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


France, Italy and Greece have made shots mandatory amid calls for Canada to do the same.

The debate over mandatory COVID-19 vaccines for health care workers is growing louder in Canada as more countries move forward with controversial approaches to protect health care settings and fight the spread of more infectious forms.

The need for vaccination as a condition of employment in hospitals, long-term care homes and other sectors working with patients is nothing new in Canada – and experts agree when it comes to this pandemic. So it should be no different.

Canada lacks detailed data on the percentage of health care workers who have been vaccinated. but more than 80 percent Eligible Canadians have had at least one dose of the COVID-19 vaccine and about 60 percent There are two – a wonderful achievement, undoubtedly, but one that is already showing signs of diminishing.

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

But the question is whether they should now be required to vaccinate to do their job, as Canada’s immunization campaign has slowed even before the pandemic has slowed. Reopening the border to US travelers And the start of school in September.

Dr. Nathan Stoll, a member of Canada’s National Advisory Committee on Geriatrics and Immunization at Mount Sinai Hospital in Toronto, said, “I absolutely think we should make COVID-19 vaccines mandatory in health care – I think It’s a no brainer.”

“It’s extremely important that we have people who are caring for our most vulnerable with direct, practical care. Fully immunized needs to be done. There shouldn’t be any ifs, and, or but.”

Debate on mandatory vaccines in Canada

France orders all health care workers to get vaccinated as of 15 september more contagious and potential more lethal The Delta variant shows increased levels of COVID-19. Greece and Italy have also made similar rules.

Ontario Medical Association and Association of Registered Nurses of Ontario Calls for mandatory vaccines for health care workers in Canada’s largest province, where Delta is expected more than 90 percent of the latest COVID-19 cases.

But Ontario Premier Doug Ford said last week that health care workers have a “constitutional right” to opt out of V, regardless of the province. Mandatory vaccination policies for long-term care home workers To protect vulnerable residents.

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

Alberta Premier Jason Kenney has repeatedly dismissed the notion of mandatory vaccines in the province, even Amendment to the province’s public health act To remove the 100-year-old power that allowed the government to force people to vaccinate.

“These people who are worried about mandatory vaccines have nothing to worry about,” he told reporters. Calgary Stampede Last week.

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Proponents of mandatory COVID-19 vaccines for health care workers are quick to point out that they need to be vaccinated against other highly infectious diseases for decades – including some less serious than COVID-19.

“I have to be vaccinated against hepatitis B, I have to be vaccinated against measles, and I have to have tuberculosis tests from time to time, otherwise I can’t work in my hospital,” says Dr. Kashif, an emergency physician in Toronto. Pirzada said. .

“There’s no reason a COVID-19 vaccination would be unconstitutional in that framework. We already need vaccinations against other diseases as a term of employment, so I don’t see why it’s any different. And this one It’s a very deadly disease.”

‘COVID-19 is not influenza’

A recent approach published in the medical journal JAMA Argued that just as health care workers should not “unintentionally spread infectious infections” to their patients and colleagues, such as measles and influenza, COVID-19 should be no exception.

An analysis in the Canadian Medical Association Journal Earlier this year it called on each provincial and territorial government to make vaccines mandatory for all private and public health care workers because of their increased risk of catching and spreading COVID-19.

Flu shots are not mandatory for Canadian health care workers, and the authors of the CMAJ paper quote a Case of 2019 won by nurses in British Columbia Against mandatory flu vaccine. But they say that should not happen in a pandemic, because “COVID-19 is not influenza.”

Stahl said the debate over mandating flu shots for Canadian health care workers in the past could heighten recent concerns in the pandemic. But he argues that the case for mandatory COVID-19 vaccines is much stronger.

“We know it is more contagious, the consequences at the patient level are much more severe than with influenza and the disruption to both the health care workforce and the health care system is much more severe with COVID-19,” he said.

“Health care workers have a fiduciary responsibility to meet the needs of their patients and the needs of those they are caring for first. I do not think those individuals should provide direct, practical care to long-term care residents . and other weak and weak persons.”

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Revath Devanandan, a global health epidemiologist and associate professor at the University of Ottawa, says it is unethical to deny life-saving care to someone who has a strong belief against vaccines, but it is ethical to deny them a job.

“If you’re a health care worker who’s refusing vaccinations, well, you need to get a different job — and you have that option,” he said.

“But for a patient, it’s probably your right, to some degree, to be skeptical about pharmaceuticals — [and] You have a right to health care when you find out.

“So that’s a delicate balancing act. We have to accommodate some of it, but not all of it.”

Reasons for Vaccine Hesitation

Toronto-based pharmacologist Sabina Vohra-Miller, who co-founded unambiguous science And this South Asian Health Network, says that not all health care workers should be put in the same category.

“If you’re talking about physicians it’s one thing. But if you’re really looking at the full spectrum of health care workers it’s a different situation,” she said. “You don’t necessarily have people coming with so much privilege or access.”

Vohra-Miller says health care workers can include individual support workers, long-term care workers and community outreach workers, who may have a variety of barriers, including vaccinations, education, paid sick leave or childcare.

“They’re doing too many jobs at any given time. They’re working crazy hours, just to fill their stomachs,” she said.

“When people think of health care workers, they automatically think of doctors and nurses and people who have all this education on vaccines and should be able to make these decisions – but not necessarily is.”

Impact on the health care system in the fourth wave

Peerzada says that if a significant proportion of health care workers remain uninsured in the fall, when COVID-19 levels are expected to rise again, there could be a significant impact on Canada’s health care system.

“When the virus rate increases in the community, it starts killing health care workers,” he said. “If let’s say 30 percent of our workforce isn’t vaccinated, you’re going to destroy a huge chunk of the workforce, right when we’re going to need them, when community transmission is about to be at its highest.”

Stoll says that ensuring as many health care workers are vaccinated as possible will maintain stability in the health care system and reduce future outbreaks in settings involving less-vaccinated workers, such as long-term care homes, as seen recently. has gone. burlington and hamilton.

“We know the havoc that an individual outbreak can cause in terms of the health care system,” he said.

“We need leadership on this issue. We need to do it now, while case numbers are low — before the decline, before it’s too late, is when outbreaks can occur in our health care settings.”

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