The Current

Why do some people disagree with vaccine mandates, and who can qualify for an exemption?

Vaccine mandates are rolling out across the country as Canada deals with the fourth wave of the COVID-19 pandemic, but with mandates comes the big question; who’s exempt?

Experts say conversation is key when consider vaccine exemptions for medical, ethical, and religious reasons

As places across the country introduce vaccine mandates, some people have raised questions about whether they qualify for an exemption. (Dado Ruvic/Reuters)

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Vaccine mandates are rolling out across the country as Canada deals with the fourth wave of the COVID-19 pandemic, but with mandates comes the big question; who's exempt?

So far 67.8 per cent of Canadians are fully vaccinated, and another 74.03 per cent of people have received at least one dose of a Canadian approved vaccine.

That includes people who are currently not eligible, including children under 12 years old. Counting only those who are currently eligible, 77.47 per cent have received both doses and 84.60 per cent have received one dose.

As more provinces introduce proof-of-vaccination certificates, there have been more protests against public health restrictions and vaccine mandates across Canada.

Quebec, Ontario, Manitoba and B.C. have all announced their own versions of a vaccine mandate, and that has some people seeking exemptions. But experts say that whatever the reason, it's important to have a conversation. 

Religious beliefs

Some vaccine hesitancy comes from religious communities, but Cheryl Pauls says it's not all about religion. Pauls is president of the Canadian Mennonite University in Winnipeg, and says there are no rules in the Mennonite faith that would prohibit people from getting a vaccine.

She said the reasons behind people's hesitancy are more complicated than that.

"It's a cluster of reasons and a religious rationale would be one of those in the cluster," said Pauls. "It's a bit of a trigger or trauma kind of response with secondary rationales for the most part."

A person receives their COVID-19 vaccine during a drive-thru clinic at Richardson stadium in Kingston, Ont., on Friday, Jul. 2, 2021. (Lars Hagberg/The Canadian Press)

Pauls said those triggers include when churches needed to be closed, or instances in the past that people where people felt government overreached. 

"If in the first lockdown, a person's experience was not understanding the threat of the virus, not understanding the seriousness of it, feeling as if this was an overreach, then it's easy to make a connection between, say, that house of worship being closed and that freedom of religion is being challenged," said Pauls. 

The Canadian Mennonite University is requiring students and staff to be vaccinated, and she says the school hasn't given any religious exemptions to anybody. She said they've received very little push back.

Medical exemptions

In Ontario, there are two reasons for a medical exemption from the vaccine. The first is for anyone who suffered a severe allergy or anaphylactic reaction to a prior dose of the vaccine, which has been confirmed by an allergist or immunologist.

The other possible exemption is the diagnosis of myocarditis, which is inflammation of the heart muscle, and pericarditis, which is inflammation of the sac around the heart muscle, after receiving a dose of a mRNA vaccine. 

Dr. Mariam Hanna has been hearing from people looking for a medical exemption since provinces have announced vaccine mandates. 

"A lot more patients are asking about, 'I had this type of reaction after my first dose. Does this merit an exemption or am I safe to get the second dose?'" said Hanna, the Ontario Medical Association's Chair for Allergy and Clinical Immunology.

She says her response comes down to distinguishing between a serious allergic reaction and an expected side effect to the vaccine.

Dr. Mariam Hanna says there are only 2 categories of people who can get a medical exemption from COVID-19 vaccines in Ontario. (Denis Balibouse/Reuters)

"Most of the time patients can safely get their second dose. And we hardly ever give a true medical exemption because of a reaction that has occurred," said Hanna. 

But she says it's very important to have a conversation with people about the vaccine and its potential side effects. 

"We want to arm patients with as much information as possible as to what the safety is about this vaccine," said Hanna. 

Having conversations

Maxwell Smith, a bioethicist and an assistant professor at Western University in London, Ont., says it gets more complicated when someone says getting the vaccine is against their conscious, because it's important not to belittle people's sincerely held beliefs.

But he says giving an exemption to everyone who asks isn't the answer either.

"Exemptions to vaccine mandates and passports tend to simply defeat their purpose. The more exemptions we have, the less effective they are," said Smith.

Maxwell Smith says it's essential to have conversations with people who don't want to get the vaccine. (Hassene Dridi/Reuters)

Like Hanna and Pauls, Smith believes it's essential to have conversations with people who don't want to get the vaccine. He says it's going to be a tough battle, but it's important. 

"Some populations have a history of marginalization and oppression and have good reason to be distrustful of governments and medical establishments," said Smith.

"If we don't want to entrench that mistrust even further, having these conversations is the right move to get them on board and at least see how we can work collectively to end this pandemic."

Written by Philip Drost. Produced by Rachel Levy-Mclaughlin, Ines Colabrese, and Joana Draghici.

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