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Will governments be able to mandate the COVID-19 vaccine for health care workers? – The Globe and Mail



A nurse receives a COVID-19 vaccine at Providence St. Mary Medical Center in Apple Valley, Calif., on Dec. 17, 2020.

Ariana Drehsler/The New York Times News Service

As the first COVID-19 vaccine slowly makes its way into arms across Canada, debate has begun over the thorny question of mandatory immunization for employees in certain fields.

Provincial governments are encouraging Canadians to roll up their sleeves when vaccine doses become more widely available but have said they do not intend to make immunization compulsory.

However, given devastating COVID-19 workplace outbreaks, some employers have begun considering whether to eventually require vaccination and how to handle employees who decide not to get their shots.

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The issue of mandatory immunization cuts through myriad sensitive areas, including workers’ personal privacy, human rights and religious beliefs. On the other side, employers could argue vaccination is a job requirement so workers don’t transmit the disease to their colleagues and, in the case of staff in hospitals and nursing homes, vulnerable patients.

The law on the issue is not clear-cut, and because the situation is still fluid, there is uncertainty around how the courts would treat vaccine requirements. Canada approved Pfizer-BioNTech’s COVID-19 vaccine last week.

“Generally employers cannot require anyone to be vaccinated,” said Tamara Ramusovic, an employment lawyer in Vancouver. The law recognizes the need to balance the competing interests of public safety and personal privacy, she said.

How employers should strike that balance, under the law, will depend on the facts and evidence, she said. What are the risks of transmission in a particular workplace? What is the evidence of the safety and efficacy of a vaccine?

Requiring COVID-19 immunization as a condition of employment is a long way off, not least because scientists still do not know the vaccine’s effectiveness at stopping asymptomatic spread of the virus, said Allison McGeer, director of the infectious-diseases epidemiology research unit at Toronto’s Mount Sinai Hospital.

“We’ll just have to wait and see how the evidence evolves about how important vaccination is at protecting the people around you,” she said.

If it turns out that the vaccine does prevent COVID-19 transmission, Toronto’s University Health Network would weigh requiring inoculations for staff, likely through negotiations with its unions, spokeswoman Gillian Howard said.

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“This is a contagious disease and if the vaccines prove out to have the efficacy that has been seen in the trials, it would be considered,” she said in an e-mail.

Provincial rules require Ontario hospital workers to prove they are immune to several infectious diseases, including measles, mumps, rubella and chickenpox. In Alberta, front-line health care workers must be immunized against rubella.

When will Canadians get COVID-19 vaccines? The federal and provincial rollout plans so far

How many coronavirus cases are there in Canada, by province, and worldwide? The latest maps and charts

Some Ontario long-term care operators worry uptake of the COVID-19 vaccine will be low among staff, especially in areas that have not had large outbreaks, and are hoping the provincial government will eventually make immunization mandatory in the sector, said Lisa Levin, chief executive officer of AdvantAge Ontario, which represents municipal and not-for-profit nursing homes.

“I have seen the devastation that can happen in a home when people get COVID-19, so it would seem to me that it should be considered,” she said.

Experience with the flu shot suggests that many health care workers will not get immunized for COVID-19. Flu vaccine uptake among health care workers lags the national goal of 80 per cent, although it is higher than coverage among the general public.

While many health care workers’ unions are encouraging their members to get COVID-19 shots, they strongly oppose mandatory vaccination policies.

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“We’ll wade into those waters if we need to,” said Vicki McKenna, president of the Ontario Nurses’ Association. “It’s a basic right, that people have the right to refuse.”

The only case law in the area thus far in Canada involves limited examples of flu vaccine requirements for health care workers.

Nurses’ unions have pushed back against vaccinate-or-mask rules for the flu shot. In 2018, an Ontario arbitrator ruled against such a policy, finding there was not enough evidence supporting either the use of masks or the flu vaccine.

In 2013, a British Columbia arbitrator upheld a vaccinate-or-mask policy as a reasonable limit on nurses’ privacy rights. But one year ago, the B.C. Nurses’ Union struck a deal with health employers to allow nurses to use their professional judgment, except in cases of flu outbreaks.

Among lawyers, there is wide agreement that those who refuse to be vaccinated against COVID-19 could face consequences.

Vicki Giles, an employment lawyer in Edmonton, said mandatory immunization policies will be possible – but such policies do not mean employers who refuse will be fired.

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“What is ‘mandatory’ is the requirement to have the vaccination in order to work with the vulnerable population,” she said in an e-mail.

And a similar “mandatory” policy may be put in place in workplaces such as meat-packing plants because the employer would have an obligation under health and safety law to keep other workers safe, she said.

Those who refuse to be vaccinated could face consequences such as being put on a leave of absence without pay, or being moved to other work, she said.

