Vaccine voluntary at AHS, but should it be?
It may depend on how many staffers get immunized, health experts say
COVID-19 immunization is voluntary for Alberta Health Services staff, but health-care experts say it could reignite debate over mandating vaccinations among medical professionals.
Health Minister Tyler Shandro announced this week that the first doses of a COVID-19 vaccine would be administered in Alberta beginning next Wednesday, following Health Canada's approval of the Pfizer and Biontech products. The first shipment will include 3,900 doses, which will be prioritized for intensive-care unit doctors and nurses, respiratory therapists and long-term care workers.
Shandro called it a “light at the end of the tunnel,” on Wednesday.
AHS confirmed Thursday that staff will not be required to immunize.
“However, it is important that our health-care workers get immunized to protect themselves and our patients against COVID-19,” AHS said in a statement.
Dr. Juliet Guichon, an associate professor at the University of Calgary's Cumming School of Medicine, said the decision on whether to make COVID-19 vaccinations mandatory should be based on the number of health-care workers who refuse it.
“If you have, say, four per cent who refuse, it could be that the health-care system could operate by redeploying those four per cent to areas where they're not going to infect patients,” Guichon said.
“But if you have 70 per cent who refuse to vaccinate, and in the midst of a pandemic, then it will probably be mandatory. That would be the only way to limit the spread of (COVID-19) while caring for patients.”
She said a mandatory vaccine policy would be permitted so long as it complies with employment law, human-rights codes and the Charter of Rights and Freedoms. The policy would only be ethical, Guichon said, if the vaccine offers a “clear benefit” and if compulsion is the only way to ensure patient protection.
She said it would be “odd” for health-care workers to decline, considering it's currently the biggest workplace hazard.
“Health-care workers tend to be in favour of vaccination the greater their knowledge of the vaccine, the longer their career in health-care and the greater their exposure to seriously ill patients who have that vaccine-preventable illness,” said Guichon.
In 2014, Guichon participated in a symposium focused on influenza immunization in the health-care workplace. At that time, it was stated the flu vaccination program was “ineffective in achieving vaccine uptake in numbers sufficient to protect optimally both patients and workers.” It sparked a heated public debate but remains a voluntary option for health-care professionals.
A similar debate could arise with COVID-19.
“It will push forward the issue for discussion because I think patients expect that health-care workers have done everything they can not to infect them and make them sick,” said Guichon.
AHS said COVID-19 vaccinations will be tracked among staff, much like with influenza immunization.
The health authority declined to provide details on the number of staff working in long-term care compared to acute care that will receive the first of 3,900 doses of the vaccine.
AHS has more than 103,000 employees.
At the end of November, the clinical workforce was approximately 86,000, not including physicians, AHS said in a statement.
REDUCING ANXIETY, MISCONCEPTIONS
Some Albertans remain skeptical of the COVID-19 vaccine, says public-health specialist Dr. Sajjad Fazel.
But if the first recipients of the vaccine share their experiences publicly, it could go a long way in combating anxieties and misconceptions, he said.
“I urge every person who gets the COVID-19 vaccine, whether it's in the long-term care home or frontline staff, to share their story,” said Fazel. “If you see somebody more like you who's taking the vaccine, someone who might explain to you exactly how they feel before going and explains followups after a week — I think that would be one of the most effective strategies of curbing vaccine hesitancy.”
About one in 10 Canadians will “not be vaccinated under any circumstances,” according to a recent survey conducted by Abacus Data.
Another one in 10 surveyed said they are “not inclined” to take the vaccination but could be persuaded.
The majority of respondents, averaging about 44.5 per cent, said they will get vaccinated but want to “see how things turn out.”
Only 32 per cent said they would get vaccinated as soon as possible.
Fazel said people must engage those who have reservations about the vaccine related to issues such as side-effects and safety, with some questioning the speed in which it was produced.
“Those who think it is rushed — we have to clear their doubt. Rushed means things haven't been done properly, they just want to get it out there, which is not the case,” he said.
“This pandemic was unexpected but we know from history, from SARS, from MERS, pandemics are going to happen. They will happen, outbreaks will continue, so scientists and researchers have been preparing for such things to happen. It's like someone saying, `oh, now we have iphones.' It didn't come in a day. Someone was working on it for a long time.”
Canada is the third country in the world to approve the Pfizer vaccine, after the United Kingdom and Bahrain. Fazel reaffirmed that Health Canada would not have approved the vaccine if it posed a significant risk to Canadians or wasn't effective.
He added there may be side-effects, such as nausea or fatigue, but that every medication has some.
“I always tell people to look at the benefit of the vaccine, which is preventing severe disease, admission to the ICU, death and all these other symptoms of COVID-19,” said Fazel.
“On the other side, you have maybe pain in the arm ( because of a needle), nausea and fatigue. Which would you choose?”