Covid vaccination requirement means lost opportunity for Guelph, Ont., nurse
Public health says no mandatory vaccinations, but inoculation team chosen only from vaccinated staff
A Guelph, Ont.-based practical nurse says she has lost a work opportunity after choosing not to get vaccinated for COVID-19 because of a medical condition.
Monica Lueddeke, a registered practical nurse who works at a family medical clinic in Guelph, said she was a candidate with Apex Occupational Health and Wellness, an agency contracted by Region of Waterloo Public Health to carry out COVID-19 immunizations. She said she was being considered for a three month assignment as a nurse immunizer in long-term care and retirement facilities.
Lueddekke, who has been working in healthcare since 2013, said she lost the work opportunity after indicating she would not get vaccinated due to her medical concerns.
She said Apex told her it is following direction from regional public health that requires immunization nurses get the COVID-19 vaccine. Public health officials said vaccinations are not mandatory, but immunization teams are composed of employees who are vaccinated.
Concerns and recommendations
Lueddeke said she has a severe allergy to bumble bees and fears she will have an anaphylactic reaction to the vaccine, indicating she has previously reacted to a flu vaccine. Lueddeke also has Crohn's disease and takes an immunosuppressant.
"As a person who is immuno-compromised, I'm ... at risk for dying from [COVID-19]. I would love to have the vaccine, but I need to know it's not going to kill me," she said, noting she is hesitant about both the Pfizer-BioNTech and Moderna vaccines currently available in Canada.
Health Canada is advising people not to receive a shot if they have allergies to ingredients in either vaccine. However, insect venom that could trigger a reaction in people in this situation is not a component in the vaccine profiles, according to Dr. Zainab Abdurrahman, a clinical immunologist and allergist and assistant clinical professor at McMaster University in Hamilton, Ont.
"If people have concerns about specific conditions [they] can speak to their own physician ... speak to an allergist ... the key is to try and talk to someone who you trust to get medical guidance who can provide you with information ... that will hopefully help reassure people," said Abdurrahman. "The benefits are quite monumental and really exceed the low, low risk of having a reaction."
The Canadian Association of Gastroenterology released a statement endorsing the U.S. Centers for Disease Control and Prevention statement on the use of COVID-19 vaccines in special populations including people with inflammatory bowel diseases (IBD), which includes a conditional recommendation for people on immunosuppressants.
"In patients with IBD on immunosuppressive therapy, we suggest the COVID-19 vaccine to be given (conditional recommendation, low-certainty of evidence)," the statement read.
Health Canada indicates on its website that of the 338,423 doses of COVID-19 vaccines administered as of January 9, there were 24 cases of adverse events, 10 of which were considered serious. The reactions included anaphylaxis, parathesia, nausea and chest discomfort. No one has died after receiving the vaccine in Canada, the website reports.
Public health rules
According to a statement from the Ontario Ministry of Health, the COVID-19 vaccine is not mandated for Ontarians, but employers can implement their own guidelines.
Region of Waterloo Public Health said it's not mandating immunizations for staff, but "in order to protect our most vulnerable populations, we are requiring that members of the immunization teams be composed of staff who have been immunized and they are also required to wear PPE [personal protective equipment]," public health officials said in a statement to CBC.
"Employees of the region are assigned and supported as required by legislation, regional policy and relevant collective agreements. Where an employee is unable to be immunized, we recognize our duty to accommodate, where appropriate," public health said in a statement.
Public health said processes regarding accommodations would be the responsibility of the employer, in this case Apex, which said it is following public health guidelines on immunization requirements and seeking information about exemptions for people who are unvaccinated to work in vulnerable settings.
The agency told CBC it is trying to find accommodations.
"If we are allowed to hire such [unvaccinated] employees we will be pleased to have them join our team," Apex said.
Lueddeke said she should be able to work as a nurse immunizer without having received the vaccine herself. She said she feels she's been discriminated against over her medical situation and is seeking legal advice.
Lueddeke said the situation has made her question the future of health care in Canada.
"There's absolutely no reason why I couldn't be giving a vaccine," she said. "What does this mean for other nurses, PSWs [and] health care staff? Will your employer far reach and say you can't come to work unless you get the COVID-19 vaccine because you might be off sick for a month with COVID-19?"
The Ontario Ministry of Labour, Training and Skills Development said whether or not employers set policies on receiving immunization as a condition of employment is not addressed in legislation.
"Most Ontario employers have obligations under the Occupational Health and Safety Act (OHSA) and its regulations to protect workers from hazards in the workplace, including infectious diseases. The OHSA does not require employers to mandate immunizations of employees in the workplace. Whether or not an employer chooses to institute their own policies for their workers about immunizations is at their own discretion and is beyond the scope of what the OHSA requires," a representative said in a statement.
"Workers who wish to discuss concerns they have regarding worker rights and employer policies regarding vaccinations may wish to discuss with their labour union (if they have one) or the Human Rights Legal Support Centre."
Luedekke is not unionized nor is she an employee of the region's health unit.
Other health units
CBC News reached out to other Ontario public health units about their policies on vaccinations for health care workers.
Hamilton Public Health said vaccinations aren't mandatory but are recommended for public health care workers administering the COVID-19 vaccine. This applies to all staff, including those in vulnerable settings. Staff are screened ahead of time, tested regularly and wear appropriate PPE.
Officials with Toronto Public Health and Wellington-Dufferin-Guelph Public Health said vaccinations are recommended but not mandatory for health care workers. Those workers can still work in immunization clinics if they are not vaccinated.
Middlesex-London Health Unit said it's not mandatory for employees to be vaccinated but staff members deployed to long-term care or retirement facilities have been vaccinated.