Should AHPRA deny registration over COVID-19 vax refusal?

 The speed and skill of COVID-19 vaccine developments is impressive. The extent to which such viral vaccines prevent death and — in the short-term — serious illness has been established in randomised trials.  

But do they prevent infection and what are their long-term effects?

We don’t know yet as that information comes only from careful follow-up of many vaccinated people. The data we have at hand are incomplete but encouraging.

In a Q&A on the vaccines in the New England Journal of Medicine, Professor Paul Sax, an infectious disease specialist at Harvard Medical School, US, sums up the current information well.

 “Findings from population-based studies now suggest that people without symptoms are less likely to transmit the virus to others. It would be highly unlikely in biological terms for a vaccine to prevent disease and not also prevent infection,” he writes.¹

“If there is an example of a vaccine in widespread clinical use that has this selective effect — prevents disease but not infection — I can’t think of [it]!

“The likelihood is that these vaccines will reduce the capacity to transmit the virus to others. [But], the protective effect will never be 100%, which is why … we still recommend the use of social distancing and masking in public.

“These caveats notwithstanding, the likelihood that these vaccines will reduce the capacity to transmit the virus to others remains excellent.”

Read more: Your rights: Can your practice demand you have the COVID-19 vaccine?

In light of this, all healthcare workers — unless exempted on sound medical grounds (a rare situation) — should be expected to have the vaccine, not only to protect themselves, but to protect their patients.

This has raised the question of whether vaccination should be mandatory.

Around one third of 400 respondents to an Australian Doctor poll agreed it should be compulsory for healthcare workers in high-risk settings including GP practices, hospitals and aged care facilities.

The remaining two thirds said it shouldn’t be made compulsory. Their reasons were evenly split; first, because efficacy and safety of the current vaccines are not guaranteed and second, because vaccination should be a choice.

Several respondents said that unvaccinated health workers should be expected to inform patients accordingly.

These are valid concerns for now.

But, let’s imagine a time when it’s proven that COVID-19 vaccination prevents infection, transmission, serious disease and illness. And that is found to have no serious side effects.

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Read more from Professor Leeder:

• Here come the vaccines - now we need a successful rollout plan
• It's not helpful to talk about herd immunity with COVID-19
• Is it wise to remove medicine's eponymous male names?

In this case, I believe compulsory vaccination for all healthcare workers would be in the public interest. 

I would even go so far as to say that vaccination could come under the jurisdiction of AHPRA — which regulates more than 740,000 doctors, nurses and other health professionals.

The regulator would deny registration to unvaccinated practitioners.

Sound heavy-handed?

Not when you consider the alternative.

Published in Medical Observer Opinion
3rd March 2021