First things first, if you’ve read the title of this blog, and are hoping to find ammunition to promote a vaccine hesitant agenda, you won’t find it here. Go watch Fox News or Newsmax or any other QAnon affiliated vaccine disinformation service.
The COVID vaccines are safe and they are incredibly effective. Something like 99.5% of all patients in hospital ICUs with COVID are people who have not been fully immunized. Many of them beg to get immunized after getting sick, but by then it’s too late.
Frankly, I think an argument could be made that the mRNA COVID vaccines are the most effective vaccines science has ever developed. If you remember nothing else from this blog – remember this – I encourage you to all voluntarily get vaccinated for COVID, especially now that we seem to have adequate supplies.
Making vaccines mandatory/vaccine certificates however, introduce a whole new set of concerns that I don’t think have been well thought out.
The rationale for introducing Vaccine Passports/Certificates appears to be to protect society. By requiring documentation that you have been vaccinated prior to allowing you to go to a restaurant/travel in Canada/attend sporting events etc, the thinking is that you will prevent the spread of COVID.
The argument for making COVID vaccinations mandatory for health care workers is that patients should feel safe when accessing health care, and be assured they won’t get COVID19 from someone who is treating them. The point has also been made that health care workers are often required to show proof of immunity to things like Hepatitis B and Tuberculosis. So why not add COVID to the list? (Interestingly, those who espouse this view conveniently forget that health care workers are not required to immunize yearly for the flu, and the flu kills far more people every year than either TB or Hep B).
But.
One thing this pandemic has taught us, is that there is a small group of people out there who are extremely mistrustful of authority. They won’t trust doctors/public health officials/nurses etc. They prefer to do their own “research”. Their “research” is frankly guided by confirmation bias (looking only at information that supports your agenda, as opposed to looking at all the facts, whether supportive or not). These people then (sadly very successfully) use social media to spread their half truths (and in the case of noted health experts Donald Trump and Tucker Carlson – outright lies).
The damage caused by these people is in calculable. COVID appears to be resurgent in the United States and is being (rightfully) called a pandemic of the unvaccinated. Third world countries are struggling with another wave, and are desperately trying to keep their health systems afloat, while they get the needed vaccines. International travel remains in limbo, and the economic damage caused worsens by the day.
So why then are vaccine certificates or mandatory vaccinations for health care workers a bad idea?
Because no matter what I or other health officials think of the idea, the simple reality is that the vaccine hesitant crowd will spin this as co-ercion.
And that, in a nutshell, is why I oppose the idea of vaccine certificates, and mandatory vaccinations. We have the weight of evidence on our side that vaccines work. We have been able to debunk many of the stories about the COVID vaccines (remember when the Pfizer vaccine was going to cause an outbreak of Bell’s Palsy and we were all going to walk around with half droopy faces?). With each passing day seeing only unvaccinated people being admitted to hospital with severe COVID we keep building our case. We should be pro-actively promoting all of this in order to let the vaccine hesitant know that their concerns are unfounded.
One thing that has been badly done during this pandemic is the dissemination of information. In any crisis, the first thing to do, should be to have clear, consistent, factually accurate communication. This has been sorely lacking in the past 16 months with health authorities disagreeing with each other.
Yet now, we are again running the risk of doing the same thing. On the one hand, we’ve got experts (quite correctly) proclaiming the vaccines are the best way to prevent COVID.
And now health authorities are turning around and essentially saying ” yah, but we’re going to make you have a special passport to go anywhere so you are protected.”
What exactly do you think those that are already suspicious of authority are going to think? They are simply going to double down on their belief that we have to be “forced” into getting a vaccine, because it’s really not as good as we say it is. We’re going to lose any chance of trying to build bridges with the vaccine hesitant crowd, and win them over with the force of reason and facts (which is overwhelmingly on the side of those who believe in vaccinations).
The whole point of taking the incredibly effective COVID vaccines, is so you can go places and NOT WORRY if the other person is unvaccinated. Even if you are exposed to COVID, it will be the unfortunate misguided unvaccinated individual who will get sick, not you.
Building trust with the vaccine hesitant crowd is hard. It takes time, effort, repetition of facts and a calm approach. But if we go down the road of creating the impression of co-ercion, we’re going to embolden hesitancy and create more fear and mistrust. Vaccine hesitancy will only rise as a result and mistrust of health authorities will increase. Who knows what the long term implications of that are? I worry those implications will last beyond the pandemic, and will cause ongoing problems for health care in the future.
We have facts/reason/data to support the COVID vaccines. Let’s keep promoting that, and not give those who mistrust health authorities, more ammunition.
justanoldcountrydoctor 
Hi Sohail.
Thanks for a thoughtful blog, as always.
Here are some counterpoints to addressing vaccine hesitancy;
Self reported data suggest that 80% of Canadians are keen to become fully vaccinated. Of the 20% remaining, perhaps 15% are hesitant and 5% are never going to be interested.
With increasingly infectious variants, 80% of eligible population won’t get us to “herd immunity”, so it may be critical to convince the hesitant to come aboard, whether by incentives (lottery ticket, tax credits) or limitations (vaccine passport for public events, etc).
Waiting for the hesitant to come around eventually, may put all of us at risk in the meantime, and we risk losing an opportunity to control the variants.
The 5% who are card carrying anti-vaxxers, already have an extreme distrust in medical science and no amount of coercion will change their position.
As far as healthcare workers, I do believe that the public has a right to know, and expect, that their caregiver is maximally protected and less likely to infect them. Healthcare workers are certainly high risk of being vectors. It also sends a mixed message to the public when healthcare workers refuse vaccines.
The analogy of ‘mandatory’ flu vaccine is not entirely comparable. The arguments that killed flu “vax or mask” were (a) that flu shot didn’t reliably protect worker or public. Overwhelming evidence to date suggests that covid vaccine is 10 x as effective, against a disease that’s 10 x deadly … and (b) that wearing a mask stigmatized the wearer as someone who chose not to be vaccinated. I think we can get over that quickly.
We need to educate and reward the public for doing the right thing. Now. Waiting until a significant number of the vaccine-hesitant are begging for the jab, just prior to intubation, seems like a suboptimal strategy.
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