Quebec and Ontario will not be mandating health care workers to be vaccinated, with both provinces citing significant concerns about staffing levels.
The Quebec government will no longer require its health care employees to be vaccinated while Ontario announced that it won’t pursue a similar program to mandate vaccinations for hospital workers.
Quebec Health Minister Christian Dubé said Wednesday that the province faced a looming labour shortage that would have caused serious disruptions in service if it implemented its mandate as planned.
The province’s reversal is a major retreat for a government that announced the requirement in September. The province had already pushed back its mandatory vaccination deadline by three weeks in the hopes of encouraging holdouts to get their shots.
Although 97 per cent of the health care work force in the province has received at least one dose of vaccine, 8,000 “on the ground” employees are still unvaccinated, including 5,000 who are in direct contact with patients.
The province cannot afford to maintain its tough line, Mr. Dubé said, since going ahead with the requirement would have involved hundreds of service cuts across Quebec’s health network. The unvaccinated will now face COVID-19 testing three times a week instead, with unpaid suspensions for those who refuse. New hires will still face the vaccine requirement.
Giving up on mandatory vaccination for existing staff was the “least bad” decision available, the minister added. “It’s not a decision that we like making.”
In Ontario, Premier Doug Ford had been weighing whether to require shots for health care workers across the province. It is still requiring those who work in long-term care to be vaccinated by Nov. 15.
Mr. Ford wrote to hospitals and other stakeholder groups on Oct. 15 asking for input on a provincewide vaccination mandate, and on Wednesday said that his government has reviewed the responses along with “real-world” evidence, including staffing levels.
Mr. Ford said that because of high vaccination rates among hospital workers and “robust” infection prevention and control measures, including frequent testing of any hospital worker who isn’t vaccinated, only six out of Ontario’s 141 hospital systems, or less than 5 per cent, currently have an active COVID-19 outbreak.
In addition to Quebec’s decision to cancel its mandate, the Ontario Premier said that British Columbia has had to cancel surgeries and diagnostic tests because more than 3,000 unvaccinated health care workers have been placed on unpaid leave.
“This is a complex issue. But when the impact of the potential departure of tens of thousands of health care workers is weighed against the small number of outbreaks that are currently active in Ontario’s hospitals, I am not prepared to jeopardize the delivery of care to millions of Ontarians,” he said in a statement.
“Having looked at the evidence, our government has decided to maintain its flexible approach by leaving human-resourcing decisions up to individual hospitals.”
Mr. Ford’s decision was met with “disappointment” by the Ontario Hospital Association, which had called for a consistent provincial approach across the entire health care sector.
A vast majority of hospital CEOs backed the call for a provincewide mandate. Some hospitals, including Toronto’s University Health Network and SickKids, have made vaccinations mandatory on their own.
“Vaccination is the best way to keep hospital staff and their patients safe from COVID-19,” OHA president and CEO Anthony Dale said.
In Quebec, health care providers have been scrambling to fill the shifts that would have been vacated by suspended workers. Health administrators spent stretches of October calling retirees to persuade them to come back to work, in part by dangling $12,000 bonuses offered by the provincial government.
Recruitment efforts were slowed by rampant burnout and understaffing in the sector. One union representing Quebec health care workers said some unvaccinated nurses were happy to be suspended without pay because they were so exhausted by the pandemic.
In a news conference on Wednesday, Mr. Dubé continued urging health workers to get vaccinated, for the sake of their colleagues if not themselves, but acknowledged that there was a “hard core” who were unlikely to get their shots and without whom the system could not manage.
“For many Quebeckers, including me, it remains incomprehensible that health workers don’t want to be vaccinated,” he said.
Speaking to reporters at Queen’s Park, Ontario Health Minister Christine Elliott said the decision was made to avoid staff shortages that could hamstring efforts to catch up on the province’s surgical backlog. However, she said the government would continue to monitor the situation and would not rule out a different approach down the road.
Ms. Elliott said she would not release the information the government received from those hospitals who raised concerns or say where in the province they are. Nor could she provide estimates to back up the Premier’s assertion that the health care system stood to lose “tens of thousands” of workers who would walk off the job before getting their shots.
Both the opposition New Democrats and the Liberals accused the government of pandering to those opposed to vaccines.
Meanwhile, Ontario on Wednesday announced that it is expanding booster shots to people 70 and older, along with other groups.
Health care workers, essential caregivers in congregate settings such as long-term care homes, those who received two doses of the AstraZeneca vaccine and Indigenous people and their households will all be eligible to receive another vaccine dose, as long as six months has passed since their second shot.
Those groups – about 2.75 million people – can book shots as early as Saturday, either online or by phone, and in some pharmacies.
Kieran Moore, Ontario’s Chief Medical Officer of Health, said that two vaccine doses still provide strong protection against severe illness, but for certain populations, another dose may be needed. He said anyone offered a third dose should take it. Either Moderna or Pfizer mRNA vaccines can be used as a booster dose, regardless of which COVID vaccine was used initially, Dr. Moore said.
People who completed a full series, or two shots, of a “viral vector” vaccine such as AstraZeneca are eligible because they may have a “gradual waning immune response” sooner than people who received at least one mRNA vaccine. Those who received the one-shot Johnson & Johnson vaccine will also be eligible, although it was never issued in Ontario.
But the general population won’t be eligible for boosters until the new year, with officials awaiting further health guidance. It is expected those 12 and up will be eligible between six and eight months after their second dose, with timelines based on age and risk.
Our Morning Update and Evening Update newsletters are written by Globe editors, giving you a concise summary of the day’s most important headlines. Sign up today.