In September 2021, all libraries in the Greater Toronto Area created mandatory staff vaccination policies. Employees have been told that they must vaccinate or they will be fired. Deadlines range from late October to early November 2021
These policies are based on the premise that unvaccinated individuals contract and spread Covid-19 at a greater rate than unvaccinated individuals. Up until recently, many people believed this to be true. However, we now know through new data that vaccinated and unvaccinated individuals contract and spread Covid-19 at equal rates (Centers for Disease Control and Prevention, 2021-a).
With this compelling, evidence-based information, libraries must decide upon the most ethical course of action:
Is it more ethical to fire unvaccinated employees so that vaccinated employees that are fearful feel safer, or is it better to respond to the latest Covid-19 research?
Fallacy: Vaccination reduces Covid-19 transmission
It has now been shown that there is no correlation between a high vaccination rate and a lower Covid-19 infection rate in a population. Mass vaccination does not lower the infection rate (Subramanian and Kumar, 2021).
There is currently no evidence to show that vaccinated people have a decreased risk of spreading the Delta variant, as compared to unvaccinated people. Despite this lack of evidence, the fallacy that unvaccinated people are more dangerous than vaccinated people has been perpetuated by the media and some government entities, without substantiation, and forms the basis for the these policies.
On July 30, 2021, the U.S. Centers for Disease Control and Prevention (CDC) released a study that found similar viral loads and transmission rates for Covid-19 when comparing vaccinated to unvaccinated people (CDC, 2021-a). This study has informed the CDC’s recommendation that fully vaccinated people should continue to wear masks and follow social distancing measures in order to prevent spread. In addition the U.S. FDA states that there is no research suggesting that those who are fully vaccinated with the Pfizer Covid-19 vaccine have reduced transmission of the virus compared to unvaccinated individuals (FDA, 2021-a) .
Do our employers take the position that the advice of the U.S. CDC and the U.S. FDA should be disregarded in favour of library management’s sincere belief that vaccination reduces transmission of Covid-19?
On a short-term basis, Covid-19 vaccines do offer protection against severe outcomes. We agree that Ontario data shows that vaccinated individuals have a decreased incidence of hospital admission and ICU admission due to Covid-19. However, the data from Ontario is in stark contrast to worldwide data, particularly in countries that have vaccinated their populations earlier than Canada and particularly against the Delta variant.
Pfizer reported 91% efficacy of its vaccine against symptomatic Covid-19 disease after 6 months (Pfizer, 2021). Unfortunately, the Pfizer Covid-19 vaccine has markedly lower, transient efficacy against the Delta variant (Israel Ministry of Health, 2021), which has become the dominant variant in Canada. The government of Israel released data in July 2021 which showed that vaccine effectiveness wanes with time. The report stated that as of July 2021, average vaccine effectiveness in Israel’s fully vaccinated population had reduced to 39% against Covid-19 infection and 40.1% against symptomatic Covid-19 infection (Israel Ministry of Health, 2021). This study found that vaccine effectiveness rapidly declines in the months post-vaccination. For those that received their second dose in January 2021, vaccines were only 16% effective against symptomatic infection by July 17 (Israel Ministry of Health, 2021). It is important to look at this data from Israel, as they are approximately three months ahead of Canada in terms of our vaccination timeline. We can therefore expect this low level of protection in our vaccinated population in October-November 2021.
As fully vaccinated people are able to contract and transmit the disease at similar rates to the unvaccinated, and as the protection against symptomatic disease has been shown to reduce to 16% after only six months, we reject the claim that mandatory employee vaccination is an effective method of reducing Covid-19 transmission and severe consequences of Covid-19.
Fallacy: Our employers are trying to protect us
We respectfully submit that offering medical advice to employees is not within the realm of the employer’s role. If our employers were to take on the role of caregiver for its employees, there are far greater health concerns than Covid-19. Heart disease and lung cancer are each more than twice as deadly as Covid-19 (Statistics Canada, 2020). Will our employers be threatening dismissal to employees that do not meet a certain BMI, or who do not quit smoking? Both of these lead to a death rate far exceeding that of Covid-19.
