Vaccine Mandates: The Pre-COVID Landscape

By: Ally Buchanan

Since the introduction of the COVID-19 vaccine to Canada in December 2020, the discourse surrounding the novel immunization and potential mandates has become widespread. As different jurisdictions have begun implementing workplace and business vaccination requirements, the conversation has become increasingly divisive and antagonistic.

What is the scope of vaccine mandates across Canada? Are these requirements unprecedented? This article hopes to explain the state of vaccine mandates in public sectors across the country and if there were comparable mandates prior to the onset of the COVID-19 pandemic.

What vaccine mandates currently exist in Canada?

On August 19th, 2021, the province of Ontario mandated that all public servants, specifically those working in ministries and commission public bodies, be vaccinated. Those who remain unvaccinated would be required to take regular COVID tests. The Chief Medical Health Officer for Ontario announced that same week that staff working in education, healthcare, childcare, and with vulnerable populations be vaccinated for taking regular antigen tests.

On October 6th, 2021, Prime Minister Justin Trudeau announced that the COVID-19 vaccine would be required across the public service and federally regulated transportation services. The Core Public Administration, which includes the RCMP, would face “administrative leave without pay” if they failed to get vaccinated or disclose their vaccination status by November 15th, 2022. The federal government also required Crown corporations, the Canadian Armed Forces, and federally regulated transportation and service agencies to implement their own vaccine requirements for staff.

Alberta, Nunavut, and the Northwest Territories are the only provinces that do not have “vaccine passports,” which require evidence of vaccination to enter recreation establishments and businesses, although many provinces have announced an upcoming rollback on these measures. All provinces have some form of vaccine requirements for public service employees, including school personnel, public servants, long-term care staff, and healthcare workers. Some provinces have strict vaccine mandates, while Alberta, Saskatchewan, Ontario, Manitoba, Quebec, Northwest Territories, and Nunavut allow frequent tests for those remaining unvaccinated. New Brunswick, Nova Scotia, Newfoundland and Labrador, and Yukon have the most stringent requirements, with vaccine mandates for all public employees and no alternative option for testing. Quebec, Ontario, and Nunavut, on the other hand, offer fewer mandates. PEI stands out as the only province to have no vaccine mandates for public employees.

What are common arguments against mandatory vaccines?

Opponents to vaccine requirements employ similar arguments across jurisdictions. The first common argument is the denial that vaccines and masks have a significant effect on lowering case numbers and severity, which is not the focus of this article. The second reoccurring argument is the idea that mandates are an element of government overreach and that governments should not, or do not, have the authority to place requirements on the personal decision to get vaccinated. This leads to the third argument, which claims that mandated vaccination is a breach of Canadian Charter rights, specifically freedom of conscious. This freedom is included in section 2(a) of the Charter of Rights and Freedoms, which states that “freedom of conscience and religion” is a fundamental freedom. Across the country, we have seen these arguments inform protests, a mass exodus from workplaces, and tensions rising between government and public offices and unvaccinated groups.

Those in favour of mandated vaccines reference the available science that demonstrates the effectiveness of vaccines against infection and in lowering case severity and frequency in the population. They also argue that in extreme cases, such as an unprecedented global pandemic, additional government action to support public health is warranted. This argument, and the position that governments do not have the authority to mandate vaccinations in certain populations, will be explored further in this article. The third argument in favour of mandated vaccinations cites the section 1 of the Charter, which states that the rights and freedoms set out in the Charter are guaranteed “only to such reasonable limits prescribed by law as can be demonstrably justified in a free and democratic society.” Proponents of vaccines argue that the evidenced benefits vaccines have to public health and safety are justification for mandates. Additionally, the anti-vaccine argument citing section 2 of the Charter, as discussed above, has been largely dismissed by legal experts. These arguments, among others, have helped lead to an 85% complete vaccinated rate in the population aged five and above, and majority support for consequences and restrictions for those who choose not to get vaccinated.

Is there precedent for requiring vaccinations in the public sector?

