Why providing mandatory COVID-19 vaccines for health care workers can help Canada fight the fourth wave


As more and more countries adopt controversial methods to protect the health care environment and combat the spread of more infectious variants, Canada’s controversy over mandatory COVID-19 vaccines for health care workers has intensified.

The requirement for vaccination as a condition of employment in hospitals, long-term care homes and other sectors involving hands-on work with patients is not new in Canada-experts believe that in this pandemic, it should be no different.

Canada lacks detailed data on the percentage of health care workers vaccinated.but More than 80% Of eligible Canadians have at least one dose of the COVID-19 vaccine, and Close to 60% There are two-no doubt this is an amazing feat, but one is already Showing signs of diminishing.

Health care workers are one of them Get access first Get the COVID-19 vaccine in Canada to protect them and their patients from infection and prevent hospitals and long-term care homes from being overwhelmed by the epidemic.

However, as the Canadian vaccination campaign slows down, the question of whether they should now be required to be vaccinated to complete their work has become more and more urgent. Reopening the border to U.S. tourists And school starts in September.

On December 14, 2020, Zuo Tamara Duss (left) injected the first COVID-19 vaccine for personal support worker Anita Quidangen in a Toronto hospital. (Frank Gunn/Canada Press)

“I definitely think we should make the COVID-19 vaccine mandatory in healthcare — I think it’s very simple,” said Dr. Nathan Stall, a geriatrician at Mount Sinai Hospital in Toronto and a member of the Canadian National Immunization Advisory Board.

“It is very important that we fully vaccinate those who care for our most vulnerable through direct, hands-on care. There should be no ifs, ands, or buts.”

Controversy over compulsory vaccination in Canada

France has ordered all medical staff to be vaccinated As of September 15 More contagious And maybe More deadly The delta variant drives the recovery of COVID-19 levels. Greece with Italy Similar rules have also been formulated.

This Ontario Medical Association with Registered Nurses Association of Ontario Call for mandatory vaccination for health care workers in Canada’s largest province, estimated to be in the Delta More than 90% The latest COVID-19 case.

But Ontario Governor Doug Ford said last week that even though Ontario health care workers have the “constitutional right” to choose not to be vaccinated Mandatory implementation of immunization policies for staff in long-term care homes To protect disadvantaged residents.

“I think it is their constitutional right to accept or not to accept,” he told reporters on Thursday. “No one should be forced to do anything.”

Alberta Governor Jason Kenney has repeatedly refuted the concept of compulsory vaccination in the province, even Revision of the Provincial Public Health Law Remove a 100-year-old power that allowed the government to force people to vaccinate.

“These people who are worried about mandatory vaccination have nothing to worry about,” he told reporters during the meeting. Calgary Stampede last week.

Watch | Canada lacks national standards for COVID-19 vaccination certificates:

Canada does not have a national standard for COVID-19 vaccination certificates, so provinces and companies have created a “mishmash” approach. 1:54

Proponents of providing mandatory COVID-19 vaccines for health care workers are quick to point out that for decades, they have been required to be vaccinated against other highly contagious diseases—including some that are not as serious as COVID-19.

“I must be vaccinated against hepatitis B, I must be vaccinated against measles, and I must be checked for tuberculosis regularly, otherwise I cannot work in my hospital,” said Dr. Kashif Pirzada, a Toronto emergency doctor. .

“Under this framework, there is no reason to think that COVID-19 vaccination will be unconstitutional. We have already required vaccination against other diseases as terms of employment, so I don’t understand why there is any difference. This is a more deadly disease.”

“COVID-19 is not the flu”

Views recently published in the medical journal JAMA Think that just as health care workers should not “inadvertently spread infectious infections such as measles and flu” to their patients and colleagues, COVID-19 is no exception.

Analysis of the Journal of the Canadian Medical Association Earlier this year, provincial and territorial governments required all private and public health care workers to be vaccinated because of their increased risk of contracting and spreading COVID-19.

Canadian health care workers do not compulsory vaccination against influenza. The author of the CMAJ paper cited an British Columbia nurses win in 2019 Oppose mandatory flu vaccine. But they said that this should not be the case in a pandemic, because “COVID-19 is not the flu.”

Stoll said that past controversies surrounding compulsory flu shots for Canadian health care workers may have exacerbated recent pandemic concerns. But he believes that the reason for compulsory COVID-19 vaccination is much stronger.

He said: “We know this is easier to spread, and the consequences for patients are much more serious than the flu, and COVID-19 is much more devastating to health care workers and the health care system.”

“Health care workers have a fiduciary responsibility to put the needs of patients and the people they care for first… I think these people should not provide long-term care residents with direct, hands-on care and other weak and vulnerable people. people.”

Watch | What the COVID-19 vaccine means for front-line medical staff:

Dr. Tasleem Nimjee, a physician in the emergency room of the Humber River Hospital, described what the COVID-19 vaccine means for healthcare workers on the front lines of the pandemic. 2:29

Raywat Deonandan, a global health epidemiologist and associate professor at the University of Ottawa, said that while it is unethical to refuse someone to provide life-saving care if they have a deep-rooted belief in vaccines, it is ethical to refuse them to work.

“If you are a healthcare worker who refuses to be vaccinated, then you need to change jobs – and you have this choice,” he said.

“But for the patient, to some extent, it may be your right to be skeptical about the drug— [and] When you figure this out, you are entitled to medical care.

“So there is a delicate balancing act. We have to adapt to some of them, but not all of them.”

Reasons for vaccine hesitation

Sabina Vohra-Miller, Toronto pharmacologist Clear science with South Asia Health Network, Which means that not all health care workers should fall into the same category.

“If you’re talking about doctors, that’s one thing. But if you’re really looking at more comprehensive health care workers, it’s different,” she said. “You don’t necessarily have people from privilege or accessibility.”

Vohra-Miller said that health care workers can include personal support workers, long-term care workers, and community outreach workers, who may have different barriers to vaccination, including education, paid sick leave or parenting.

“They do multiple jobs at any given time. They work frantically just to make ends meet,” she said.

“When people think of health care workers, they will unconsciously think of doctors and nurses and people who have access to and received all vaccine education, and should be able to make these decisions-but that is not the case.”

Personal support worker Michael Gellizeau received a dose of COVID-19 vaccine from nurse practitioner Victoria Pierri at the clinic opened by the University of Toronto Health Network on December 15, 2020. (Evan Mitsui/CBC)

The impact of the fourth wave on the health care system

Pirzada said that if in the fall, when COVID-19 levels are expected to rise again, a large proportion of health care workers are still not vaccinated, it could have a significant impact on Canada’s health care system.

He said: “When the spread of the virus in the community rises, it will start attacking healthcare workers.” “Assuming that 30% of our workers are not vaccinated, then when we need them, the community’s spread will reach its peak. At the same level, most of the labor force will be eliminated.”

Stoll said that ensuring that as many health care workers as possible will be vaccinated will keep the health care system stable and mitigate future outbreaks in environments related to undervaccinated workers, such as long-term care homes, as recently exist Burlington with Hamilton.

He said: “We know that a single outbreak can cause severe damage to the healthcare system.”

“We need to take a leadership role on this issue. We need to do this now when the number of cases is low-before autumn, before it’s too late, before our medical facility may have an outbreak.”



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