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Patient receiving COVID-19 vaccine

COVID-19 and vaccination employment guidance

 

The information below has been compiled by RCN advisers in public health, infection control, and employment relations. We'll be updating it as the situation develops - so please do check back often.

Information on the UK vaccine programme delivery is detailed in Immunisation against infectious disease ‘the Green book’.

The vaccine roll out for the COVID-19 vaccines commenced 8 December 2020. See the specific green book chapter COVID-19 vaccination chapter 14 and UKHSA COVID-19 vaccination: information for healthcare practitioners for full details on the COVID-19 vaccine policy. 

For further country specific information and resources to support the vaccine programme across the UK, see:

Looking for something different? Try our COVID-19 FAQs. Also see the RCN clinical pages on immunisation.

Please see our guidance on COVID-19, mandatory vaccination and vaccination as a condition of employment.

The RCN actively encourages its members to take up the COVID-19 vaccine. The NMC Code requires nurses to take measures to protect their patients and the public as well as to protect themselves against serious illness as a professional responsibility.

Employers should take all reasonable steps to support the vaccination of staff deemed to be at risk. The RCN believes that this includes employers allowing these staff reasonable paid time away from work to attend vaccination appointments. See the section 'employers responsibilities' in mandatory vaccination and vaccination as a condition of employment. 

The RCN recommends taking up vaccination as best practice. RCN members who are refusing vaccination should refer to our section on COVID-19 and mandatory vaccination for the latest information on this.

How do I get the vaccine (NHS, agency, students and those outside the NHS)?

Any staff who have not been offered the vaccine should contact their employer to find out how to go about getting it in the first instances.

In England, frontline staff who have not had the COVID-19 vaccine can call 119 or book online.

In Northern Ireland: NI Direct

In Scotland: NHS Inform

In Wales: NHS Wales

The groups in the population eligible for vaccination are all detailed in the Green Book chapter for COVID-19 vaccination and recommends that temporary staff such as bank or agency workers, including those working in the COVID-19 vaccination programme, students, trainees and volunteers who are working with patients in the NHS or in an independent or voluntary setting, must also be included. 

Please see our guidance on mandatory vaccination and vaccination as a condition of employment. 

Communication materials in different languages

Please see our further information section below for help with accessing a range of materials, leaflets and videos in different languages.

The PHE Migrant Health Guide, a free online resource for primary healthcare professionals to help them support their migrant patients. The information includes guidance on health topics, entitlements to an interpreter, information on data sharing and clarifies migrants’ entitlements to NHS services, among other resources. There is a section specifically on immunisation.The PHE animation Keeping up to date with vaccinations for migrants and the NHSE / PHE resources on reducing health inequalities in vaccine uptake may also be helpful.

Doctors of the World have produced an animation on how to register with a GP and Book a Vaccine. As well as the English version, you can access the animation in other languages by visiting Doctors of the World. 

BAME communities 

There are some understandable concerns about vaccination from some groups, particularly Black Asian and other minority ethnic communities. The Royal College of Nursing recommends that everyone accepts a COVID-19 vaccine when they are offered it. Vaccination is a vital step in protecting already vulnerable communities from further harm and we know that Black, Asian and Minority Ethnic communities are amongst the group that are at higher risk of becoming critically ill and dying as a result of contracting COVID-19.

Tailored local implementation to promote good vaccine coverage in BAME communities is an important factor within a vaccine programme. Such programmes should aim to build trust and confidence in the vaccine as well as tackle misinformation.

Employer's duties

Employers are responsible for undertaking staff risk assessments to identify individuals at higher risk of contracting the virus and/or experiencing serious illness if they do. These risk assessments include factors such as ethnic background, and should be used as the basis for prioritising access to vaccines for staff. It is essential that all staff including those from BAME backgrounds have access to the vaccine as soon as they are offered it. Please see our individual risk assessment guidance for more information.

What is the evidence to show the vaccine is safe for BAME communities?

The Public Assessment Reports from the MHRA contain all the scientific information about the trials and information on trial participants.

There is no evidence either of the vaccines will work differently in different ethnic groups.

