Several European countries have made COVID-19 vaccines mandatory for their healthcare workers – and now there are growing calls to do the same in Canada as the country slowly reopens.
They joined Italy which in April became the first European country to mandate the shots for health workers through a government emergency decree.
In Canada, while frontline workers were prioritized to get the vaccines in the rollout across different provinces, many doctors feel it should be a requirement to mitigate the risk of transmission in hospitals.
“It’s really not fair that people go to hospitals or clinics and seek access to health care and their healthcare workers may not be vaccinated,” said Dr. Naheed Dosani, a palliative care physician and health equity lead at Kensington Health in Toronto, Ont.
“That puts them in very precarious and unsafe positions”
Besides putting the patients’ lives in danger, being unvaccinated could also pose a threat to the healthcare workers themselves, Dr. Donald Vinh, an infectious disease specialist and a medical microbiologist at the McGill University Health Centre (MUC), said.
“It should be mandatory to be vaccinated if you are going to work with patients,” he added.
Since the start of the pandemic, more than 65,000 health-care workers have been infected with COVID-19 in Canada, as of Jan. 15, according to a report by the Canadian Institute for Health Information (CIHI). Some 43 health workers have also died across the country, as of Feb. 19, data from the Canadian Federation of Nurses Union shows.
Dr. Isaac Bogoch, an infectious diseases physician at the Toronto General Hospital, said that anyone who comes into contact with patients — not just doctors and nurses — should be vaccinated.
This includes a long list featuring physiotherapists, occupational therapists, dieticians, speech language pathologists, and personal support workers, he said.
“If you are going to be patient facing, you can’t put people who you’re trying to protect, especially the most vulnerable populations, at risk,” he told Global News.
Dosani said that a number of barriers were holding back healthcare workers from getting vaccinated.
Access to vaccines, limited paid sick days for side effects and misinformation were among them. Hence, institutional support was needed to increase the vaccine uptake, he said.
“I think we really need to focus on that one-on-one education, counseling, but we also need to give people paid time off for vaccine side effects,” he said.
“We need to bring the vaccines to people’s workplaces.”
Right to refuse vaccines
According to an Ipsos poll conducted exclusively for Global News in April 2021, 69 per cent of Canadians said they were in favour of making the COVID-19 inoculations compulsory.
Mandatory vaccines is a controversial topic in Canada and there are some legal barriers to enforcing it.
Under the Section 7 of the Canadian Charter of Rights and Freedoms, Canadians have a right to refuse medical treatment and to make “reasonable medical choices” without the threat of criminal prosecution.
From an ethical standpoint, Kerry Bowman, a professor of bioethics and global health at University of Toronto, argued that the safety and well-being of patients takes precedence over the rights of healthcare workers.
But he added that more information was needed about the percentage of unvaccinated healthcare workers and their reasons before coming out with a blunt requirement.
“We’re really not in a position at this point to do mandatory (vaccines) because we haven’t fully defined the problem yet,” Bowman said.
The Ontario Medical Association, which represents more than 43,000 physicians, medical students and retired physicians across the province, said in a statement on July 16 that all healthcare workers should be required to get fully vaccinated.
In an open letter to the provincial government dated July 20, Ontario’s Registered Nurses Association also stressed the importance of mandatory vaccination for all health-care workers.
But Ontario Premier Doug Ford has previously said that his government is not considering making COVID-19 vaccinations mandatory for health-care workers, saying it is their “constitutional right” to decide whether or not they want to get the shot.
While it is not current protocol for healthcare workers to disclose their vaccination status to their colleagues or patients, Dosani said he has been asked that question a couple of times.
“I do think they (patients) should really know the vaccination status of the health worker that they have or have the faith in the system that has mandated all healthcare workers to get vaccinated so they don’t have to worry about that anymore.”
To offer reassurance, many healthcare workers are also voluntarily sharing that information with their patients at the time of visit, Bowman said.
When asked if patients should have a say in choosing to be seen if they wished by only vaccinated healthcare workers, Bogoch said the onus should preferably be on the institution and the healthcare system at large in making such a distinction.
“Not everyone’s going to have the capacity to discuss and have a conversation with their provider or providers in a very complex environment to say, who’s vaccinated, who isn’t.
“I don’t think that’s really fair.”