 

Ministers also say that staff have had months of warning; care workers were given a 16-week “grace period” to book their jabs in July.

What’s more, Javid insists the ultimatum has persuaded many workers to get their double dose: the number of unvaccinated care workers in England was as high as 88,000 when the announcement of the decision was made. 

Critics insist this law is a breach of civil liberties, and overturns years of vaccination policy built on trust, persuasion and consent. Flu jabs are not mandatory for health and social care staff in England. 

Some also argue that firing individuals who’ve worked tirelessly throughout the pandemic without PPE, and are willing to do regular Covid tests but simply too nervous to get the jab, is unconscionable. Plus there’s a strong argument that many of the unvaccinated care workers who’ve already had Covid will have just as good, if not better, natural immunity compared to those who are vaccinated. 

Ethics aside, another grave concern is that the care sector simply cannot afford to lose thousands of workers overnight, especially during the high-pressure winter months. 

There were over 112,000 pre-existing vacancies in care, according to Christina McAnea, UNISON general secretary: “Ministers risk decimating a sector already struggling with chronic staff shortages.”

An estimated 750 care homes have already stopped taking new admissions because of staffing shortages. This new law will intensify the buildup of elderly patients in hospitals unable to be discharged. 

Another fear is that differing vaccine deadlines for social care and health staff will simply shift the problem across to hospitals. Wade Newmark of The Dales Nursing Home in Exeter says agencies are already turning up at care homes offering unvaccinated staff larger wages to switch to working in hospitals until April. 

The UK is not the first country to make vaccination a condition of employment for staff in the health and care sector. It’s already policy in countries including Italy, Greece and France while US President Biden has gone even further, making vaccination a legal requirement for all 100 million federal employees in the US. 

But this policy has its own problem. One hospital in Southeast France, was recently forced to cancel some operations due to a shortage of vaccinated staff. 

Weighing up the risk of unvaccinated health and social care workers transmitting the virus to patients against the risk posed by a law which exacerbates staff shortages in the NHS is no easy task.