Covid-19 and Vaccination: A BASW position statement

Social workers are a high priority for vaccination

Key messages

  • BASW recommends that social workers take-up vaccination against Covid-19 when it is offered to them.
  • BASW is working to ensure social workers and social care workers in all types of provider organisations are prioritised for vaccination and have access equal to that for health and other priority staff within the practicalities of the roll out programme. 
  • Vaccination protects the individual. Although the exact impact of the vaccine on transmission of the virus between people cannot yet be known, as more people take up the vaccines, it is expected that population level risk will be reduced.
  • For social workers, the offer of vaccination may come through your employer or via other means.   It may come via your General Practitioner or other health professional/service.
  • Social workers need to be ready to deal with the issues that social work service users and carers raise about vaccination within the context of existing legislation and policy around supporting positive health outcomes
  • Social workers should be particularly alert and informed in respect of informed consent, parental consent and processes to determine best interests when a person lacks capacity to decide about the vaccine, to protect people’s rights and wellbeing.
  • Full guidance on the first phase of the vaccination roll out can be found on the government website.

Policy brief

1.  Background

At the time of writing Covid-19 has resulted in the deaths of over 75,000 people across the UK and this figure is rising. Hospital admissions for Covid-19 are now above levels in the first wave. Recurring lock downs and related restrictions have worsened mental health issues, made victims of domestic abuse more vulnerable, increased concerns about children and young people who are ‘at risk’, and significantly reduced contact between people living in care homes and other settings and those who care and support them. Education has been disrupted. In addition, large sectors of the economy have been devastated (for example, leisure, hospitality and retail) with many losing their jobs and a resultant increase in economic insecurity and poverty. The impact of restrictions has been felt disproportionality by those who were already disadvantaged by poverty and discrimination[1].

Extensive vaccination against Covid-19 is our main current solution to this recurring cycle of soaring infection followed by lock-down followed by an easing followed by further rising infection rates and increased deaths followed by another lock down.

A number of vaccines are in various stages of development and approval by the regulator. The vaccine developed by Pfizer/Biontech is the first vaccine in the UK which has been approved and vaccination is already underway. The vaccine developed by Oxford University/Astra Zeneca has also been recently approved for use and roll out started in early January 2021. It seems possible that other vaccines will be approved in the future.

No vaccine provides 100% protection. Nevertheless, vaccination is an effective way for individuals to protect themselves as much as possible. As take up increases overall population risk will reduce.

2.  Speed and variation in the roll-out of the vaccination

There are some 65 million people in the UK. It will take time to vaccinate all those in the population who wish/need to be vaccinated. Moreover, guidance suggests both vaccines currently available need a double dose to be fully effective. Precise timescales are uncertain, but this process is likely to take many months.

Take up of a vaccine is not legally required. Employers can encourage uptake but cannot make it mandatory or a condition of employment. Employers also need to understand the personal health factors or concerns affecting decisions to take vaccines.

Different groups in the population will be prioritised for vaccination, for example, those who because of age, or underlying health conditions, or exposure to infection are more likely to become infected by, and become seriously ill with, Covid-19. The following priorities have now been set for the first roll out across the four nations of the UK.

  1. residents in a care home for older adults and their carers
  2. all those 80 years of age and over and frontline health and social care workers
  3. all those 75 years of age and over
  4. all those 70 years of age and over and clinically extremely vulnerable individuals
  5. all those 65 years of age and over
  6. all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
  7. all those 60 years of age and over
  8. all those 55 years of age and over
  9. all those 50 years of age and over

Priority 2 includes social workers. As noted above it will take time to vaccinate all the individuals in Groups 1 and 2.

BASW is working to ensure all social workers and social care workers in all types of provider organisations are prioritised for vaccination and have access equal to that for health staff within the roll out programme.

It is expected the vaccine will be made available on a priority risk basis to further groups over time and eventually be available to the whole population.

3.  Social workers and vaccination

BASW recommends that social workers take-up vaccination against Covid-19 when it is offered to them subject to advice about any (rare) contra-indications.

The offer of vaccination may not come through your employer. It may come via your General Practitioner, other health professional or in Northern Ireland via the PHA and HSCBs.

If you are in employment, an independent social worker, a social worker in the voluntary sector, or student you are advised to take up the first offer of vaccination that becomes available.

You may also find that individual social workers are offered the vaccination at very different points possibly separated by long periods. This may reflect the fact that some social workers are in priority groups (for example, by reason of age, being clinically extremely vulnerable or those with underlying health conditions). Whilst all areas are progressing vaccinations in the priority list order, individuals and groups within each priority may be called at very different times.

4.  Social workers and risk

There is a continuing level of risk for those who choose not to take up the vaccination.

There is rarely 100% take-up of any vaccine in any population, sometimes because there are health contra-indications for a minority of people, sometimes because of fears and unevidenced beliefs about vaccination. In the past, there has been less take-up of vaccination in certain geographical communities, and certain ethnic and socio-economic groups. People in diverse socio economic communities are less likely to be vaccinated[2]. The reasons for this are complex but it seems possible that this pattern of lower vaccination rates may well be replicated with lower take-up of the vaccines against Covid-19.

It is accepted that those who work in ‘people-facing’ roles are by nature of their work more at risk of catching Covid-19. This includes social workers.

Since social workers often undertake work in diverse socio economic communities, it therefore follows that if social workers are not vaccinated, they may face increased risk.

5.  People currently accessing social work services

While vaccination against Covid-19 is in some respects a ‘new issue’ in fact it is part of the wider work of supporting decisions about appropriate health care.

Social workers need to be ready to deal with the issues that people may raise about vaccination. They need to be able to discuss vaccination within the context of existing legislation and policy around individual rights and risk whilst supporting positive health outcomes. This is an opportunity to help people currently using social work services to make informed choices about whether they wish to take up the vaccine.

Social workers, together with other professionals, will be regularly involved in supporting decisions about appropriate health care for people accessing social work services.

Depending on people's wider needs and circumstances, existing legal and policy requirements apply to discussions about health, for example, with children and young people, or for people who do not have capacity or where capacity is an issue.  

Social workers should be particularly alert and informed in respect of informed consent of adults, parental consent for children and processes to determine best interests when a person lacks capacity to decide about the vaccine. Social workers have a key role in protecting people’s rights and promoting wellbeing in this matter as in all areas of our work.

A significant proportion of the population are not registered with a GP. If a service user wants to take up the vaccine, but is not registered with a GP, it seems likely that supporting registration with a GP may be the necessary first step towards achieving this.

The information in this position statement was correct as at 6 January 2021.

 

[1] See for example, Blundell R, Costa Dias M, Joyce R, and Xu X (2020) Covid-19 and Inequalities. London: IFS/Nuffield.  https://www.ifs.org.uk/inequality/covid-19-and-inequalities/

[2] See for example, Marmot M and Wilkinson R (2006) Social Determinants of Health: Second Edition. Oxford: OUP.

Resources

Vaccinating frontline social care workers by NHS England

Process is launched 14 January 2021 which aims to ensure all frontline social care workers who have close personal contact with those who are clinically vulnerable to COVID-19 are vaccinated.  The operational procedure has been launched along with a joint letter by NHS, ADASS, DHSC and LGA.

Read more on the standard operating procedure (SOP) which aims to  support deployment of vaccinations to frontline health and social care workers in priority cohort 2, which includes social workers as identified by the Joint Committee for Vaccination and Immunisation (JCVI).