Thirty-two thousand care home staff and tens of thousands of NHS personnel could quit over the government’s insistence that both workforces get vaccinated against Covid, it is feared. The warning came as Sajid Javid confirmed that health service workers in England will have to be fully jabbed by next April or risk being sacked. The move will bring the NHS into line with the care home sector, in which staff have until Thursday to prove that they have had two doses. The health secretary appeared to disclose to MPs when making the announcement about the NHS that, with Thursday’s deadline for care home staff imminent, as many as 32,000 of them have still not yet been jabbed. The Conservative MP Mark Harper, a former government chief whip, told Javid that 32,000 was “a very significant number”. He also asked the government to publish “a plan to deal with what sounds like will be something like tens of thousands of NHS staff who, if the care home workforce is any precedent, are going to end up leaving the national health service”. The minister replied that the number of care home staff was accurate: “The 32,000 number he’s referred to, I would just point out that was the latest number that we had – it’s a published number – at the end of last month.” But it might include potentially thousands of people who are medically exempt, he added. Javid said staff such as doctors and nurses “carry a unique responsibility” to keep patients safe. Workers who deliver personal care services in people’s homes will also have to be vaccinated. “I have concluded that all those working in the NHS and social care will have to be vaccinated. We must avoid preventable harm, and protect patients in the NHS, protect colleagues in the NHS and of course protect the NHS itself,” he told MPs. The only exceptions among the NHS workforce will be for those who are medically exempt from being vaccinated and those who have no face-to-face contact with patients. Javid decided to press ahead with making jabs mandatory despite health unions and some organisations representing doctors voicing strong opposition. He had been warned that compulsion would lead to an exodus of NHS staff who have chosen not to get immunised. “Concerns [were raised] that some people may choose to leave their posts if we went ahead with this. [But] I have carefully considered the responses and the evidence and I’ve concluded that the scales clearly tip on one side,” he told the Commons on Tuesday. Javid said that while 90% of NHS staff had already had both jabs, about 103,000 have not, and in some trusts only 80% have been double-vaccinated. Many are younger women who are or hope to become pregnant, or those from a minority ethnic background. He considered imposing the new legal duty of vaccination on NHS personnel before this winter. But he opted to delay it until April 2022 after warnings from hospital groups NHS Providers and the NHS Confederation that doing that sooner would exacerbate understaffing by triggering an exodus of staff at the time when the health service is under its greatest pressure. Chris Hopson, the chief executive of NHS Providers, said: “Had the policy been introduced any sooner, we would have risked worsening the NHS’s current workforce shortages at a time when the health service is already under huge operational pressure. This could have posed a risk to the quality of care we were able to provide.” Javid said that a statement about the impact of the move to mandatory jabs would be published later on Tuesday but that a full impact assessment would be made public “later”. Other countries including France, Italy and the US have already made vaccination compulsory, he added. Some hospitals in the US have recently fired small numbers of employees after they refused to get immunised. The union Unison, which represents both NHS and care home staff, said there would be “dire consequences” for care homes from Javid’s “draconian approach”. “The staffing crisis will become a catastrophe for a sector already on its knees. Some homes may have to close if care staff are barred from their jobs. Forcing the vaccine on care staff is an own goal by the government,” said Christina McAnea, Unison’s general secretary. Take-up rates would only increase with “persuasion, not punishment”, she added. But Javid believes that, while some NHS staff may leave, making jabs mandatory will drive up vaccination rates by prompting workers in the NHS to finally get immunised in the same way that has already occurred with care home staff. While some care home workers have quit, vaccination rates in that sector have risen sharply since Javid announced in June that he was making it compulsory there. He decided not to force NHS staff to have a flu jab, though is keeping that option “under review”.