8 December 2021

Supporting optometrists in their vaccine decisions

We believe that vaccine uptake will be maximised when staff are supported to make their own decisions, having been provided with clear, evidence-based information on the benefit and value of vaccinations.

The College of Optometrists believe all health and social care workers in primary and secondary care, and their colleagues, should have all recommended vaccinations, unless they are medically exempt. Vaccination is considered to be among the safest, most effective and evidence-based approaches to help protect people from infectious diseases.

However, in line with other healthcare professional bodies, we do not support the Department of Health and Social Care (DHSC) policy of mandatory Covid-19 vaccination in CQC registered healthcare settings in England. We believe that vaccine uptake will be maximised where staff are supported to make their own decisions, having been provided with clear, evidence-based information on the benefit and value of vaccinations.

All optometrists can now self-book an appointment for their Covid-19 vaccinations (including their booster vaccine) on the nhs.uk website 

Primary care optometrists

The policy to make Covid-19 vaccination mandatory currently only applies to CQC regulated settings, and will apply to all optometrists working in secondary care and social care settings. However, it will not impact on the majority of primary care optometrists. Nevertheless, we strongly encourage all primary care optometrists, and practice staff, to have all recommended vaccinations, particularly as the DHSC could choose to implement these rules across all settings in the future.

Encouraging vaccine uptake

While the vast majority of healthcare workers, including optometrists and practice staff have had at least one dose of the Covid-19 vaccine, some that are eligible to be vaccinated may have not yet chosen to do so. 

We recognise that some individuals have concerns about vaccination. Some of the common reasons for vaccine hesitancy include lack of access to appointments, doubts and misinformation about their mode of action, safety and efficacy4, 9, 10, 11, 12 and lack of support and reliable information from colleagues and other social groups9, 12

Evidence suggests that mandating vaccination may actually be counterproductive, as it may shut down the opportunity to discuss and dispel myths and increase knowledge, and may increase distrust in health and science information 6, 7, 8. Furthermore, those who are initially accepting of vaccinations may choose not to by objecting to the government mandating what they should do6, 7.

Previous studies looking into maximising vaccine uptake suggest that providing accessible and flexible services, and regular reminders/recalls are most effective3, 4, 12, 13. Evidence also suggests that good interactions between health professionals and educators to discuss concerns, explain evidence, and discuss the risks and benefits as part of an active listening and motivational interview approach are effective at reversing vaccine hesitancy3, 4, 12, 14.

We therefore believe that 1-2-1 discussions with employers and line managers, and targeted information to dispel misinformation can be highly effective in encouraging vaccine uptake, as well as time off being granted to attend vaccination appointments. 

Resources

There are a range of videos and materials which have been produced to help healthcare professionals and the public understand the benefits of vaccination for themselves and for their patients:

Information and materials provided by each UK nation authority

Information and materials provided by other organisations

Appendix

The impact on the workforce in England

The DHSC have published an Impact Statement on making Covid-19 vaccination a condition of deployment in the health and wider social care sector, which suggests the impact on workforce levels could be significant.

  • As of 14 October 2021, 92% of all NHS employees had received at least one dose of the vaccine, while 89% were fully vaccinated.
  • 1.8 million staff will be subject to the new regulations across both NHS and independent health care providers - of these, 1.68 million are already vaccinated.
  • It is estimated that around 27,000 will take up vaccination following the introduction of the policy, 36,000 will be exempt, but 88,000 will remain unvaccinated.

References

  1. Coronavirus and vaccine hesitancy, Great Britain - Office for National Statistics (ons.gov.uk)
  2. BAME community hesitancy in the UK for COVID-19 vaccine: suggested solutions | Postgraduate Medical Journal (bmj.com)
  3. COVID-19 vaccine hesitancy – debunking the myths using a community engagement approach underpinned by NICE guidance | NICE
  4. Covid-19 vaccination hesitancy | The BMJ
  5. 2021-11-02-coronavirus-covid-19-infection-in-pregnancy-v14.1.pdf (rcog.org.uk)
  6. Vaccine hesitancy: guidance and interventions (2019) K4D, Tull, K
  7. Mandatory infant & childhood immunization: Rationales, issues and knowledge gaps (2018) Vaccine, MacDonald, N. et al
  8. COVID-19 vaccination beliefs, attitudes, and behaviours among health and social care workers in the UK: a mixed-methods study (2021) medRxiv, Bell, S. et al (Not yet peer reviewed)
  9. Vaccine hesitancy and healthcare providers - PubMed (nih.gov)
  10. Vaccines | Free Full-Text | Healthcare Providers’ Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review (mdpi.com)
  11. Knowledge, attitudes, beliefs and behaviors of general practitioners/family physicians toward their own vaccination: A systematic review (nih.gov)
  12. Increasing the coverage of influenza vaccination in healthcare workers: review of challenges and solutions - ScienceDirect
  13. BNT162b2 vaccine uptake and effectiveness in UK healthcare workers – a single centre cohort study | Nature Communications
  14. Using Best Practices to Address COVID-19 Vaccine Hesitancy: The Case for the Motivational Interviewing Approach - PubMed (nih.gov)

Related further reading

COVID-19 and its impact on eyecare: a review

Here we summarise three research papers from a recent issue of Optometry in Practice.

This article provides practical tips for assessing and managing eye health in people with varying degrees of hearing loss.