Mandatory vaccination in process; vaccine certificates coming to Ontario

RNAO has led the call for mandatory vaccination of workers in health-care and education and has pushed for enacting vaccine certificates in the province. Mandatory vaccination is already under way in key sectors, but much work remains. We are calling on the Ontario government to make an announcement on vaccine certificates on Monday.

RNAO action

Let’s recap a bit of the background. RNAO has been at the forefront of the effort to fight the pandemic in Ontario and specifically, to mitigate the impacts of the fourth wave driven by the treacherous Delta variant. Canada has been for several months in the privileged position of having enough vaccine doses for all its eligible population, but the vaccine uptake has stalled at levels that will not bring about herd immunity with the highly transmissible variant.

RNAO launched on July 15 a #FullyVaccinated social media campaign to encourage everyone to receive both doses of the COVID-19 vaccine, and was the first major organization in Canada calling for mandatory vaccination for all health-care workers in contact with patients. In our July 21 open letter to the premier we surveyed the evidence on mandatory vaccination and called for measures to address inequities, such as vaccination clinics in accessible places, and paid time off to get vaccinated and recover from the shot. The Ontario Medical Association and then the Canadian Nurses and Medical Associations alongside many other organizations joined the call for mandatory vaccination of health-care workers. We were thrilled to know a coalition had emerged.

In a second, 28 July, open letter to the premier, RNAO called for mandatory vaccination of teachers as part of a comprehensive set of measures required to reopen schools safely in September. On August 3 the government announced mandatory indoor masking for students in grades one through 12 and improving ventilation systems, two of the measures RNAO had advocated for. However, it did not include mandatory vaccination for educators or mandatory indoor masking for children in daycare and kindergarten – measures that RNAO has consistently recommended.   

The government announced on August 13 that it is starting to move on mandatory vaccination for workers in hospitals, long-term care (LTC) and homecare, will give booster shots to the vulnerable, and will halt further reopening given the impending fourth wave. In response, RNAO urged the government to do more: expand mandatory vaccination to include all health-care workers in all sectors and settings; mandatory vaccination for all teachers and educators in all education settings – from daycare to post-secondary – and implementing indoor masking for those in daycare, kindergarten and schools, from the age of two and up.

On August 17 the government announced more measures on vaccination policies for health-care, education and other congregate settings. In a media release, RNAO emphasized the measures announced don’t achieve the goal of mandatory vaccination since they allow anyone who wishes to substitute vaccination with rapid testing (once a week, which RNAO deems insufficient) and an educational session. RNAO is seeking stronger provincial vaccination mandates in both health-care and education. We are also insisting on vaccine certificates for all eligible Ontarians.

RNAO urges the government to implement a vaccine passport / certificate / safe pass that is mandatory for access to risky indoor non-essential services – such as indoor entertainment, sports events, restaurants, bars and gyms – as well as long-distance travel. A vaccine certificate will keep the workforce safe, energize dormant sectors of the economy and protect businesses that implement these measures. RNAO had joined on August 5 the organizations demanding vaccine passports following a motion unanimously passed by the RNAO Board of Directors calling to enact such a system in a way that addresses concerns about inequity, privacy and safety.

RNAO issued an Action Alert calling on premier Ford to implement the 3 Mandatory Asks of Nurses: 1) #MandatoryVaccination for health-care workers (unless medical exemption); 2)     #MandatoryVaccination for teachers and educational staff (unless medical exemption); and 3)     #MandatoryVaccinePassports for everyone (unless medical exemption). In addition, we are asking for indoor masking for children two years old and up.

The context for vaccine certificates    

The push for vaccine certificates in Ontario is widespread and the question is why the government has taken so long to announce it. Business associations, mayors, medical officers of health, universities and political leaders have joined the call. After denying that the province was working on a vaccine certificate program, they acknowledge it is now under consideration. The announcement cannot come soon enough.

An article in CBC News surveys the advances in vaccine certificates across Canada. In the campaign trail, prime minister Justin Trudeau announced a billion-dollar fund to help provinces create their own vaccine passports. The plan is for Ottawa to pay for the development and the rollout of that program. The federal government has long promised its own vaccine passport-style program for international travel but that too is taking much too long. At a press conference before the election, the government said work is underway on a smartphone app and it could be available sometime this fall. Other countries have had it in place for months. Ottawa has explained the delay by pointing to the provinces, which control vaccination records.

Some provinces, notably B.C. and Quebec, already have created smartphone-based vaccine passports that people can use to prove their COVID-19 immunization status in commercial or public spaces — everything from bars and restaurants to bowling alleys and sports venues — where provincial law will soon require proof of a shot before entry. Manitoba is also expected to make its passport system mandatory for some nonessential businesses in the coming weeks.

The CBC reports that in two of the country's largest provinces — Alberta and Ontario —provincial leaders have refused to implement such a system. Ontario Premier Doug Ford has said earlier a vaccine passport would lead to a "split society" and claimed the paper receipts people receive at vaccine clinics are sufficient proof of status. In Alberta — where COVID-19 case numbers are high and vaccination numbers comparatively low — government officials have been insisting that a proof-of-vaccination program is a non-starter.

The European Union, with 27 member states, implemented their system much earlier. The EU Digital COVID Certificate Regulation entered into application on July 1. EU citizens and residents are now able to have their Digital COVID Certificates issued and verified across the EU. The Digital COVID Certificate is a digital proof that a person has either been vaccinated against COVID-19, received a negative test result or recovered from COVID-19.

In Ontario, immediate action is required. In the absence of a province-wide vaccine certificate, large private businesses and universities have stepped into the void by creating their own vaccine verification programs. This hodge-podge of measures disadvantages small businesses who do not have the same resources. Small businesses experience troubling animosity and bullying when they ask patrons if they are vaccinated. A provincial mandate is necessary to bring legitimacy, consistency and legal protection. RNAO is very hopeful the premier will make an announcement this Monday on Ontario’s implementation of vaccine certificates.

In an August 5 media release RNAO delineated the requirements for a good vaccine certificate program, that would address equity, safety and privacy considerations.

Take action to implement the 3 Mandatory Asks of Nurses: mandatory vaccination for health-care workers; mandatory vaccination for teachers and educators; and implement a vaccine passport mandatory for access to non-essential services. Sign our Action Alert.