This statement also disregards the risk of serious illness as a result of the Covid-19 vaccination. The CDC lists possible side effects of Covid-19 vaccination as anaphylaxis, myocarditis, pericarditis, thrombosis with thrombocytopenia syndrome (TTS), Guillain-Barre syndrome, and death. The Pfizer Covid-19 label states that “(p)ostmarketing data demonstrate increased risks of myocarditis and pericarditis, particularly within 7 days following the second dose” (FDA, 2021-b). Long-term effects of Covid-19 vaccination are unknown, as no long-term or middle-term studies have been completed by the manufacturers. The CDC has only recently begun to investigate long-term effects of myocarditis and pericarditis post-vaccination (CDC, 2021-c).
In addition to the adverse events already declared by the manufacturers, the U.S. Vaccine Adverse Reporting System (VAERS) reports over two million adverse events following Covid-19 vaccination, including 2,783 reports of Bell’s Palsy and over 8100 reports of death, as of Sept 22, 2021 (VAERS, 2021; CDC, 2021-b). The European adverse event database EudraViligance reports 4,219 deaths after Covid-19 vaccination as of Sept 18, 2021 (European Medicines Agency, 2021). According to a Harvard study on adverse event reporting after vaccination, adverse events are highly underreported, and the 8100 reports of death likely reflect only 1% to 13% of actual events (Lazarus, R. & Klompas, M., 2010).
Forcing universal vaccination on employees also ignores the fact that those that have already contracted Covid-19 already have robust natural immunity and that vaccinating has a greater risk of adverse events after a previous infection (National Institutes of Health, 2021; Rajneesh, K.J. et al., 2021). It also disregards the unique medical needs of each person. Some of our colleagues have a history of severe adverse reaction to immunization, yet have been denied a medical exemption by our employers.
Fallacy: 98.7% of hospitalized cases are unvaccinated
Our GTA employers have leaned on Toronto Public Health's news release stating that since May 1, 98.7 percent of hospitalized COVID-19 cases with known vaccination status were not fully vaccinated. This data is exceptionally misleading and fear mongering when taken out of context. On May 1, 2021, 97.5% of Ontarians were unvaccinated. Only 2.5% of Ontarians were fully or partially vaccinated on May 1. Vaccinations only began to rise sharply in June. In addition, comparing the four months of the May-August period, more Covid cases occurred in May, when the vast majority of the population was unvaccinated, than in the other three months combined. On May 1, when 97.5% of the population was unvaccinated, the 7-day case average in Ontario was 3618 cases. By July 7, the 7-day case average was down to 216. Therefore, it is entirely unsurprising that the vast majority of Covid-19 infections occurred in unvaccinated people at at time when the vast majority of people were unvaccinated. This data was presented to staff in a way that erroneously suggested that the current unvaccinated population would experience the same rate of hospitalization (Government of Ontario Data Catalogue, 2021).
The positive test rate in Ontario is also affected by the makeup of the test population. Currently in Ontario, the daily Covid-19 test results released by the Ministry of Health show a higher number of unvaccinated people testing positive for Covid-19. This data does not, however, reveal the proportion of tests submitted by unvaccinated people. Vaccinated people are now being told by their employers that if they come into contact with a confirmed Covid-19 case, they do not need to test for Covid-19 unless they develop symptoms. We respectfully submit that since vaccinated people are no longer encouraged to be tested in many scenarios, unvaccinated individuals are more likely to test. This leads to skewed testing proportions and also creates a population of asymptomatic, untested, vaccinated carriers.
Fallacy: Mandatory vaccination protects our colleagues
The promotion of vaccination as a way to protect our colleagues is based on an additional fallacy that our libraries are unsafe environments and that visitors and staff require further protection than that offered by the protocols already in place. We respectfully submit that since our libraries are already safe environments, no further protection is offered by these mandates.
To date since the beginning of the pandemic, there have been zero cases of in-library spread of Covid-19 in Ontario. In the Toronto Public Library, the busiest library system in the world, there have been two positive staff Covid-19 cases among thousands of employees across 100 branches in the last 10 weeks (Toronto Public Library, 2021). Both have been in fully vaccinated individuals. We submit that the evidence maintains that our libraries are safe, current health and safety protocols are working, and that colleagues do not require protection from their unvaccinated colleagues.