During flu outbreaks, some long-term care homes move unvaccinated staff to different floors or place them on unpaid leave.

Courts are unlikely to accept employers’ demands that their workers be immunized because it is a “extreme intrusion” on their bodily integrity, said Richard Press, a Vancouver employment lawyer. But the time is coming when “most employers are going to have to consider at least asking employees if they have been vaccinated.”

As with the immunizations themselves, employees probably could not be required to disclose, Mr. Press said. But employers could impose consequences on those who do not. The employees would almost certainly be treated as if they had not been vaccinated. They might then be subject to being placed on leave or, if possible, moved to another location, required to wear extra personal protective equipment, or to work remotely.

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The initial COVID-19 vaccinations in Canada and around the world raise questions about how people react to the shot, how pregnant women should approach it and how far away herd immunity may be. Globe health reporter Kelly Grant and science reporter Ivan Semeniuk discuss the answers. The Globe and Mail

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2 COVID-19 deaths in Manitoba as province announces 180 more cases –



There are 180 new COVID-19 cases in Manitoba on Saturday and two more people have died from the illness, the province says in a news release.

The latest deaths are two men: one in his 70s from the Southern Health region and one in his 80s from the Winnipeg health region, the release says.

Just under half the new cases on Saturday — 83 — are in the Winnipeg health region, the release says. There are also 69 new cases in the Northern Health Region, which has seen a sharp uptick in cases this week due to outbreaks in several communities, health officials have said.

A COVID-19 outbreak has been declared at the Lynn Lake Hospital, the release says, while an outbreak previously declared in Winnipeg’s Seven Oaks General Hospital’s 4U4-7 unit is now over.

Lynn Lake, a small northwestern Manitoba town of fewer than 500 people, was already dealing with an outbreak of its own. As of Wednesday, the community had 121 known active cases of the illness.

The health district that includes Lynn Lake now has a total of 145 active cases, according to the province’s data portal.

The remaining new cases are spread out between the Southern and Interlake-Eastern health regions (with 10 each) and the Prairie Mountain Health region (with eight).

The update comes one day after the provincial government asked people for their input on the possibility of lifting some pandemic restrictions next week.

Manitoba’s current public health orders banning most gatherings and the sale of non-essential goods are set to expire on Friday.

Because of a data error, one previously reported death has been removed from Manitoba’s totals, the release says. That brings the province’s COVID-19 death toll to 761.

Manitoba’s five-day test positivity rate increased slightly to 10.2 per cent, up from 10 on Friday. In Winnipeg, that rate dropped from 7.2 per cent on Friday to seven per cent.

There are now 283 COVID-19 patients hospitalized in Manitoba — down by one from Friday — including 36 who are in intensive care, one more than Friday.

The province reminded people to check restrictions in other regions before they go anywhere if they have to travel. In Ontario, new public health rules say people can only go to another residence or cottage in the province for less than 24 hours to do essential business, the release says. If they stay any longer, they may have to stay and self-isolate for 14 days.

There have now been 27,322 COVID-19 cases identified in Manitoba. To date, 23,575 are considered recovered, while another 2,986 are still listed as active — though health officials have recently said that number is inflated by a data entry backlog, and there are likely only about half as many active cases.

There were 2,043 COVID-19 tests done in Manitoba on Friday, which brings the total number completed in the province to 450,104.

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Canada says first COVID-19 vaccine for refugees in Jordan offers glimmer of hope – Powell River Peak



OTTAWA — Canada’s international development minister says the world’s first inoculation of a refugee against COVID-19 this week is an important milestone in ending the pandemic everywhere.

Karina Gould told The Canadian Press in a statement that it was encouraging to see the rollout of new vaccinations because “it brings an early glimmer of hope to the most vulnerable people right across the globe as we fight this terrible pandemic.”

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A woman living in the northern Jordanian city of Irbid who had fled northern Iraq became the first United Nations registered refugee to receive the COVID-19 vaccine on Thursday.

Before the pandemic, Canada committed $2.1 billion in security, humanitarian and development funds to help Jordan and neighbouring Lebanon cope with the massive influx of refugees they face due to the crises in Syria and Iraq.

Since the pandemic began, Canada has committed more than $865 million to the ACT-Accelerator, a global effort to ensure low- and middle-income countries have equitable access to medical treatments during the pandemic. It has also committed $220 million to its partner initiative, the COVAX Facility, to help buy vaccine doses for low- and middle-income countries.

“While we’re fighting for the health of our own citizens, I am committed to ensure we’re not leaving the rest of the world behind,” said Gould, who was appointed Friday as the co-chair of the COVAX international engagement group.

The appointment will see Gould working with the Indonesian foreign minister, the Ethiopian health minister and Gavi, the Vaccine Alliance, which has emerged in the last two decades as the major distributor of vaccines to poor countries.

