Vaccine-hesitant frontline health and social care workers across England faced an ultimatum on Thursday.
It was their final chance to come forward for a first Covid-19 jab if they are to meet the 11 November deadline, after which everyone working in the sector must be fully vaccinated if they wish to keep their jobs. 
Compulsory vaccination raises a complex ethical question: is the imperative to protect the health of the wider population enough to justify an act which denies people autonomy over their own bodies? 
When it comes to mandatory vaccines for those in the healthcare sector, the issue is particularly heated. 
Some insist the rule is entirely reasonable; after all, healthcare workers have a duty of care to do everything within their power to protect vulnerable patients. Doctors are also bound by the General Medical Council’s “Good Medical Practice” guidance, which instructs them to: Protect patients and colleagues from any risk posed by your health”. Arguably, this now extends to getting a jab – a measure which has been proven to reduce community transmission.
But others feel the ruling is a major breach of our civil liberties. “It overturns 120 years of vaccination legislation and policy which has been built on trust, medical confidentiality and informed consent,” says Prof Allyson Pollock, Clinical Professor of Public Health at University of Newcastle.
Some argue that threatening individuals who are fearful of side effects with job loss, especially ones who have worked tirelessly and risked their lives throughout the pandemic, is unconscionable. 
Grounds for exemption to the new legislation are still ambiguous. Care England, which represents social care providers, has urged the government to provide clarity. 
But the ruling will no doubt create some thorny legal issues. For instance, if people have refused the vaccine on religious grounds, could firing them be a form of employer discrimination? And if reluctant healthcare workers develop rare side effects post-vaccination, who is liable? 
Others fear this is a slippery slope – that compulsory vaccines for health workers will pave the way for other industries offering employees the same ultimatum. 
Ethical issues aside, how much of an impact is this law really going to have? In other words, while the principle of compulsory vaccination might be objectionable, are there actually a lot of health and care staff refusing the jab? And is there a real danger that this law will exacerbate the chronic staff shortages within this sector? 
Around 8 per cent of the NHS and care home workforce are yet to get a vaccine, according to government data. Meanwhile, 28 per cent of care homes in England say that between one and five staff members have already handed in their notice, citing concerns over mandatory vaccination. Community Care has warned that care homes risk losing up to 40,000 staff from the compulsory vaccination policy. 
To make matters worse, as Nadra Ahmed, chair of the National Care Association, reminds us: “Before the pandemic there were already 120,000 vacancies in the sector.” 
The UK is not the first country to make vaccination a condition of employment. Italy enforced this rule for health workers back in May after clusters of hospital infections were linked to unvaccinated staff. Greece has done the same, while President Biden has made vaccination a legal requirement for all 100 million federal employees in the US. 
In France, a law requiring health care workers to prove they have had at least one shot of the vaccine came into effect this week. Already, an estimated 3,000 health workers in the country have been suspended as a result. Despite Emmanuel Macron issuing the ultimatum two months ago, tens of thousands of staff are still resisting the vaccine.
And so, libertarian concerns aside, it seems mandatory vaccination might lead to the very outcome it was implemented to prevent; the staff shortages that will ensue could end up risking the lives of many more patients than the transmission risk of unvaccinated healthcare workers.