Care home operators have warned that mandatory Covid vaccinations for staff could worsen workforce shortages and threaten standards of care. The prime minister, Boris Johnson, and health secretary, Matt Hancock, have reportedly agreed to legislate to require vaccinations among the social care workforce in England, after the latest figures showed that about a quarter of care staff have not been vaccinated, rising to 40% in areas of London, Manchester and Luton. Hancock said on Tuesday: “It is something that we are looking at because people who are looking after elderly residents in care homes, who we know to be the most vulnerable to Covid, they have a duty of care not to pass on the disease and it is a reasonable question.” But care operators who employ about 1.5 million workers said it was the wrong approach to tackling vaccine hesitancy, in particular among young women citing unfounded fears the vaccine could affect their fertility, as well as among some black and minority ethnic groups and among workers from the EU. Nadra Ahmed, the executive chair of the National Care Association, which represents independent care operators and will meet Department of Health and Social Care officials on Tuesday afternoon to discuss the issue, said: “It will hinder recruitment.” Vic Rayner, the chief executive of the National Care Forum, which represents charitable care operators, said legal enforcement posed a “real risk to the ongoing delivery of care”. “It has the potential to drive people out of the profession and all of the pressure is going to be on managers and employers to do this,” Rayner said. “We have a relatively older workforce and we really struggle to get young people to join and stay working in care, and there are concerns that this may present a further barrier for young people to join, particularly if this is not applied universally across health and care. “The group that are regularly reported as not wanting the vaccine are those who have questions about fertility. To suggest an employer might be required to force someone to take a vaccine in that position would be extraordinary.” There are an estimated 115,000 care worker vacancies. The GMB trade union, which represents some care staff, said the government’s “heavy handed, we-know-best approach will cause unnecessary anxiety and discontent”. In February, the prime minister’s official spokesman said: “Taking a vaccine is not mandatory and it would be discriminatory to force somebody to take one.” But, according to reports in the Daily Telegraph of a cabinet report circulated last week, a law change is being considered in order to “reach a position of much greater safety for care recipients”. The paper reportedly warns of workers leaving the sector and possible lawsuits on human rights grounds, if the change is made. In the London borough of Lambeth, only 43% of care home workers have been vaccinated, according to NHS and DHSC figures up to 14 March. That is the lowest rate of any borough in England. Nine other London boroughs have rates of between 50% and 60%. The lowest rate outside the capital is in Luton (57%), followed by Reading and Manchester (both 61%). Families considering moving loved ones into care homes are increasingly asking about levels of vaccine coverage among staff, providers said. Barchester, the UK’s second biggest care home provider, has already said it expects all staff to have had the vaccine by 23 April, adding that anyone refusing on non-medical grounds will “make themselves unavailable for work”. It said just over 90% of its 15,000 staff had had the vaccine, and it had been actively tackling misinformation and offering one-on-one discussions with worried staff. It said only 3% were declining. Pete Calveley, its chief executive, said testing of staff showed triple the number of infections among unvaccinated staff compared with vaccinated staff. “People who haven’t had the vaccination are a risk to our residents,” he said. “My view is we should leave this to the decision of the care provider,” said Prof Martin Green, the chief executive of Care England, which represents the largest commercial care home chains. He called for a logistical push to get vaccination teams back into care homes. “If you weren’t on shift when the vaccinations were done for residents then you might have to go to a vaccination centre and care workers might have been homeschooling their children, have other jobs and other caring responsibilities,” he said. “So for them the logistics [matter] as much as anything else.” Mike Padgham, the chair of the Yorkshire-based Independent Care group provider organisation, added: “Rather than force it through legislation, the government has more work to do in terms of persuading everyone, not just care workers, about how important it is that the whole country has the vaccine.”