Italy made COVID-19 vaccines mandatory for health-care workers in April.
In France, workers in the sector have been ordered to get immunized by Sept. 15, or face the consequences.
And in Greece, such workers were warned they’d be suspended from their jobs if they refuse to get their shots.
Is it time Canada followed suit and made vaccination compulsory for those who care for our most vulnerable?
While some health and ethics experts told the Star Canada’s current high vaccination rate could mean a mandatory immunization policy for health-care workers might not be necessary, others said it’s a matter of public safety and people deserve to feel secure when they interact with those in the health-care system.
“It is coming time for us to really put protocols into place to ensure health workers are vaccinated. It’s unfair to patients who are receiving care in a variety of settings, that they are potentially being cared for by unvaccinated health workers,” said Naheed Dosani, a palliative care physician and lecturer at the University of Toronto.
Ontario and the other provinces and territories, which are responsible for delivering health care in Canada, should be mandating immunization of those staff and should do so in a compassionate way, said Dosani. Many workers who are unvaccinated are dedicated to caring for others, and have faced systemic barriers to vaccination, he said.
“We should also reduce barriers to vaccination, this includes encouraging paid time off for vaccine side effects, supporting mobile clinics … and arranging transportation for workers to go to the clinics,” he said.
So far in Canada, only Quebec has mandated that staff in certain hospitals be immunized or they might be put on unpaid leave or face other consequences such as having to undergo frequent COVID-19 testing.
B.C. said this month it is considering making vaccination mandatory for long-term-care workers.
However, Ontario has moved in the opposite direction as Premier Doug Ford announced last week that he opposes mandatory shots and proof of vaccination for anyone, including health-care workers.
In Ontario as of July 1, staff, student placements and volunteers in long-term-care must provide proof of vaccination, documented evidence of a medical exemption for the vaccine, or participate in an educational program about the benefits of the vaccine and the risks of not being vaccinated.
Following Ford’s comments, the Ontario Medical Association called for mandatory vaccinations in health care. On July 15, the Registered Nurses Association of Ontario also launched a campaign urging the province to make vaccination mandatory for those in contact with patients.
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As of Wednesday, about 80 per cent of adults in the province had received one dose of the vaccine and close to 64 per cent had received two.
According to the most recent vaccine surveillance report from Public Health Ontario dated July 10, some 729,000 Ontario health-care workers had been fully vaccinated, including long-term-care workers, retirement home workers and others in the health-care sector.
Ontario has an abundance of vaccines and it is the right time to put a policy in place requiring vaccination for health-care professionals, said Doris Grinspun, CEO of the RNAO.
“The first duty of a health professional is do no harm. If you’re not fully vaccinated, the chances you can transmit the virus are higher, both to patients and to colleagues,” said Grinspun.
What has impeded vaccine access, especially for personal support workers is lack of supports including sick days, time off to get the vaccine and transportation to clinics, she said. That’s why the RNAO is calling on the province to bring vaccinations to workplaces and to add an additional two sick days to cover feeling unwell after the vaccine.
The provinces and territories can implement compulsory vaccination policies if they choose and such a move likely wouldn’t be considered a rights violation, said Tracey Tremayne-Lloyd, a health law specialist and founder of TTL Health Law.
Claims anyone might make against an immunization policy through citing the Charter of Rights and Freedoms would likely not hold up, as mandatory vaccination would be in the interest of a free and democratic society, said Tremayne-Lloyd.
“What they’re trying to do is protect the citizens of the country from this deadly virus. And you are in a job where you can get it and transmit it,” she said. This means an individual could refuse a vaccination, but they can’t expect to be allowed to continue to work in health care if they do so and if a mandatory vaccination policy is in place, she said.
The safety of patients has to supersede that of a health-care worker’s choice, but it’s important to know what percentage of all health-care workers are not vaccinated before a mandate comes in, said Kerry Bowman, a professor of bioethics at the University of Toronto. That data is not currently publicly available.
“I’m not sure we’re at the point where it has to be mandatory right now,” he said, adding he believes it’s an ethical obligation to get vaccinated but it’s important to see how many are refusing at this point. Some may have just not had the chance yet, and we should be working on getting them the vaccine before we start imposing mandates, he said.
When making choices around mandating the vaccine, Canada should look to other nations to see how policies are impacting those populations, and what’s working and not working, said Andrew Boozary, executive director of social medicine at the University Health Network.
“We can’t just feel that we’ve done the best we can on the vaccine,” said Boozary. “This is when we need an immense amount of effort in ensuring we aren’t claiming victory in any way too early, and ensuring we are in lockstep in where the evidence and science is going.”
Olivia Bowden is a Toronto-based staff reporter for the Star. Reach her via email: firstname.lastname@example.org
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