Further Information

British Red Cross video encouraging everyone to join the conversation around vaccines.

Colleagues from University Hospitals Birmingham share their experiences of the COVID-19 vaccine, to encourage others to have the vaccine: 

Information from the British Islamic Medical Association on COVID-19 vaccines which addresses many of the myths.  

Learning disabilities

The Challenging Behaviour Foundation

National Development Team for Inclusion (NDTi) guidance on reasonable adjustments

Please see our guidance COVID-19 and mandatory vaccination. 

Guidance from the RCOG on COVID-19 vaccines, pregnancy and breastfeeding and Coronavirus infection and pregnancy.

Conception and fertility

There is absolutely no evidence, and no theoretical reason, that any of the vaccines can affect the fertility of women or men. Everyone is advised to have the vaccine as soon as they are eligible. Those who are trying to become pregnant do not need to avoid pregnancy after vaccination.

The British Fertility Society COVID-19 vaccines and fertility FAQs.

Pregnancy

Pregnant women are advised to be vaccinated. MBRACCE UK, UKOSS and BPSU have produced an infographic summarising the latest data showing the worsening outcomes from COVID-19 among pregnant women and their babies.

The advice, in the Green Book, chapter 14a on COVID-19  is that pregnant women should be vaccinated and if necessary, discuss the risks and benefits of vaccination with their midwife or clinician. The Department of Health and Social Care has produced a new short film encouraging pregnant women to come forward for vaccination.

There is good evidence of the safety of vaccines in pregnancy - please see the UK government COVID-19 vaccine weekly surveillance reports.

Breastfeeding

There is no known risk associated with giving non-live vaccines whilst breastfeeding. JCVI advises that breastfeeding women may be offered any suitable COVID-19 vaccine.

Additional information

Guidance from the RCOG on COVID-19 vaccines, pregnancy and breastfeeding and Coronavirus infection and pregnancy. 

The RCM has also produced information on COVID-19 vaccines. Merged information sheet and decision aid tool (RCOG, RCM, MacDonald obstetric medicine society and UK teratology information service.

The British Society for Immunology video COVID-19 vaccine Q&A: fertility, pregnancy and breastfeeding

Short webinar Pregnancy and fertility Q&A

The COVID-19: the green book, chapter 14a gives detailed information.

The Pfizer BioNtech vaccine: Regulatory approval of Pfizer/BioNTech vaccine for COVID-19 and the Moderna(Spikevax): Regulatory approval of COVID-19 Vaccine Moderna vaccines are both authorised for children aged over 12 years.

A paediatric dose 10μg of the Pfizer BioNTech has also been approved for children 5-11 years old. 

Information provided about the vaccine should cover all the details needed to ensure a parents and young people are able to give informed consent.

More information is available from:

Individuals who have already had COVID-19 or who are suffering from ‘Long Covid’ should be vaccinated.

Having prolonged COVID-19 symptoms is not a contraindication to receiving COVID-19 vaccine. See COVID-19 vaccination: information for healthcare practitioners and the ‘Green Book’ chapter COVID-19: the green book, chapter 14a.

If you are experiencing difficulties at work as a result of time off due to COVID-19 please see our COVID-19 and time off guidance. If you are subject to formal absence management, speak to your RCN steward for support or contact us.

What to expect after vaccination

As with any medicine, the COVID-19 vaccines can cause side effects. These are mostly mild and short lived and while not everyone will get them they are not uncommon. People should be advised that they may get side effects and reassured that these are to be expected. Anyone who becomes very unwell should call 111 or their GP. 

Please see the UKHSA COVID-19 vaccination: information for healthcare practitioners for further information. 

The Resuscitation Council UK have recently updated their position statement regarding Covid-19 and vaccinations.

Please see 'What to expect after your COVID-19 vaccination' for more detailed information and printable leaflets in a range of languages. Contact us if your employer is taking any formal action against you due to sickness absence in relation to the vaccine. You can also see our COVID-19 and time off guidance.