As of 2015, the Canada Immunization Guide recommends an increased vaccine schedule and additional doses of certain immunizations for healthcare workers and childcare and education professionals. These immunizations include Diphtheria Tetanus, Influenza, Hepatitis B, Measles, Meningococcal, Mumps, Pertussis, Polio, Rubella, and Varicella, with varying requirements based on expected exposure and existing immunity. They also list recommendations for various vaccines for laboratory workers, workers with exposure to animals, humanitarian relief and refugee support employees, emergency responders, and military personnel.

On the provincial level, the Ontario Hospital Association details surveillance protocols for a list of communicable diseases, such as mumps, measles, blood-borne illnesses, tuberculosis, and 15 others. These protocols are in accordance with the Ontario Ministry of Health and the Public Hospitals Act and require different levels of isolation, immunization, and other precautions for the listed diseases for all people who carry out activities within hospitals. The Ontario government also provides standards for emergency responders and ambulance services through the Emergency Health Services Branch of the Ministry of Health and Long-Term Care as of 2015.

In the education and childcare sector, there has long existed requirements for both children and staff in the province of Ontario. Provincial law requires that students in primary and secondary schools, as well as licensed childcare settings, be vaccinated against nine diseases. There is a list of valid exceptions, but there are also stipulations regarding the suspension of students if they refuse vaccination and orders for exclusion from child care settings in the case of outbreaks that were put in place in 2018. As of 2017, both the Ministry of Education and Toronto Public Health list immunization requirements, health assessments, and immunization records for educational staff. There are also administrative penalties for immunization infractions detailed in the Child Care and Early Years Act of 2014.

Broadly, these immunization requirements are the most common in fields that face additional risk to certain illnesses or that work with vulnerable groups, such as children or those in hospital. In most cases, proof of the required vaccinations would be requested at the time of hiring or, in the case of healthcare, when students begin training programs. Administrative consequences, such as forced leave with or without pay, are employed in certain fields, specifically education and healthcare.

How does this effect the arguments against mandated vaccinations?

Outrage regarding mandated vaccines is not a new phenomenon. Protests against vaccine requirements date back as far to 1885, when Montreal officials attempted to mandate smallpox vaccines amid an outbreak. This led to “public violence across the city,” and similar protests arose in other cities. It took decades for the smallpox vaccine to be widely accepted, but the disease was eradicated in Canada by the 1940s and no imported cases have been reported since 1962. Similar outrage to mandates vaccines for polio and measles existed in the 20th century, but through awareness campaigns and public health efforts, they too gained widespread use. As of 2019, 90% of Canadian children are vaccinated against measles, and 92% are vaccinated against polio.

It is true that there are some sectors that are being impacted by immunization mandates for the first time in recent memory. However, neither government mandates nor the responding protests are unprecedented. The narrative around COVID-19 and the public health measures taken as a result has framed it as “once-in-a-lifetime” and “never-before-seen,” which can make measures such as mandated vaccines and lockdowns seem experimental and make the public more uncertain. While the current pandemic is in many ways historic, elements of what we are experiencing now have been done before and have been successful.  It is natural to become reactionary when your life and what is being asked of you has changed, but it is possible that the current vitriol surrounding COVID-19 vaccine mandates will dissipate the way it has in the past.

Prior to the pandemic, in 2019, public perception of vaccines was “trending in a positive direction,” with 96% of Canadians agreeing that childhood vaccines were safe, 98% believing they were effective, and 97% believing they were useful in protecting the community.

Vaccine requirements have long existed and been accepted in various sectors to protect the population and reduce the risk for the more vulnerable. As stated by Anthony Dale, president, and CEO of the Ontario Hospital Association, “there is no reason to treat the COVID-19 vaccine any differently.”

Ally Buchanan is a Master of Public Policy candidate at the University of Toronto’s Munk School of Global Affairs and Public Policy. She currently works as a Training Assistant with the New Brunswick Institute for Research, Data, and Training. Her interests include education, social, and international policy. Ally holds a Bachelor of Philosophy in Interdisciplinary Leadership from the University of New Brunswick.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s