The impact of vaccine mandates to healthcare workers in Canada.

A new paper by Professor Claudia Chaufan has reported troubling results.

A recent paper by Professor Claudia Chaufan and colleagues reported the results of a cross-sectional survey of 468 Canadian healthcare workers examining the impact of COVID-19 vaccination decisions and the impacts of vaccine mandates. The sample used in the study is interesting because it consists predominantly of nurses and other supporting disciplines but very few medical doctors. The study provides only descriptive statistics; however, the reported results are astounding.

Here are some highlights: 75% of respondents that received the COVID-19 vaccine reported that the reason for taking the injectable product was employer vaccine mandates. Only 22% of vaccinated respondents reported no adverse events. Moderate adverse events were reported by 35.6% of respondents and severe adverse reactions were reported by 29.8% of respondents. Out of the 87 respondents that received the COVID-19 vaccine, 1 reported a life-threatening adverse reaction. Interestingly, only 4.3% of respondents were trained on how to report post-vaccination adverse events and only 4.5% of respondents reported that they were encouraged to report adverse events after vaccination.

From the entire sample of both vaccinated and unvaccinated healthcare workers, 74.6% reported anxiety and/or depression and 18.3% the reported experiencing suicidal thoughts due to employer vaccination requirements (agree and strongly agree responses). Although 40% reported willingness to return to their previous role if vaccine mandates were dropped, another 42.5% reported an intention to leave their occupation or the healthcare industry as a result of their experience with vaccine mandates (agree and strongly agree responses). 85% reported that employers did not offer alternatives to vaccination to satisfy their vaccine mandate, with only 1 out of 468 respondents reporting that their employer was willing to accept proof of natural immunity, even though 75% of respondents reported that they worked with COVID-19 patients prior to the availability of the COVID-19 vaccines. Only 9.5% reported being offered regular testing as an alternative to vaccination.

59% of respondents reported that they were not provided by anyone with any written information about the vaccines, necessary for informed consent, and only 2.4% of respondents were provided with the package insert from the vaccine manufacturer.

Finally, only 16.1% of vaccinated respondents reported being happy with their choice to get vaccinated, whereas 92.6% of unvaccinated respondents reported being happy with their decision to not get vaccinated (agree and strongly agree). Furthermore, 70.3% observed differential treatment of patients based on their vaccine status and only 4.1% report that they are confident that the current healthcare system will provide adequate and quality care while respecting personal preferences and values (agree and strongly agree).

For more details, you will have to read the paper.

Here's the paper's conclusion:

In 2021 the Organization for Economic Cooperation and Development (OECD) announced six evaluation criteria that jointly provide "a normative framework (...) to determine the merit or worth of an intervention"- a policy, a strategy, or an activity (42). The first criterion is "relevance", i.e., to what extent a policy is responsive to beneficiaries, meaning those who "benefit directly or indirectly from the policy". The second criterion is "coherence", i.e., to what extent a policy is compatible with other policies in a given setting. The third is "effectiveness", i.e., to what extent a policy has achieved or is expected to achieve its objectives. The fourth criterion is "efficiency", to what extent a policy converts inputs into outputs in the "most cost-effective way possible, as compared to feasible alternatives in the context" and within a reasonable timeframe. The fifth criterion is "impact", i.e., to what extent a policy "has generated or is expected to generate significant positive or negative, intended or unintended", effects. The sixth and last criterion is "sustainability", i.e., whether benefits are likely to last (42).

If our findings indicate a trend in the health care sector in Ontario, Canada, they suggest that by these criteria the policy of mandated vaccination for HCWs in the province has failed in its purported goal of promoting safer healthcare environments and achieving better care. Concerning "relevance", the intended beneficiaries, whether HCWs, patients, or communities at large, have been harmed by exacerbated staff shortages, intimidating work environments, and health professionals coerced into acting against their best clinical judgment. Concerning "coherence", the policy has proven to be at odds with other policies within health settings, such as the imperative to maintain adequate staffing levels or to respect informed consent and bodily autonomy, not only for HCWs but for those patients who, for whatever reason, decline vaccination. As to "effectiveness", there is no evidence that the policy has improved patient care-as suggested by our findings, it has likely worsened it.

Concerning "efficiency", there is no evidence that the policy has been more cost-effective than comparable alternatives, such as relying on the superiority of naturally acquired immunity over artificial immunity (23,43-45), acquired by most HCWs during 2020 as they treated patients in critical need, and for this reason were celebrated as heroes by the media and the authorities (46,47). Notably, naturally acquired immunity, achieved through recovery from a prior infection, was not recognized by healthcare employers in Canada. In fact, there is no evidence that such (then unvaccinated) workers were deemed a threat to patient safety and disciplined for that reason. Concerning "impact", our findings also suggest that the overall impact of the policy on the well-being of HCWs and the sustainability of health systems has also been negative. Finally, concerning "sustainability", with close to half of our sample of highly trained and experienced HCWs intending to leave the health professions, we see no evidence for any net benefits, either current or future. We conclude that if, by the OECD criteria, the policy of mandated vaccination for HCWs has failed, this failure, along with the contested efficacy and safety of COVID-19 vaccines, their negative impact on HCWs' wellbeing, staffing levels, and patient care, and the threat that mandates represent to longstanding bioethical principles such as informed consent and bodily autonomy (48,49), negates any basis-policy, scientific, or ethical-to continue with the practice.

References

C. Chaufan and N. Hemsing and R. Moncrieffe, "COVID-19 vaccination decisions and impacts of vaccine mandates: a cross sectional survey of healthcare workers in Ontario, Canada", Journal of Public Health and Emergency (2024), Online First, https://jphe.amegroups.org/article/view/10313