Ableism & The Province of Ontario’s Plan to Vaccinate Those with High Risk Medical Conditions on the Honour System
Less that a week ago I thought we had achieved a victory of sorts, with the launch of vaccinations for individuals with high risk conditions (like my own). Vaccinations were to begin by April 1. Recall, NACI only recently identified those with high risk medical conditions as deserving the highest prioritization for vaccination on March 1, 2021. However, Minister Christine Elliott announced today, via a media statement, that at mass vaccination centres proof may not be necessary for high risk individuals when their turn comes for vaccination. The problem lies herein:
- There are over 2 million persons who fall into this category.
- The category is heterogenous with a smaller number falling in the highest risk group (and I would submit the risk classification scheme the province provided is problematic for some groups ie misclassifications).
- An honour system for a vaccination program that is highly rationed, and for which 90% of Ontarians desire a vaccine, is only asking for confusion and problems.
I submitted a letter to the Minister this evening. It’s included below:
March 8, 2021
Christine Elliott,
Minister of Health and Long-term Care
Via Email
RE: VACCINATING THOSE WITH HIGH RISK MEDICAL CONDITIONS AND ABLEISM
Dear Honourable Minister of Health and Long-term Care,
I learned of your press statement this evening, announcing plans not to verify serious medical conditions before offering vaccinations to these high risk groups. I realize this was one media release and perhaps there are nuances not yet disclosed. I wanted to offer my comments.
Like seniors with advanced age, tens of thousand of individuals across Ontario are at a risk of severe COVID19 outcomes. On Sunday, Dr. Stephen Betschel, Clinical Immunologist at St. Michael’s Hospital described on CBC News that those individuals with Primary Immunodeficiencies are among those at highest risk of severe outcomes. He recommended family members residing in the same house are also vaccinated, due to the possibility that responses to vaccination may be suboptimal among the immunodeficient. So I was very surprised that proof may not be necessary at mass vaccination centres.
There have been abuses noted across Canada, regarding individuals queue jumping or hospital officials vaccinating their friends and family members, before those at highest risk. I am quite fearful this will be the case with such an approach.
Currently Ontario requires proof of age for seniors to obtain vaccination.
Hospital employees, physicians, and our first responders, also receiving vaccinations presently, must provide proof or receive the vaccine at their workplace.
Regulated health professionals must provide proof before vaccination.
All these individuals I have just mentioned have COVID19 risks from infection much lower than the high risk groups with serious medical problems that you noted in your classification scheme.
Therefore, the failure to ensure that vaccinations for high risk groups are not impeded by those who would abuse an honour system is very troubling, and I believe may represent a form of Ableism.
I fully understand your desire to perhaps, not impede vaccinations for these individuals. However, there must be a balanced approach that recognizes and prioritizes these individuals.
An honour system at a mass vaccination centre will be abused. Additionally, not all risks are equivalent as is described in Ontario’s list of high risk conditions. Variants of concern are growing at a rapid rate and the risks posed to these individuals are literally growing exponentially.
Giving vaccine to family physicians and specialists (immunologists especially) to administer to high risk individuals is certainly one approach that avoids Ableism.
Giving Medical Officers of Health leeway in how they identify and verify high risk individuals will be helpful. For example, physicians could upload a pre-registration form to public health units should they decide to use mass vaccination centres as in larger urban centres.
Seniors and high risk individuals must receive priority vaccination in the upcoming weeks. Rapid growth in B117 COVID19 cases is anticipated. A policy that goes from verified vaccination to an honour system, just as those who are highly vulnerable are to be vaccinated is discriminatory. I urge you to reconsider that plan. I have included Ms. Ena Chadna, Ontario Commissioner on Human Rights, in this correspondence in case such an action would represent systemic discrimination on the basis of disability.
I remain grateful for your consideration and thank you for reviewing my comments. The comments I make are my own.
Respectfully,
Christopher Leighton MD, FRCPC
