Re-admitting no vax doctors to the ward is a dangerous and anti-science choice

We read these days that the vaccination obligation for health professionals would have been a choice based on ideological considerations rather than on scientific data. I was among those technicians who helped the Italian government manage the pandemic from March 2021 to March 2022 and I would like to share with you the scientific data that were the basis for the decision on the obligation to vaccinate health professionals.

Let’s start from the end, the decree law 31/10/2022 n. 162 modified the previous legislative decree 01/04/2021 n. 44 anticipating by two months (from 31/12/2022 to 01/11/2022) the end of the anti Sars-Cov-2 vaccination obligation for health professionals and health professionals. The legislative decree of 2021 provided for the suspension from professional practice due to non-compliance with the vaccination obligation. The main scientific reasons that motivate the vaccination obligation are the data on the effectiveness of vaccines in preventing infection with the different variants that have occurred from April 2021 to today. The data to which I will refer are taken from the most complete and recent scientific publication that compares all vaccine protection studies against infection with the Alpha, Delta and Omicron variants (PLOS Medicine). Until September 2022, vaccines relied exclusively on the Spike of the Wuhan native virus, and protection from infection decreased over time as each new variant appeared. From December 2020 until June 2021 the Alpha variant was dominant against which RNA vaccines protected around 90% from infection. From July 2021 to December 2021 the Delta variant was dominant against which RNA vaccines protected between 70 and 80% from infection. From January 2022 to today the Omicron variants are dominant (until June 1 and then 5) against which RNA vaccines protect between 30 and 40% from infection. Even the most recent data from the National Institute of Health indicate that Wuhan vaccines (i.e. the first vaccines) protect between 20% and 42% from omicron infection.

The April 2021 dl was dictated by scientific evidence that vaccines protected between 70 and 90% from infection with Alpha or Delta. So not an ideological choice but a very scientific choice based on a basic public health principle that requires the sick population not to come into contact with unvaccinated doctors because they have a greater risk of becoming infected and therefore of infecting others. Regarding protection from infection with Omicron, it is true that since April 2022 we have data indicating that Wuhan vaccines protect “only” 20-40% (depending on age and time elapsed since vaccination) from infection with Omicron , but this means that there is still a measurable greater risk of getting infected in those who are not vaccinated than in those who are vaccinated and therefore there is also a greater risk of infecting the patients with whom they will interact. Add to this that since September 2022 vaccines have been used that combine Spike Wuhan with Spike Omicron and in a few months we will have data that will tell us if, as scientific logic would have it, the new bivalent vaccines protect more than the old Wuhan monovalent vaccine from infection with Omicron.

There are also reasons of medical common sense that would suggest not allowing an unvaccinated doctor to interact with sick people: i) a doctor who does not get vaccinated and one who will probably advise not to get vaccinated and this is very dangerous for a patient; ii) a doctor who does not vaccinate not only is more likely to become infected, but has 5-7 times more risk of getting severe disease and therefore, with the current high circulation of viruses, they will be more frequently absent. We can therefore conclude that the anti-Sars-Cov-2 vaccination obligation for health professionals introduced by Legislative Decree 01/04/2021 n. 44 was dictated by scientific evidence, while the reasons underlying the legislative decree 31/10/2022 n. 162 which removes the vaccination obligation are not supported by scientific data or medical common sense.