TY - JOUR T1 - No Jab, No Job? Ethical Issues in Mandatory COVID-19 Vaccination of Healthcare Personnel JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2020-004877 VL - 6 IS - 2 SP - e004877 AU - Rachel Gur-Arie AU - Euzebiusz Jamrozik AU - Patricia Kingori Y1 - 2021/02/01 UR - http://gh.bmj.com/content/6/2/e004877.abstract N2 - Summary boxMandating COVID-19 vaccination of healthcare personnel (HCP) could maximise vaccine uptake, but risks exacerbating breakdowns in trust between HCP and their institutions.Ethical arguments for mandating COVID-19 vaccination of HCP appeal to their duties to ‘do no harm’ and to care for patients, but the fulfilment of these duties requires a safe working environment.We argue for policies aimed at strengthening HCP’s trust in healthcare systems by addressing HCP concerns, including the institutional factors that have put them at risk of infection throughout the COVID-19 pandemic, before considering a COVID-19 vaccine mandate.The COVID-19 pandemic continues, but its potential end is in sight. The first COVID-19 vaccines have been distributed.1 2 Multiple vaccine allocation plans rooted in fair, just and equitable global vaccine allocation aim to maximise the benefits of vaccination programmes.3–6 One common factor in COVID-19 vaccine allocation plans to date is the prioritisation of healthcare personnel (HCP). We define HCP as all frontline workers at healthcare settings including but not limited to: physicians, nurses, physicians’ assistants, laboratory technicians, students on rotation, administrative staff, cleaning personnel and security staff. Though hierarchies of vaccine prioritisation among different groups of HCP have been proposed, this analysis focuses on HCP generally as a population.4 Prioritising HCP to receive COVID-19 vaccines is relatively uncontroversial and commonly justified by HCP’s right to be protected from occupational infection, the need to maintain healthcare staffing, and/or the protection of patients from being infected by HCP.7The pandemic emergency has exacerbated shortages in healthcare staffing and resources,8 heightening the importance of protecting HCP. Vaccinating HCP against COVID-19 first could therefore help to maximise the benefit of a limited resource,9 assuming that vaccinated HCP continue to care for patients, including those infected with COVID-19. Vaccinated HCP may also impose less risk of … ER -