should vaccines be mandatory for health workers?

greece, italy and france are requiring health staff to be vaccinated against covid. should canada follow suit?

by maija kappler

published jul 15, 2021

last updated jul 16, 2021

5 minute read

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5 minute read

join the conversation

should vaccines be mandatory for health care workers?

the first pfizer-biontech covid-19 vaccine in ontario is administered to personal support worker anita quidangen at a hospital in toronto on monday, dec. 14, 2020. the canadian press/frank gunn

many canadian public health experts are applauding the news that several countries in europe are requiring health care workers to be vaccinated against covid-19. while some epidemiologists and advocates may be urging officials to adopt similar policy measures here, others are concerned about the message mandatory shots might send.greece and france announced this week that the government will require working doctors, nurses and other medical professionals to get the vaccine. italy announced a similar mandate in april. “the equation is simple: the more we vaccinate, the less space we leave this virus to circulate,” french president emmanuel macron said. vaccination appointment rates shot up across france in the hours following the announcement.“long past time for this in canada,” university of toronto epidemiology professor david fisman tweeted monday about news that greece would require its healthcare professionals get the shot, or face unpaid suspension from work. “there’s no reason for hcws [healthcare workers] to remain unvaccinated.”

bravo. long past time for this in canada. there's no reason for hcw to remain unvaccinated.

if you've signed up to care for people, you can't also voluntarily serve as a covid-vector. https://t.co/hscakpkubr
— david fisman (@dfisman) july 12, 2021

b.c.’s seniors advocate isobel mackenzie said monday she thinks the covid vaccine should be mandatory for healthcare workers as well.“i believe it is not unreasonable that when you choose to work in health care, like any profession that includes certain bonafide occupational requirements, that you acknowledge that you will take vaccinations and tests that are required,” mackenzie said in an interview with postmedia.after a deadly outbreak in a sherbrooke cancer ward, quebec now requires oncologists to get vaccinated or take three covid tests each week. ontario currently requires staff at long-term care homes to be vaccinated, show proof of medical exemptions for the vaccine or partake in an educational program about vaccines. cbc news reports that the province is not considering mandatory vaccination. it’s currently considering expanding that long-term care mandate to all health care workers. another option would be to require the unvaccinated to undergo regular covid screening and wear personal protective equipment while dealing with patients.“healthcare workers in general should be vaccinated to protect themselves, their family and their patients,” dr. adam kassam, president of the ontario medical association, said on wednesday. “we know that covid-19 vaccines are safe and effective, and we’re seeing that across ontario. they keep numbers coming down, and we’re seeing improvements in terms of hospital capacity, icu capacity.”in the last three months, the vast majority of young adults who contracted covid-19 — 96 per cent — were unvaccinated. most canadian hospitals do require their staff to get other vaccines, kassam pointed out.“i think it’s important to understand that we have flu vaccine campaigns, and many flu vaccine protocols,” he said, adding that there isn’t a federal or provincial mandate that healthcare workers must get the flu shot, but it’s a common policy at most hospitals, doctors’ offices and other healthcare centres.“it’s institution-specific, but the vast majority of the [places] where i’ve worked do have a mandated policy for flu vaccines.”while kassam hopes healthcare workers will get vaccinated, he’s aware that enforcing it might make people who were already unsure about getting the jab even more suspicious.“i think anything that increases hesitancy or makes people more reluctant to pursue vaccination should always be thought of as a potential side effect for any policy measure,” he said.dr. krishana sankar, a biologist and science communicator with covid-19 resources canada, says the issue of vaccine mandates is “tricky and challenging.”“when it comes to our healthcare workers, i think it’s really important that they’re protected, not just for them and their families but also for the people that they treat,” she said. “we don’t want to have a situation where unvaccinated health-care workers are falling ill and then transmitting the virus to people they’re treating.”sankar is one of several volunteers who run a twice-weekly zoom call listening to concerns people have about the covid vaccine, and answering their questions. the call is open to anyone, although when it started in january it was specifically aimed at people working in long-term care homes.“i think the reasons behind people being uncertain about getting the vaccine have shifted,” sankar said. at first, people were concerned about mrna vaccines, which they (incorrectly) worried would alter their dna. now, she’s answering a lot of questions about whether the vaccine can affect fertility.it might seem surprising that some healthcare workers — people who are highly-educated, with scientific knowledge and, in many cases, first-hand experience of the devastation of covid — might reject the vaccine. but people’s upbringing and their idiosyncrasies can supersede their knowledge, sankar said.“we’re all human,” she said. “people are still influenced by family and culture. if you’ve been raised where your parents or grandparents may not necessarily believe in certain kinds of medications or vaccines, that can still influence people, even when they’re science-literate and have that education.”because many health-care workers are from racialized communities, sankar said one effective way to raise vaccination rates would be to provide more culturally-specific vaccine information. regina, sask.-based indigenous health lab morning star lodge and toronto’s black covid task force are great examples of grassroots organizations working within specific communities, she said, and she hopes those kinds of groups get more support.while there isn’t readily-accessible data on how many canadian health-care workers have received vaccines, kassam said internal oma polling shows that “the vast majority” of ontario physicians are fully vaccinated. but the numbers might not be as high for other roles, such as personal service workers, a workforce that’s overwhelmingly female and racialized, often with low pay and no paid sick leave.it’s worth asking not just whether healthcare workers want the vaccine, said sankar, but whether they can access it. without paid sick leave, many people working as orderlies or personal support workers, for instance, aren’t able to take time off work to get the vaccine, or to recover from possible side effects.a february study of over 8,700 ontario health-care workers found that 68 per cent of respondents would be more likely to get vaccinated if they were guaranteed not to go out-of-pocket for vaccine costs, including paid sick leave and compensation for parking or transit. “those barriers, they don’t exactly make it easier for people to go get their vaccines,” sankar said.