Should coronavirus vaccination be mandatory for health workers?

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Force them. Fine them. Fire them.

When stories emerge of a significant minority of health care workers refusing to take the coronavirus vaccine, the response is often an angry one.

Of course, hospital and long-term care homes desperately want workers to get the vaccine, because it’s one of the best ways to protect patients and residents.

But instead of the knee-jerk demands to bring down the hammer – instead of shaming and blaming – we should be stepping back and making an effort to understand why this is happening.

First of all, we need to realize that health care workers are no different than the rest of the public. Their views are all over the map on any number of topics, and vaccination is no exception. Health training does not magically inoculate you from the ravages of misinformation.

Like the general public, the large majority of personal support workers, nurses, physicians, paramedics and myriad other health professionals will get a coronavirus vaccine. Many are clamouring to get the shot – the sooner the better.

Still, we need to pay attention to the hesitant minority.

Hesitancy is not the same as opposition. And hesitancy is the right word here. Very few people are actually anti-vaccination.

Hesitancy, or skepticism, is not, in itself, a bad thing. We should all be cautious and ask questions, and weigh the benefits and risks of everything we put into our bodies – food, drink and drugs, including vaccines.

Why vaccines get so much more scrutiny than any other of those substances is another matter.

It needs to be understood, too, that hesitancy among health workers often has little to do with vaccines themselves. It’s more about empowerment and agency, about doubt and burnout, than the needle itself.

Health care workers don’t get treated that well at the best of times. During the pandemic, many have been crushed by additional demands, from working in unsafe conditions to being denied holidays, to being taken for granted.

The loss of sense of control is palpable. Saying “no” to a vaccine is one way of saying: “I’m tired of being walked all over.” Maybe not the best way, but you use the tools at your disposal.

Much has been written about Canada’s bumbling vaccine rollout. A lot of the focus has been on logistics, but the communications aspect has been particularly poor.

The campaign to get health workers to embrace the coronavirus vaccine should have begun months before the shipments of vials began. Fear-assuaging education is especially important when we’re dealing with the unknown, a novel coronavirus and a vaccine made with new, unproven messenger RNA technology.

Even now, we expect health workers to “do their duty” silently. There is such a dearth of basic information that researchers like Dr. Tara Moriarty of the University of Toronto have taken to doing makeshift Zoom sessions to answer questions and address vaccine misinformation.

And there are a lot of legitimate questions. Health care workers are predominantly of child-bearing age, but the messaging has been abysmal about the safety of coronavirus vaccines for people who are pregnant (or intend to be) or breastfeeding.

Many health care workers, especially those in lower-paid jobs like personal-support workers, are also from racialized, multilingual communities. Not enough effort has been made to communicate in commonly spoken languages such as Tagalog, Punjabi, Arabic and Somali, or on social media platforms like WhatsApp, which are popular in minority communities.

There are also practical barriers to vaccination for health workers. Some have to drive hours to clinics to get the shot. Child care is not readily available. The vaccine can cause side effects such as fever that may require workers to take time off – a double burden for those who don’t have paid sick leave.

Vaccine hesitancy among health care workers can be disheartening. But it can be turned around, with everything from leading by example (vaccine selfies by peers is a powerful motivator) to addressing the underlying causes of hesitation.

Forcing health workers to be vaccinated – even if it is legal, and that’s not clear – is not the way to go. Nor is punishing them. It’s laziness.

If we put more effort into valuing the work of health workers, we would have a lot more vaccine buy-in.

Besides, if we can’t convince health workers – those who see the ravages of COVID-19 up-close – to embrace vaccination as our way out of this pandemic, what hope do we have of winning over the general public?

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