Care home staff in England will have to be immunised against Covid-19 as a condition of keeping their jobs, the government has announced, and the stricture may also be extended to health workers.

Under proposed legislation, from October anyone working in a registered care home in England for residents requiring nursing or personal care “must have two doses of a Covid-19 vaccine unless they have a medical exemption”, the government said.

The rule will apply to all workers, whether employed directly by the care home or by an agency, as well as to volunteers. They will have 16 weeks to get the jab or risk the sack. About 1.5m people work in adult social care in England.

Those going into care homes to provide other services to residents, such as hairdressers or tradespeople, will also have to follow the new regulations, unless they have a medical exemption. However, there will be no obligation on visiting friends and family to comply.

Ministers have become increasingly concerned at coronavirus vaccine take-up rates in care homes, which they believe put some of the country’s most vulnerable people at additional risk of contracting the disease.

The health department said that, while the majority of care home workers had been vaccinated, only 65 per cent of older people’s care homes in England were meeting the minimum level of staff uptake for one dose needed to reduce the risk of outbreaks in such “high-risk” settings — and this fell to just 44 per cent for care homes in London.

Overall, about 80 per cent of care workers have had at least one jab but take-up has been lower in the capital, where staff tend to be younger.

The responses to a government consultation launched in April had “made a case for extending this policy beyond care homes to other settings where people vulnerable to Covid-19 receive care, such as domiciliary care and wider healthcare settings”, the government said.

A further public consultation would be launched “on whether or not to make Covid-19 and flu vaccination a condition of deployment in health and care settings”, it added.

Matt Hancock, health and social care secretary, said: “We have a responsibility to do all we can to safeguard those receiving care including in the NHS and so will be consulting further on whether to extend to other health and social care workers.”

Meanwhile, the decision to require care workers to be inoculated was “the right thing to do and a vitally important step to continue protecting care homes now and in the future”, he added.

A Whitehall source said there was a precedent in the requirement for some frontline doctors to have the hepatitis B vaccine.

However, organisations representing care homes have consistently warned against making vaccination compulsory out of fear staff might quit rather than get a jab, deepening workforce shortages.

The GMB union on Wednesday slammed the “ill thought through” plans and warned that more than a third of its carer members would consider resigning if vaccines were mandatory. The government should instead do more to address vaccine hesitancy, it said.

Rachel Harrison, GMB national officer, said steps the government could take included “ensuring more mobile NHS vaccination teams so those working night shifts can get the jab”.

Instead, ministers were “ploughing ahead with plans to strong-arm care workers into taking the vaccine without taking seriously the massive blocks these workers still face in getting jabbed”, she added.

Professor Martin Green, chief executive of Care England, an industry body, said that if regulation was “the vehicle of choice”, it was essential that all the issues that would be thrown up by mandatory vaccination for social care staff should be “comprehensively addressed” before it was introduced.

“There must be central guidance, funding and leadership in helping to support adult social care providers in implementing the regulation. In other words, there must be appropriate infrastructure support,” he added.