February 1, 2022 - 11:12am

The Government has announced that it is scrapping the vaccine mandate for NHS staff in England. I had hoped this would happen, as I told UnHerd in my interview last month (see above). This is an undoubtedly sensible decision, given that between 80,000 and 120,000 workers still have not taken the vaccine and would have been left with an agonising choice to make by April 1st.

I explained my own reservations about the policy to Sajid Javid a few weeks ago; the conversation went viral, but it felt important to share how I and tens of thousands of other doctors felt about the issue. I was labelled as anti-vax, deluded and irresponsible, but I stood by my convictions. Thankfully, the Government eventually came round to my way of thinking.

The Government’s original justification for the mandates was this: Omicron was highly transmissible and cases were skyrocketing. But this was a purely epidemiological argument; on the moral side, vaccine mandates are in complete violation of bodily autonomy, and as a doctor, I felt like I would be undermining the principle of consent.

Historically it has implicitly fallen to the fit and healthy to acquire natural immunity. This is an entirely logical approach, but our Covid response has centred on jabbing as many people as possible, no matter how healthy. Given the tiny rates of deaths and hospitalisations for the otherwise fit and under 50, this was always a crude approach.

Viruses typically become less virulent as they evolve; Javid must have known this, but it appears that no provision was made for such an outcome. Even with Delta, there was never a strong rationale in favour of mandating vaccination in a healthcare setting— except as a tool of coercion. Given that any reduction in transmission lasts only a few months, the high rates of healthcare staff exposure would have only offered a marginal benefit at best.

The only way to keep up vaccine induced immunity would have been a programme of extremely regular vaccinations and boosters — which even the EU head of vaccination strategy advises against. 

It is not unreasonable to have a concern for side effects of newer vaccines — particularly if you are not convinced of their benefit for you in the first place — and it usually takes years before mandatory vaccinations are approved for the protection of healthcare staff. To lose as many as 100,000 NHS staff members to prove a point within a few months would cripple our health service and leave us in an even worse position to deal with the ever-growing backlog of appointments. Overall, it would have been bad for public health.

Looking beyond vaccines, there are many other areas that the Government could focus on. Tackling weight loss, for instance, would provide the country with a whole host of benefits, not least in dealing with Covid. As the virulence of Covid wanes, we should begin to treat Sars CoV2 like a seasonal flu rather than obsessing about vaccinating the entire country several times over. The Government’s scrapping of the NHS mandate is a significant step back towards a healthier attitude and, ultimately, a healthier population.


Steve James is a critical care consultant at King’s College Hospital in London.