It is really important that people return for the second dose of vaccine

Reporting and monitoring of adverse events after vaccination

All medicines adverse events are monitored by the Medicines and Health Care Products Regulatory Agency (MHRA) and there is a dedicated Coronavirus Yellow Card reporting site.

Any member of the public or health professional can submit suspected side effects through the Yellow Card scheme. The MHRA also publish a Coronavirus COVID-19 vaccine adverse reactions report detailing the adverse events to date reported from the vaccine programme roll out.

Giving other vaccines alongside the COVID-19 vaccine

The guidance in the Green Book chapter for COVID-19 vaccination recommends that COVID-19 vaccines can be co-administered alongside other vaccines. The exception to this is shingles vaccine where a seven day gap between administration of the shingles and the COVID-19 vaccine is recommended.  

COVID-19 vaccination and rare adverse events

Blood clotting, myocarditis and pericarditis and Guillain-Barré Syndrome (GBS): COVID-19 vaccination and rare side effects

COVID-19 vaccination and blood clotting collection information (including guidance for health care professionals and updated leaflets)

Information for health professionals: Blood Clotting following COVID-19 vaccination 

Guidance produced from the Expert Haematology Panel (EHP) focussed on syndrome of Thrombosis and Thrombocytopenia occurring after coronavirus vaccination 

RCGP guidance: Primary Care Management of headache after COVID-19 vaccination

COVID-19 Vaccine induced Thrombosis and Thrombocytopenia (VITT): management of patients presenting to the Emergency Department / Acute Medicine from RCP and RCEM 

COVID-19 vaccination: myocarditis and pericarditis information for healthcare professionals

COVID-19 vaccination: Guillain-Barré Syndrome information for healthcare professionals

What if I am worried about an allergic reaction?

As with any vaccine there is a small risk of serious allergy and anaphylaxis but this is very rare, please see Contraindications and special considerations: the Green Book, chapter 6.

For the COVID-19 vaccines:

  • As for any vaccine, anyone with a previous history of allergic reaction to the ingredients in the COVID-19 vaccines, should not receive it.
  • Individuals with a history of immediate onset-anaphylaxis to multiple classes of drugs or an unexplained anaphylaxis should not be vaccinated with the Pfizer BioNTech vaccine. The AstraZeneca vaccine can be used as an alternative (if not otherwise contraindicated).
  • Those with allergies to a specific drug or vaccine, food or insect stings can safely have the vaccine.

See this guidance for more information along with the Green Book, chapter 14a.

What PPE is required for administering an immunisation including the COVID-19 vaccine?

Immunisers are advised on the infection prevention and control precautions and appropriate PPE for immunisation within the UK infection prevention and control guidance document (see page 17) i.e. wear an FRSM mask on a sessional basis, and risk assess the need for eye protection.

Gloves and aprons are not routinely required unless there is an additional risk of exposure to blood or body fluid contamination/broken skin. This risk is generally very low. If gloves and aprons are worn they are single use and must be removed and changed in between each patient. Hand hygiene must be rigorously applied between each vaccination episode and patient/person contact. You can see the RCN's poster ‘Why you don’t always need to wear gloves when giving vaccines’.

The WHO Framework for decision-making: implementation of mass vaccination campaigns in the context of COVID-19: interim guidance, 22 May 2020 has similar guidance.

I have had the vaccine. Do I still need to wear PPE at work?

All vaccinated staff should still follow current COVID-19 guidelines on PPE and social distancing where appropriate.

Please also see our sections on returning to work, protection from future infection along with our PPE guide.

Find resources and guidance around COVID-19 vaccination delivery on our public health pages. See also:

Further information and education materials

Regulation

Country specific guidance

England

Wales

Scotland

Northern Ireland

 

COVID-19

Employment advice

Clinical guidance

Our work

Supporting you

COVID-19 vaccination

Clinical information, guidance and relevant RCN positions on the UK COVID-19 vaccine programmes.

Our COVID FAQs

Find out how to protect yourself, what you should expect from your employer and what to do if you have concerns.

Our guidance on PPE

Read this alongside your local infection prevention and control policy.

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Page last updated - 22/04/2022

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