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LONDON, UK: Although the New Year might cause some to hope that an end to the COVID-19 pandemic could be in sight, the soaring Omicron rates have spurred general uneasiness, and there is little sign of optimism. In order to boost vaccine uptake in England, vaccination will soon become a condition of employment for most health professionals, including dentists and their teams working in the private sector or in the National Health Service (NHS). As the deadline for getting vaccinated in order to maintain employment is quickly approaching, it is important to assess the current state of affairs in the country.
On 9 November 2021, the government announced that, from 1 April 2022, health and social care workers in England will be legally required to be vaccinated against COVID-19 if they are working in an environment which is regulated by the Care Quality Commission (CQC). The mandate includes all workers aged 18 or over who have direct, face-to-face contact with service users. However, the rule does not apply to those who are medically exempt from being vaccinated.
According to the General Dental Council, there are currently over 43,000 dentists and almost 71,000 dental care professionals working in England, including over 59,000 dental nurses, some of whom are at risk of losing their jobs in the upcoming months if they have not received their second COVID-19 shot by February. The British Dental Association (BDA), which is the main representative body for dentists and dental students in the UK, has revealed that it is pessimistic about the new mandate, saying dental services in England are already “stretched” and that the mandatory jabs will only make matters worse, leaving thousands of dental professionals without work. In response to growing fears of staff shortages, the English government decided to wait until April to introduce the policy in order to prevent a shortfall in healthcare staff over the winter months.
Regarding vaccine uptake, the BDA says that the NHS has no record of the number of dentists who are not vaccinated since it has put its focus primarily on hospitals and social care. However, a recent survey of dentists in England indicated that one in ten respondents are not fully vaccinated and 9% have not yet received their first jab. The survey has also revealed that one-third of the respondents, over 30%, believe that the mandatory vaccine mandate will force the dental nurses at their practices to leave work, and almost 15% of the responding dentists admitted considering closing their practices.
Dr Eddie Crouch, chair of the BDA’s Principal Executive Committee, said in a press release: “We now face a grim scenario where thousands of dental team members will walk as result of choices made by government, leaving thousands of vacancies that will never be filled.” He added: “Dentists have supported the vaccine roll-out, with many downing drills to play their part. But ministers must think again about compulsion.”
To jab or not to jab
A recent survey carried out by NHS Providers showed that 58% of trust leaders support the mandate and 32% oppose it, whereas 10% withheld their opinion. The great majority of the respondents, over 90%, expressed concerns about possible additional shortages in staffing in both the NHS and social care in light of mandatory jabs.
According to a report published by Public Health England, the COVID-19 vaccination programme has prevented between 23.8 and 24.4 million infections, over 82,100 hospitalisations and between 102,500 and 109,500 deaths. Additionally, various studies have examined vaccine efficacy, deeming vaccines safe and effective for preventing infection and transmission. However, some people are still on the fence when it comes to getting vaccinated, and some have underlying medical conditions that prevent them from doing so. But are standard infection control and prevention procedures currently in place enough to keep dental teams safe?
“We now face a grim scenario where thousands of dental team members will walk as result of choices made by government”
— Dr Eddie Crouch, BDA
For now, it seems that those in favour of vaccine mandates hope that vaccine uptake will help slow down SARS-CoV-2 transmission, thus bringing them one step closer to a pandemic-free future. Additionally, many regard receiving a vaccine as protection not only for themselves but also for patients and compare getting vaccinated with receiving a hepatitis B shot, which has been mandatory for clinicians for years. Finally, some dental professionals find comfort in knowing that, even if a vaccinated person contracts COVID-19, the illness will be considerably milder.
However, not everyone is as enthusiastic about the mandate, saying that vaccination acceptance, hesitancy or refusal should be every individual’s choice. As dental practices are already following proper infection prevention and control practices and using personal protective equipment, some dental professionals find it difficult to understand why, two years into the pandemic, these safety measures do not suffice. In turn, for those who reject COVID-19 vaccines or cannot be vaccinated, the mandate would mean losing jobs and closing down practices. More importantly, the unfilled vacancies would result in limited access to dental services in local communities.
Vaccine mandates around the world
England is not the only country that has introduced vaccine mandates. In Italy, COVID-19 vaccination is mandatory for people from the age of 50, and the mandate will run until 15 June. In Greece, vaccines are compulsory for those over 60. As Germany is battling a fourth wave of the pandemic, the country is considering making vaccination mandatory for all adults over the age of 18, whereas Austria has decided to make COVID-19 vaccinations mandatory from February onwards. Finally, in New Zealand, those having certain roles in the health and disability sector, the education sector, the corrections sector, Fire and Emergency New Zealand and Police must be fully vaccinated against COVID-19 since these are considered key public service sectors.
According to data on the English government website, over 14 million people have tested positive with COVID-19 since the start of the pandemic, and the total number of people on whose death certificate COVID-19 is mentioned as one of the causes is over 173,000.