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Why mandatory COVID-19 vaccines for healthcare workers could help Canada fight a 4th wave

Why mandatory COVID-19 vaccines for healthcare workers could help Canada fight a 4th wave

Debate over mandatory COVID-19 vaccines for healthcare workers intensifies in Canada as more countries move forward with controversial approach to protect healthcare facilities and fight against the spread of more contagious variants.

Requiring vaccination as a condition of employment in hospitals, long-term care homes and other sectors involving hands-on work with patients is not new to Canada – and experts say it should not be. be otherwise with regard to this pandemic.

Canada lacks detailed data on the percentage of healthcare workers who have been vaccinated. But more than 80 percent of eligible Canadians have at least one dose of a COVID-19 vaccine and almost 60 percent to have two – an incredible feat, no doubt, but one that is already showing signs of decrease.

Health workers were among the first to have access COVID-19 vaccines in Canada to protect them and their patients from infection and prevent hospitals and long-term care homes from being overwhelmed by epidemics.

But the question of whether they should now be forced to get vaccinated to do their jobs is becoming increasingly urgent as Canada’s vaccination campaign slows, ahead of the reopening of the border to American travelers and the start of the school year in September.

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

“I absolutely think we should make COVID-19 vaccines mandatory in healthcare – I think it’s a no-brainer,” said Dr Nathan Stall, geriatrician at Mount Sinai Hospital in Toronto and a member of the Committee. Canada’s National Advisory Committee on Immunization.

“It is extremely important that those who care for our most vulnerable with direct and convenient care are fully immunized. There should be no ifs and buts to that.”

Debate over mandatory vaccines in Canada

France has ordered all health workers to be vaccinated by September 15 as more contagious and potentially more deadly The delta variant raises COVID-19 levels. Greece and Italy have also put in place similar rules.

the Ontario Medical Association and the Registered Nurses Association of Ontario called for mandatory vaccines for healthcare workers in Canada’s largest province, where delta is believed to constitute more than 90 percent of the latest cases of COVID-19.

But Ontario Premier Doug Ford said last week that healthcare workers have a “constitutional right” to opt out of v, despite the province. impose immunization policies for staff in long-term care homes to protect vulnerable residents.

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

Alberta Premier Jason Kenney has also repeatedly rejected the notion of mandatory vaccines in the province, even amending the Provincial Public Health Act remove a century-old power allowing the government to force people to be vaccinated.

“Those people who are worried about mandatory vaccines have nothing to fear,” he told reporters during the Calgary Stampede Last week.

WATCH | Canada does not have national standards to prove vaccinations against COVID-19:

Canada does not have national standards for proof of a COVID-19 vaccination and, as a result, there is a “mishmash” of methods created by provinces and companies. 1:54

Supporters of mandatory COVID-19 vaccines for healthcare workers are quick to point out that they have already had to be vaccinated against other highly infectious diseases for decades, including some less severe than COVID-19.

“I need to be vaccinated against hepatitis B, I need to be vaccinated against measles and I need to be tested for tuberculosis periodically, otherwise I cannot work in my hospital,” said Dr. Kashif Pirzada, emergency physician in Toronto . .

“There is no reason for a COVID-19 vaccination to be unconstitutional in this framework. We already require vaccinations against other diseases as a condition of employment, so I don’t see why it’s any different. it’s a much more deadly disease. “

“COVID-19 is not the flu”

A recent view published in the medical journal JAMA argued that just as healthcare workers should not “inadvertently spread contagious infections,” such as measles and influenza, to their patients and colleagues, COVID-19 should be no exception.

An Analysis in the Journal of the Canadian Medical Association Earlier this year, he called on every provincial and territorial government to require vaccines for all private and public healthcare workers because of their increased risk of catching and spreading COVID-19.

Flu shots are not mandatory for Canadian healthcare workers, and the authors of the CMAJ article cite a 2019 case won by nurses in British Columbia against compulsory influenza vaccines. But they say the same shouldn’t be the case during the pandemic, because “COVID-19 is not the flu.”

The debate over mandatory influenza vaccines for Canadian healthcare workers in the past could be at the root of recent concerns about the pandemic, Stall said. But he argues that the case for mandatory COVID-19 vaccines is much stronger.

“We know it is more transmissible, the consequences at the patient level are much more serious than influenza and the disruption to both the health workforce and the health system is much more serious with COVID-19”, a- he declared.

“Healthcare workers have a fiduciary responsibility to put the needs of their patients and those in their care first… I don’t think these people should be providing direct and convenient care to long-term care residents. . and other fragile and vulnerable people.

WATCH | What COVID-19 vaccines mean for frontline healthcare workers:

Humber River Hospital emergency physician Dr Tasleem Nimjee describes what the COVID-19 vaccine will mean for healthcare workers who have been on the front lines of the pandemic. 2:29

Raywat Deonandan, a global health epidemiologist and associate professor at the University of Ottawa, says it is unethical to deny someone life-saving care if they have a deeply held belief against vaccines, he it is ethical to deny him a job.

“If you’re a healthcare worker who refuses vaccination, well, you have to find another job – and you have that option,” he said.

“But for a patient it’s probably your right, to some extent, to be skeptical about pharmaceuticals – [and] you are entitled to health care while you determine it.

“So there is this delicate balance. We have to adapt to some of it, but not all of it. ”

Reasons for reluctance to vaccinate

Toronto pharmacologist Sabina Vohra-Miller, co-founder Unambiguous science and the South Asian Health Network, says that not all healthcare workers should be put in the same category.

“If you’re talking about doctors, that’s one thing. But if you actually look at the wider spectrum of healthcare workers, it’s different,” she said. “You don’t necessarily have people coming in with that much privilege or accessibility.”

Vohra-Miller says health workers can include personal support workers, long-term care workers, and community outreach workers who might have different barriers to immunization, including education, paid sick leave. or child care.

“They have multiple jobs at one time. They work crazy hours, just to make ends meet,” she said.

“When people think of healthcare workers, they automatically think of doctors, nurses, and people who have access and have all of this education about vaccines and should be able to make those decisions – but that’s not necessarily the case. “

Impact on the health system in a 4th wave

Pirzada says that if a significant proportion of healthcare workers go unvaccinated in the fall, when COVID-19 levels are expected to rise again, there could be significant impacts on Canada’s healthcare system.

“When the virus levels rise in the community, it will start hitting healthcare workers,” he said. “If let’s say 30% of our workers are unvaccinated, you’re going to eliminate a large chunk of the workforce, just when we need it, when community transmission is at its peak.”

Stall says ensuring that as many healthcare workers are vaccinated as possible will maintain the stability of the healthcare system and mitigate future outbreaks in settings related to under-immunized staff, such as long-term care homes, such as we saw it recently in Burlington and Hamilton.

“We know the havoc that an individual epidemic can wreak in terms of the health system,” he said.

“We need leadership on this issue. We need to do it now when the number of cases is low – before the fall, before it is too late, when we may have epidemics in our healthcare facilities. health.”

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