“Canada has invested $865 million into global health efforts against COVID-19 and continues to make equitable access to a vaccine and health solutions to the pandemic a reality for all, including refugees living in precarious conditions,” said Gould.

In an updated mandate letter released Friday, Prime Minister Justin Trudeau told Gould to work with new Foreign Affairs Minister Marc Garneau and other cabinet colleagues to “reinforce international efforts to ensure that people around the world have access to health interventions to fight COVID-19, including vaccines, therapeutics and strengthened health systems.”

Rema Jamous Imseis, the Canadian representative for the UN High Commissioner for Refugees, said if refugees aren’t vaccinated, they run the risk of infecting people in their host countries.

“If you want to defeat the pandemic, you have to include refugees in the vaccine rollout around the world,” she said.

“That’s sort of the bigger context and what we’re doing is calling on all governments, Canada included, to ensure that refugees and other displaced populations are included.”

Jordan is also the home to the Zaatari refugee camp, one of the world’s largest, less than 15 kilometres from the Syrian border. It is home to almost 80,000 people, including more than 40,000 children, fleeing the carnage of Syria’s decade-long civil war and the unrest sparked by Islamic militants in Iraq.

Canada has deployed hundreds of military personnel to northern Iraq and neighbouring Kuwait as part of a Western effort to fight the Islamic State of Iraq and the Levant. Canada supplies the commander of the NATO training mission in northern Iraq that is trying to professionalize Iraqi security forces to protect its own citizens from ISIL.

“COVID has essentially been an emergency on top of an emergency for refugees around the world,” said Jamous Imseis.

“Canada came out early and strong as one of the donors to the COVAX initiative,” she added.

“But we also need Canada to use its influence with his friends and other countries around the world to ensure that that basic principle of equitable and global access to vaccines for everyone is something that we’re all working towards.”

This report by The Canadian Press was first published Jan. 15, 2021.

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Ontario reports 3,056 COVID-19 cases and 51 deaths as province adjusts vaccine plan over Pfizer delays – Toronto Star



Ontario reported another 3,056 COVID-19 cases and 51 more deaths Saturday as the province announced plans to account for a temporary cut to vaccine deliveries from manufacturer Pfizer beginning later this month.

The seven-day average for new cases fell slightly to 3,218 cases daily, or 155 weekly per 100,000, according to the province’s latest report released Saturday morning. Ontario’s seven-day average for deaths rose to 59.7 daily, a record for the second wave.

Ontario’s reported infection rate is down somewhat this week while the rate of fatal cases continues to near the highest levels seen so far — that daily average is just shy of the province’s worst period in the first wave in early May, when it hit nearly 62 deaths daily.

Ontario has administered 14,460 more doses of the vaccine since its last daily update, with 189,090 vaccines given in total as of 8 p.m. the previous night. The province also says 19,333 people have completed their vaccinations, which means they have had both shots.

On Saturday, Chief Medical Officer of Health Dr. David Williams said the province will delay giving second doses of Pfizer’s COVID-19 vaccine to some patients after the pharmaceutical giant announced a production delay will cut deliveries to Canada by half early next month.

On Friday, Pfizer said it was cutting promised vaccine deliveries to several countries, including Canada, amid efforts to expand a production facility in Belgium. The move means that in the week of Jan. 25, Canada will see deliveries fall to about a quarter of the more than 200,000 doses it had expected, and to about half the schedule in early February.

Staff and residents of long-term-care homes and high-risk retirement homes who have already received their first doses of the Pfizer-BioNtech COVID-19 vaccine will receive their second dose within 27 days, Williams said in a statement. Everyone else who has been given their first dose will now get their booster shot between 21 and 42 days later, he said.

Anyone receiving does of the vaccine produced by Moderna will still get their second shot at the existing schedule of 28 days, Williams said.

There are 1,632 people currently hospitalized with COVID-19 in the province, including 397 patients in intensive care. There are 281 people on ventilators.

Locally, Health Minister Christine Elliott says 903 new cases are in Toronto, 639 in Peel, 283 in York Region, 162 in Durham and 152 in Ottawa.

Meanwhile, 27 more residents in long-term care have died for a total of 3,112 since the pandemic began, in the latest report released by the province.

Ontario is reporting three more LTC homes in outbreak, for a total of 246.

There are 90 more active positive cases among residents than the previous day for a total of 13,104.

Additionally, there are 65 more staff members with an active case, for a total of 5,134.



Since the pandemic began, 10 staff members in Ontario’s long-term care homes have died due to the virus, according to the province.

This data is self-reported by the long-term care homes to the Ministry of Long-Term Care. Daily case and death figures may not immediately match the numbers posted by the local public health units due to lags in reporting time.

With files from Ed Tubb

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