As Canadians decide what fixings to put on the table this Thanksgiving, many also face a different, more difficult decision: whether to invite unvaccinated family members to feast alongside them.
With Thanksgiving weekend just days away, experts say choosing not to invite your unvaccinated relatives is the safer, smarter and more ethical option — especially while kids can’t get a COVID-19 jab.
“The vaccines are really effective, but they’re most effective when you’re surrounded by vaccinated people,” said Dr. Matthew Miller, assistant dean at McMaster University’s department of biochemistry and biomedical sciences.
“If you introduce an unvaccinated person who might be infected into that group, then everyone’s risk of a breakthrough infection increases.”
While breakthrough cases among the vaccinated are rare, they do happen.
As of Sept. 18, Ontario alone said there had been just over 8,200 cases reported among the more than 10,000,000 fully vaccinated residents in the province.
Having that awkward conversation with your unvaccinated relative or friend is actually the most ethical thing you can do, according to bioethicist Vardit Ravitsky, who teaches at Université de Montréal and Harvard’s medical school.
“It’s absolutely reasonable, beyond reasonable. I think it’s totally ethical,” Ravitsky said. “I think the people who should worry about the ethical aspects of their decisions are those who choose not to be vaccinated.”
At this point, she said, those who are able to be vaccinated but choose not to do so aren’t just doing the equivalent of driving without a seatbelt — they’re driving drunk.
“Not being vaccinated is driving drunk. You are actually risking others,” Ravitsky said.
“And so I think that even in this very, very sensitive context of families and friends, a part of our ethical responsibility right now is still to educate, to advocate for vaccination and to try and convince our relatives and friends to do the right thing.”
Research shows that the best way to strike up a conversation with vaccine-hesitant Canadians is to do so with “respect and empathy,” according to Ravitsky. It’s important not to laugh at them, she said, and not to dismiss their concerns.
“Come from a place of empathy. Say things like, ‘I understand that you’re feeling under pressure. I understand that you’re feeling under threat.’ Usually, our human rights and freedoms are the main consideration in our society, but we’re living in a very particular point in time,” she said.
“This is all temporary. We will get out of this. But in order to get out of it and get back to respect for human rights and your liberty to choose what to do, we need the vaccine.”
If the conversation goes poorly and you’re feeling guilty about booting a relative from this year’s invite list, Ravitsky said you should cut yourself some slack.
“Those who are struggling with the fact that we cannot invite people that we usually invite, we should not carry this burden of guilt,” she said. “It’s those who are not vaccinated that should carry this burden.”
No vaccine is 100 per cent effective, Miller said. People can have different immune responses when they get vaccinated that result in slightly different degrees of protection — that’s why some immunocompromised Canadians have gotten a third shot.
“It’s like wearing a bulletproof vest, right? Just because you’re wearing that vest doesn’t mean you want to get shot at, and there are places the vest doesn’t cover where you can still get hurt,” Miller said.
“Vaccines are similar. They’re really good protection, but they’re not perfect protection, and we know that.”
Taking away the “weapon” is the best way to keep people safe, Miller added, and in this case, that weapon is the coronavirus.
Because kids can’t be vaccinated just yet, this responsibility falls to the adults, Miller said.
“The best way to keep children safe is to ensure that the adults around them are vaccinated.”
Any uptick in cases this year, Miller added, is “most likely to disproportionately affect” children.
“That not only has health implications, of course, for the children directly, but also problematic implications for the ability for schools to stay open and operate safely,” he said.
As of Oct. 1, a significant number of COVID-19 cases across Canada — more than 20 per cent — were among those under the age of 19. On top of that, just days after schools opened in September, COVID-19 outbreaks forced a number of them to close again throughout the country.
There are lots of different considerations that should come into play when deciding who should sit around the Thanksgiving table, according to Dr. Alexander Wong, an infectious diseases specialist.
“If you’re in a Delta hot spot … especially Alberta, Saskatchewan, southern Manitoba and other parts of the country, which are surging — Northwest Territories, for example — then honestly, it does not make sense at this point to gather in large groups,” Wong said.
“I would try to do the best you can to keep your bubbles as tight as possible and, to the best of your ability, try to keep your bubbles comprised of individuals who are fully vaccinated.”
Miller added that Canadians can take other steps to make their dinners safer, including opening windows, keeping their gatherings small or even eating outside. Getting family members tested for COVID-19 can add another layer of protection, too.
“When you combine all of those layers together, right, the virus is more likely to run into a barrier,” he said.
But before sitting down to supper, Miller says Canadians should take that awkward, added precaution of telling unvaccinated family members not to attend.
“The consequences are minimal in comparison to the potential consequences of having to contact everyone who is at your gathering days later, because you found out that someone was infected and now everyone needs to isolate,” he said.
“It’s hugely disruptive.”