Fallacy: These policies are required according to Ontario's Occupational Health and Safety Act.
Untrue. The Ontario Government specifically states on its website that “The OHSA and the ESA do not directly address vaccination or the enforcement of employer vaccination policies for workers” (Government of Ontario, 2021-b).
In relation to Covid-19, the Province of Ontario has made the following announcement:
Requirements for all workplaces under the Occupational Health and Safety Act
OHSA requirements for all employers include:
ensuring workers know about hazards by providing information, instruction and supervision on how to work safely
ensuring supervisors know what is required to protect workers’ health and safety on the job
creating workplace health and safety policies and procedures
ensuring workplace parties follow the law and the workplace health and safety policies and procedures
ensuring workers wear the right protective equipment and are trained on how to use it
taking all precautions reasonable in the circumstances to protect workers from being hurt or getting a work-related illness
(Government of Ontario, 2021-a)
Mandating vaccines is not a reasonable precaution to take to prevent workplace spread. The Government of Ontario explains this on their website:
How COVID-19 vaccines protect people
Vaccination (also known as immunization) increases a person’s ability to fight infection if they are exposed to a specific virus. The vaccine activates the body’s natural immune response and makes it more ready to fight the virus.
The COVID-19 vaccines approved for use in Canada have been shown to work well to protect those who receive them.
After being vaccinated you are much less likely to get sick if you are exposed to COVID-19. However, you could still:
spread the virus to others
This is because no vaccine works 100% of the time, and we are still learning:
how well the COVID-19 vaccines may work against new variants
how long protection will last after COVID-19 vaccination or infection
(Government of Ontario, 2021-b)
The Government of Ontario further explains that:
The most effective way to limit exposure to COVID-19 is to avoid interactions between people. All workers who can work from home should do so. This is an important way to help protect these workers as well as those who have to go into the workplace.
(Government of Ontario, 2021-b)
In addition to there being no health and safety basis for these policies, these mandates are in direct violation to Federal and Provincial Law.
Mandatory Vaccination Policies Violate Health Privacy Law
In Ontario, health information privacy is protected by the Ontario Occupational Health and Safety Act and the Personal Health Information Protection Act.
The Ontario Occupational Health and Safety Act states:
Employer access to health records
(2) No employer shall seek to gain access, except by an order of the court or other tribunal or in order to comply with another statute, to a health record concerning a worker without the worker’s written consent. R.S.O. 1990, c. O.1, s. 63 (2).
(Government of Ontario, 1990)
The Personal Health Information Protection Act further states that consent to disclose information must not be obtained through coercion.
Elements of consent
18 (1) If this Act or any other Act requires the consent of an individual for the collection, use or disclosure of personal health information by a health information custodian, the consent,
(a) must be a consent of the individual;
(b) must be knowledgeable;
(c) must relate to the information; and
(d) must not be obtained through deception or coercion. 2004, c. 3, Sched. A, s 18 (1).
(Government of Ontario, 2004)
By demanding to know our vaccination status and threatening dismissal for non-disclosure of this personal health information, do our employers take the position that their vaccine mandate overrides the Personal Health Information Protection Act and the Ontario Occupational Health and Safety Act?
Mandatory Vaccination Policies Violate Employees' Right to Informed Consent
The coercion that is embedded in these mandates also violates employees’ right to informed consent, as granted by the Ontario Health Care Consent Act, which states:
Elements of consent
11 (1) The following are the elements required for consent to treatment:
1. The consent must relate to the treatment.
2. The consent must be informed.
3. The consent must be given voluntarily.
4. The consent must not be obtained through misrepresentation or fraud. 1996, c. 2, Sched. A, s. 11 (1).
(2) A consent to treatment is informed if, before giving it,
(a) the person received the information about the matters set out in subsection (3) that a reasonable person in the same circumstances would require in order to make a decision about the treatment; and
(b) the person received responses to his or her requests for additional information about those matters. 1996, c. 2, Sched. A, s. 11 (2).
