Some front-line hospital workers still haven’t been vaccinated for COVID-19

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Despite greater access to COVID-19 vaccines, some front-line hospital workers across Canada have still not gotten immunized as the variant-driven third wave threatens to overwhelm the health care system.

Vaccination rates range from about 50 per cent of all health care workers in acute-care facilities in Alberta, where eligibility was restricted until recently, to an estimated 90 per cent of those who interact with patients in some Ontario hospitals, according to a Globe and Mail survey.

Less-than-optimal inoculation rates mean that thousands of hospital staff across Canada have not been vaccinated – which could potentially put patients at risk.

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Experts say there are varied and complex reasons why a small minority of health care workers have so far opted not to get jabbed, including scheduling issues, concerns about the second-dose delay, a desire to wait and see, vaccine hesitancy and outright opposition.

“Just because you’re a health care worker does not mean you are inoculated against misinformation,” said Sajjad Fazel, a postdoctoral scholar at the University of Calgary who researches COVID-19 misinformation. “Yes, a health care worker is less likely to believe in misinformation … but at the end of the day, we are all human beings.”

Unlike the Italian government, which recently issued a decree requiring health workers to be vaccinated, provincial governments have said they do not intend to make COVID-19 shots mandatory in health care. However, Quebec recently began requiring personnel in certain units to provide proof of immunization or else face repeated testing, possible reassignment or even unpaid leave.

Four months after vaccines first became available to health care workers, officials are using a range of strategies to boost uptake, including information sessions, hotlines, one-on-one conversations and easy access to appointments.

At Sunnybrook Health Sciences Centre in Toronto, where more than 70 per cent of health care workers who interact with patients have been immunized, the holdouts must either get vaccinated by the end of the month or watch an educational video and sign a form stating they are declining. The approach, which the hospital also uses for flu shots, is designed to force staff to make a decision about immunization, rather than letting it slide. (Individuals can also demonstrate they are medically exempt.)

“What we have found is this is actually a really effective nudge towards the vaccine option,” said Jerome Leis, the hospital’s medical director of infection prevention and control.

Since Sunnybrook announced the policy at the beginning of April, more than 500 additional workers have booked appointments for their COVID-19 shots. Doctors have the highest immunization rate, at 91 per cent, while cleaners are among the lowest, said Dr. Leis, who added that the figures are not adjusted to exclude staff who are on leave.

In a recent letter urging staff to get vaccinated, Kevin Smith, president of Toronto’s University Health Network, said 4,000 people working on site had not yet gotten shots, with rates below 50 per cent in unspecified areas and programs. He cited “rumours about the vaccines” and said “vaccine ambassadors” would be available to answer questions.

“We have the privilege and the inordinate responsibility of caring for Canada’s sickest citizens. Nowhere more than here must we see maximal uptake of these safe and effective vaccines,” he wrote on March 22, noting UHN is the country’s largest research hospital.

Since the letter, another 2,300 workers have gotten their shots, according to a spokeswoman, for an estimated vaccination rate of 90 to 95 per cent among those who interact with patients.

The Globe and Mail contacted several large hospitals, health authorities and provincial governments for vaccination rates among hospital-based health care workers and found significant variations, incomplete data and aggregated figures.

For example, several Ontario hospitals said they could only provide estimates of workers’ immunization rates based on registration because there is no requirement to report COVID-19 vaccination to employers.

More than half of Unity Health Toronto’s eligible staff and physicians have been vaccinated at the network’s own sites, but the figure is likely an underestimate because it doesn’t include workers who got jabbed elsewhere, according to a spokeswoman.

While “a significant number” of staff, doctors and volunteers at William Osler Health System in the Greater Toronto Area have been vaccinated, “specific data is not yet available at this time,” spokeswoman Emma Murphy said.

Having accurate vaccination data for health care workers is crucial so institutions can work to increase rates, especially given the higher risk posed by the variants, said Kumanan Wilson, a physician scientist at the Ottawa Hospital who is an expert on vaccine policy.

If there are still holdouts among staff who work directly with patients, Dr. Wilson said hospitals would have to “seriously consider policies” requiring immunization as long as clear evidence emerges that vaccination prevents transmission of the virus to others.

In Alberta, approximately 50 per cent of health care workers in acute-care facilities had been immunized based on individual circumstances, including age and underlying health conditions, as of April 8, an Alberta Health Services spokeswoman said. The province expanded vaccine eligibility to more health care workers on April 12.

In Montreal, 80 per cent of eligible health care workers at McGill University Health Centre have been vaccinated, a spokeswoman said. At the Jewish General Hospital, 40 per cent of all staff have been immunized, according to a spokesman, who added that many are not yet eligible.

In Nova Scotia, 94 per cent of all health care workers – including those in hospital as well as homecare workers, paramedics and even dentists – have received at least their first dose, a government spokeswoman said.

In Manitoba, 75 per cent of health care workers who work in hospitals, long-term care homes and home care have been vaccinated, according to a provincial spokesman.

In Saskatchewan, 69 per cent of eligible workers, including those based in hospitals, long-term care, seniors’ homes and home care, have gotten at least their first vaccine dose, the government said.

The British Columbia government did not provide a vaccination rate but said more than 88,000 eligible acute care staff and physicians had received a first dose as of April 12.

Several hospitals, including Ontario’s Humber River Hospital, Windsor Regional Hospital and Scarborough Health Network, did not respond to multiple requests for immunization rates.

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