When Are Mandatory Vaccinations Not Mandatory?

When large loopholes are allowed.

As I wrote recently, almost all mandatory vaccine orders allow for both medical and religious exemptions. The only problem is that no religions forbid vaccinations, and the grounds for medical exemptions are very limited. Despite the latter, unscrupulous doctors in the United States, as I wrote, are issuing baseless notes. 

Will the same happen in Canada? In the earlier post, I expressed the concern that some physicians might issue exemptions for those with needle phobias. However, the signs thus far suggest a cautious optimism that won't happen.

It turns out the list of conditions valid for a medical exemption from vaccines in Canada is extremely limited, and even narrower than for masks. The only valid exemptions are for people allergic to ingredients in the vaccine, or those who experienced severe allergic reactions or heart inflammation after their first dose.

This has implications for health-care providers and citizens nationwide, as provinces including Quebec and B.C. introduce or plan to introduce vaccine passports, and organizations such as the Toronto Police Service and Air Canada announce mandatory policies for employees.

“The whole discussion of medical exemptions to COVID vaccine is a pretty straightforward one because the bottom line is there aren’t many,” said Dr. Barry Pakes, a physician and program director of the Public Health and Preventive Medicine residency program at the University of Toronto’s Dalla Lana School of Public Health.

“And we’re encouraging physicians to not give medical exemptions for invalid reasons, and despite the fact that their patients are pleading with them … it is really important to just help them understand that those aren’t genuine reasons not to get the vaccine,” he added.

There will, of course, always be those who try to pressure their doctor or offer cash inducements. Pakes says,

“The real challenge is when you have some doctors writing letters of exemption charging $50, $100, whatever they might do. And that undermines the stand of the 99 per cent of doctors or health-care practitioners who are not doing that.”

Regulatory bodies have high expectations of their doctors: 

The College of Physicians and Surgeons of Ontario’s website says health-care providers must be “comprehensive, accurate and objective” when providing notes, and if a patient does not have a valid reason for a medical exemption, they must still write a note and “state the accurate clinical information (e.g., patient doesn’t have any medical conditions/risks to their health).”

Pakes said mental health challenges such as anxiety or needle phobia are a worthy consideration but “not a reason to get a medical exemption,” noting there are clinics that cater to people with needle phobia.

The list of valid exemptions is short (acute illness -wait until it resolves, bleeding disorders - wait until under control, and myocarditis or pericarditis). Essentially, very, very few qualify for an exemption.

Today's conditions require decisive action for the public good. Let's hope that all medical professionals are onboard with that imperative.

 

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