Some British companies are planning to give their workers a stark choice this year: Accept the coronavirus vaccine or lose your job.

Labor rights groups have come out against the policy, dubbed “jabs for jobs,” arguing that mandatory vaccines would not stop the spread of the virus but could lead to discrimination on socio-economic and ethnic grounds.

“A ‘no jab, no job’ approach will be counterproductive,” said Christy Hoffman, general secretary of UNI Global Union, a Swiss-based group that represents more than 2 million service workers worldwide. “To make workplaces safer, employers cannot take shortcuts, and that is what these proposals are.”

In Britain, two private elderly care home companies, employing more than 20,000 people between them, have said they will require vaccinations for staff, citing concerns about the spread of the virus in a sector that has seen a large proportion of covid-19 deaths.

Care UK announced last week that vaccinations would be required for any new staffers. Another firm, Barchester, announced shortly before that it expected all workers to be vaccinated by April 23, though it said that there would likely be an exemptions for pregnant staff.

Supporters of the “jabs for jobs” policies in care homes have pointed to the reports of low uptake of the vaccine among elderly care home staff, which stood at around 52 percent in London last week, according to government officials.

But these policies may not be limited to care workers. In January, the chairman of Pimlico Plumbers, a London-based maintenance company that employs around 400 people, said he expected all of his staff to get the vaccine to continue working.

“No vaccine, no job,” Charlie Mullins announced in an interview with financial newspaper City A.M. “When we go off to Africa and Caribbean countries, we have to have a jab for malaria — we don’t think about it, we just do it.”

Businesses decide

Vaccine uptake has historically been high in Britain without mandatory requirements, but even before the pandemic some doctors were urging a move toward a stricter system. The coronavirus may hasten those concerns.

U.K. Chief Medical Officer Chris Whitty said last month that he expected the coronavirus vaccine to be “a norm” for health-care workers. “There’s an expectation if you’re a surgeon, you’ve got to get a hepatitis B vaccine. So it’s not that this is completely new territory,” Whitty told the Evening Standard.

The Daily Mail reported this week that the government was reviewing if workers in Britain’s state-run National Health Service could be required to accept coronavirus vaccines.

The report drew critical responses from groups that represent doctors and other medical workers. “Forced vaccinations are the wrong way to go and send out a sinister and worrying message,” Christina McAnea, general secretary of UNISON, Britain’s largest union.

Private employers may face a different calculation. While vaccine minister Nadhim Zahawi said last month “it is obviously up to businesses what they do,” other government guidance has suggested that forcing existing employees to take the vaccine may be illegal.

Karl Plunkett, head of marketing and public relations at Pimlico, told The Washington Post that vaccinations would be required of all new hires, but the firm has not rolled out the policy as most younger people are not able to get vaccines yet.

Plunkett said that the new contracts had been checked by lawyers and would be in place within months. Many of Pimlico’s staff were already conscious of health concerns at work, he said.

“When you’re going into people drains, most of our guys are already using vaccines for some of the nasty, virtually medieval diseases you see,” Plunkett said.

Some legal experts have argued that issues of consent could mean such contracts violate Public Health (Control of Disease) Act 1984, a British law that stops individuals from being forced to undergo medical treatment, including vaccination.

A separate law, the Equality Act 2010, that precludes discrimination on lines of age, gender, disability and religious or other beliefs, may also be relevant.

The issue cuts across complicated lines of race and class in Britain. A poll conducted by the Royal Society for Public Health in December found that 79 percent of White people said they would seek the coronavirus vaccine compared to 57 percent of ethnic minorities.

The same poll found significant differences in vaccine hesitation between managerial and professional occupations and those in manual labor occupations, with 84 percent of the former saying they would take the vaccine compared to 70 percent of the latter.

Shereen Hussein, a professor at the London School of Hygiene & Tropical Medicine, noted that many employees in the care-home sector were minorities and the sector was predominantly female. Pregnant women are not recommended to get the vaccine yet due to limited testing data.

The issue was not just one of legal discrimination, Hussein said, but practical staffing issues in social care, “where we have issues of high vacancies, high turnover rate.”

A global debate

The question extends beyond Britain, where polling suggests support for vaccination is among the highest in the world.

In Australia, the Council of Small Business Organizations said last summer it would support making vaccines mandatory, while the chief executive of United Airlines reportedly said in January he thought the right thing to do was make the vaccine mandatory for all staff.

But matters of public health are rarely a decision left to businesses. In Israel, which is leading the world in getting vaccine doses out, the Ministry of Health announced this week that unvaccinated people would be prohibited from working in some parts of the health sector.

In the United States, guidance from the Equal Employment Opportunity Commission that was published in December did not prohibit businesses from making vaccinations mandatory. However, lawmakers in almost two dozen states have proposed laws that outlaw vaccination mandates for employees.

While those laws are not expected to pass, there are some complications for employers: The EEOC guidance does not include clear provisions for disabled workers with health risks or those who refuse vaccines on religious grounds.

While some U.S. health-care workers have been required to get vaccines in the past, James Brudney, a professor of employment law at Fordham University in New York, said there was a big legal difference between an influenza vaccine and a coronavirus vaccine.

“Employees challenging employer mandates of influenza vaccines have often been unsuccessful in the courts. However, the medical community knows a lot more about influenza vaccines than covid vaccines,” Brudney said, noting that the Food and Drug Administration has cleared coronavirus vaccines only under emergency use authorization.

Brudney added that many countries would likely impose stricter rules than the United States, with the European Convention on Human Rights including provisions that could affect cases, and several Asian countries that recognized individual rights to choosing medical treatments.

Some labor advocates are urging employers to try different approaches, including education and paid leave to take the vaccine. Hoffman said it was not surprising that there were doubts about vaccines that had been developed quickly and issued under emergency rules.

“It will take some time to overcome these fears, and a threatening environment will only exacerbate tensions,” Hoffman said.