(3) The matters referred to in subsection (2) are:
1. The nature of the treatment.
2. The expected benefits of the treatment.
3. The material risks of the treatment.
4. The material side effects of the treatment.
5. Alternative courses of action.
6. The likely consequences of not having the treatment. 1996, c. 2, Sched. A, s. 11 (3).
(Government of Ontario, 1996)
Consent under duress due to the threat of loss of employment is not voluntary, informed consent. Without consent, a medical treatment is considered assault under Section 265(3) of the Criminal Code of Canada:
(3) For the purposes of this section, no consent is obtained where the complainant submits or does not resist by reason of
(a) the application of force to the complainant or to a person other than the complainant;
(b) threats or fear of the application of force to the complainant or to a person other than the complainant;
(c) fraud; or
(d) the exercise of authority.
(Government of Canada, 1985)
Mandatory vaccination policies violate the Canadian Charter of Rights and Freedoms
These policies violate employees’ Section 7 right to Liberty under the Canadian Charter of Rights and Freedoms. Under Section 7, “(e)veryone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice”. We have the right to exercise our liberty and make the inherently private choice to refuse medical treatment.
Life, liberty and security of person
7 Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.
(Government of Canada, 1982)
In addition, Section 2(a) of the Canadian Charter of Rights and Freedoms grants all Canadians Freedom of Conscience. Employees who conscientiously object to mandatory vaccination through their strong and researched beliefs have the right to refuse vaccination. We affirm that mandatory vaccination violates the Charter 2(a) Right to Freedom of Conscience.
Guarantee of Rights and Freedoms
Rights and freedoms in Canada
1 The Canadian Charter of Rights and Freedoms guarantees the rights and freedoms set out in it subject only to such reasonable limits prescribed by law as can be demonstrably justified in a free and democratic society.
2 Everyone has the following fundamental freedoms:
(a) freedom of conscience and religion;
(b) freedom of thought, belief, opinion and expression, including freedom of the press and other media of communication;
(c) freedom of peaceful assembly; and
(d) freedom of association.
(Government of Canada, 1982)
Fallacy: Toronto Public Health advice is the best advice
Would our libraries be in the wrong if they refused to follow Toronto Public Health's advice to make a mandatory vaccination policy? If we don't follow Toronto Public Health, who should we follow? We respectfully submit as information professionals that we should follow the data. As people that not only profess, but teach information literacy, we believe in consulting trusted academic and government sources of data and using these to make informed decisions.
Throughout the pandemic, Toronto Public Health has gained itself a reputation for making public health recommendations that are not evidence-based and have large, negative repercussions to society. Indeed, when writing to the Ministry of Health to request the Fall/Winter lockdown of 2020,Toronto’s Medical Officer of Health used the model of Melbourne’s lockdown, which is among the strictest in the world (deVilla, 2020).
Toronto Public Health has a history of making decisions based on fear instead of medical knowledge, such as ordering that all tennis courts, community allotment gardens, dog off-leash parks, and school fields be closed to prevent the spread of Covid-19 (City of Toronto, 2000). Our public health agencies advised us that AstraZeneca's vaccine was safe and effective (now banned), that we should take the first vaccine we could get (Moderna is now not recommended for 18-24 year olds), and to mix mRNA vaccines (not recommended by the manufacturers).
Outside of Ontario, with very few exceptions, public health units respect their employees personal health privacy and medical autonomy. Ontario libraries may feel that they do not believe they have a choice regarding this mandate. In fact, the province has directed employers to create a vaccine policy, but not a vaccine mandate. In 2019, Toronto Public Library showed its strong respect for the Charter of Rights and Freedoms by choosing to allow a controversial room booking (Toronto Public Library, 2019). This is a similar opportunity for TPL to independently analyze the law and make a just decision.
In summary, research informs us that the unvaccinated do not pose a greater risk to others than the vaccinated and the library is already a safe environment. It also shows us that there are valid concerns about long-and-short-term effects of vaccination. In addition, this policy violates provincial privacy laws as well as our Constitutional and Charter rights and is an illegal, unconscionable action. We ask that the our libraries make the brave decision to retract the policy.
The Ethical Librarian
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