The Health Information and Quality Authority has recommended a series of measures to encourage Covid-19 vaccination uptake among health staff, including mandatory vaccination as a last measure to be considered.

The advice to National Public Health Emergency Team (NPHET) says that another option would be the redeployment of staff to lower risk areas, if they do not avail of a vaccination.

HIQA has proposed a progressive series of measures, starting with one-to-one conversations, to extra testing and personal protective equipment, to redeployment, and using mandatory vaccination as a last step.

Its report on the issue says that only Italy currently has a national policy of mandatory vaccination for health staff. The UK has guidance on the issue.

HIQA Deputy CEO Dr Máirín Ryan said she was encouraging all healthcare staff to avail of vaccination as soon as they are eligible.

She said the HIQA recommendations were based on the "intervention ladder" principle.

Meanwhile, the General Secretary of the Irish Nurses and Midwives Organisation has said there is "no indication" that mandatory vaccination of healthcare workers would "help the situation" in relation to uptake of the Covid-19 vaccine among health staff.

Speaking on RTÉ's Today with Claire Byrne, Phil Ní Sheaghdha said the "majority of healthcare workers" are being vaccinated, but she said there is a "big concern" in the group of people who have received one dose of the AstraZeneca vaccine.

She said the INMO are due to meet with the HSE today, where Ms Ní Sheaghdha said she hopes "specific instruction" will be provided for healthcare workers who are concerned about receiving a second dose of the AstraZeneca vaccine.

Ms Ni Sheaghdha said about 150,000 healthcare workers have had the AstraZeneca vaccine.

She explained that last week student nurses were told that if they refuse to take the vaccine that they could not continue with their clinical placement.

She said this issue has been resolved and the directive has been removed.

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Ms Ní Sheaghdha said the Irish health service "cannot cope with a fourth wave".

She said Ireland’s healthcare workers "have done a very good job considering the resources that have been available to us during this pandemic".

Ms Ní Sheaghdha said the HSE confirmed to the INMO that there is a high level of long Covid among INMO members, and that "the level of exhaustion is a weighing feature for them".

She said "it is not humanly or humanely possible" for the health service to provide Covid and non-Covid services at the same time.

"The idea that we will be able to provide Covid and non-Covid services at the same time, will result in a collapsing, of those that work in the health service, because it simply is not humanly possible or humanly possible to continue at the pace they've been going."

She also said there is a "real problem in recruitment".

"Many of our nurses come from countries like the Philippines and India, that have been delayed because of the travel restrictions, generally throughout the pandemic.

"We also have a real issue now with having staffing levels of public health nurses who are providing services and screening, providing vaccination clinics, and extra public health services."