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B.C. doctors navigate medical, ethical issues of vaccine exemption requests

Last Updated Sep 15, 2021 at 12:04 am PDT


'The legitimate medical exemptions are very few and far between': B.C. family physician

Ethical considerations around vaccine exemption letters are something top of mind for doctors

VANCOUVER (CityNews) — B.C. doctors don’t have a clear-cut set of guidelines to refer to when deciding whether to write a letter exempting someone from getting the COVID-19 vaccine, which is one of the issues physicians have to contend with when they get requests from patients.

Workplaces in the health care sector will soon require vaccination, but medical exemptions will be allowed. So far, the BC College of Physicians and Surgeons has not provided a framework for when a doctor should offer or decline a letter, according to Dr. Jessica Chan.

However, when it comes to medical grounds, Chan says they’re fairly straightforward and easy to establish using NACI guidelines and the rules set out by the Ontario College of Physicians and Surgeons.

“The legitimate medical exemptions are very few and far between, so they’re mostly related to allergy,” Chan says, adding that these kinds of serious reactions would require a visit to a doctor, or emergency room and therefore be documented.

What Chan often encounters is people who say they are worried about side effects, either because they experienced them after their first dose or heard from someone else who did. But Chan says she’s had a lot of productive conversations with patients afterward.

“Actually, I welcome those discussions, one on one with patients because it actually opens a window, it has helped me, helped them explore the reasons behind why they don’t want to become fully vaccinated,” she says.

RELATED: Requests for false vaccine exemption letters cause ‘dismay’ for B.C. doctor

But if an ineligible patient is insisting on a letter, Chan says it puts the doctor in a difficult position.

“I think what weighs on our mind is the ethical responsibility, because when I write an exemption letter it doesn’t only affect one patient it affects public health. So, by writing a semi-justified exemption, it’s a butterfly effect, right?” she says.

“You might cause someone else to be infected, possibly hospitalized, and die. So, it is the ethical liability that weighs heavily on our minds.”

Overall, she’s seeing fewer requests than she did earlier in the pandemic from people who wanted exemptions from the mask mandate.

“I think people have more or less made up their minds whether they’re going to get vaccinated or not,” she says.

While making it clear that no one in the province will be denied medical care because they are unvaccinated, Chan notes clinics are starting to change protocols.

“Some clinics are starting to consider booking people in different time slots, so they’re trying to book the people who are not fully vaccinated at the end of the day, and the people who are vaccinated have their choice of time,” Chan says, explaining this gives staff more time to clean and minimizes contact between unvaccinated patients and the immunocompromised and otherwise vilnerable.

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With files from OMNI News