Why some Canadians believe delaying their COVID-19 vaccination is the ethical choice

TORONTO — With vaccine supply increasing and provinces getting more shots in arms, some Canadians are wondering if it’s ethical to take the shot if they’re not among the most vulnerable to COVID-19.

Provinces continue to expand eligibility for the COVID-19 vaccines as supply increases. Some provinces are vaccinating patients with the highest risk of severe illness or death, but some of those eligible under that rule feel they can wait for their age group to be called before getting their dose and don’t want to take a shot away from someone else.

It is up to individual Canadians to answer their own moral and ethical concerns over when to get the vaccine, particularly those in hotspots who can safely work from home or have health conditions they can manage easily at home.

Tara Sachs qualifies for the vaccine in Ontario as part of phase two of the province’s rollout, but she’s prepared to wait for her age group to become eligible before getting the vaccine.

“I have this condition but it doesn’t affect me every day, I don’t feel like, because it doesn’t affect me every day, I should be able to use it as some as a token to get my vaccination,” she told CTVNews.ca in a phone interview on Monday.

She’s been able to maintain masking, physical distancing and pandemic guidelines since the start, and is comfortable continuing with that until her age group is called up for the vaccine.

“I’m doing those measures to protect myself and so far it’s worked, so I’m not anxious about getting the vaccine so much,” she said. “I don’t have that anxiety, whereas other people in my life are stressing and freaking out about, like, they have to get it as soon as possible.”

Because she works from home and has a lot of control over who she comes into contact with, she hopes that by waiting someone who is more vulnerable is able to get it instead.

“I’m able to control the instances, like my community exposure, right, and there are people who don’t have that luxury and so I would much rather someone else get that opportunity,” she said.

Sachs harbours no ill will against those who do want to do everything in their power to get the vaccine as soon as possible.

“We’ve all been living through this collective trauma of this pandemic, and not everyone has the coping mechanisms, or the support in order to get through it the same way as everybody else,” she said.

Putting ourselves over others is part of the human condition, she said.

“Especially in this pandemic, you really see how strong we as humans are led by our egos to think that our comfort, our safety, our personal well being trumps that of those around us.”

It’s not so cut and dried for some who live in COVID-19 hotspots. Amelia Visconti worked in restaurants last summer, and plans to again when they’re allowed to reopen, and her Toronto neighbourhood is vaccinating those 18 and above.

“There are so many people right now, especially people who are working the front line and they’re out every single day, that need it ahead of me,” she told CTVNews.ca in an interview. “On the other side of the spectrum, I’m terrified of this virus.”

She wants to be able to go back to serving this summer without having to worry about bringing the virus home to her dad.

“On a selfish point, I stop and think, if I get this vaccine, I also can go back to work and feel safe,” Visconti said.

But she’s still worried that if she goes to a pop-up vaccine clinic in her neighbourhood, she’ll be taking someone else’s spot.

“When and how can I do this in a way that will be the least impactful on the rest of my community because … I can’t see numbers in front of me, and I can’t make a moral decision clearly that way,” she said.

It’s a complicated situation not made easier by any clear guidance on who the vaccine rollout is meant to target.

“It’s a matter of personal conscience,” University of Toronto bioethicist Kerry Bowman told CTVNews.ca in a phone interview.

He said that the rollout is meant to target those who are most vulnerable, but that’s not always the case when COVID-19 hotspots feature both $2-million homes and shelters for those who are homeless.

The other side of the argument is that the faster vaccines go into arms, the faster COVID-19 restrictions can be lifted, but vaccine supply may not yet be ready for that.

“There’s something to be said for just utilization, for saying the faster we vaccinate, the sooner we get through it. So, if there’s an appointment, then to take it and go. I think it’s a little early for that,” said Colin Furness, infection control epidemiologist at the University of Toronto.

Furness said that the people should allow room for those who are most vulnerable to get vaccinated first, but waiting if no one is getting vaccinated anyway isn’t going to solve any problems.

“If people decide to hold back on the vaccine because others need it more urgently, it needs to be paired with some kind of program to actively reach those who need it,” he said.

For Furness, if people who are eligible hold off on the vaccination to leave room for more vulnerable people, but governments are taking no action to get vaccines to those who need it, the whole system collapses.

“Provincial policy and vaccination campaign strategy is actually of pivotal importance here. Focusing on what steps various [local health authorities] might take to reach those marginalized folks would be really important,” said Furness.

With herd immunity being the goal of vaccination plans, waiting longer than necessary for the vaccine may seem counter-intuitive.

“It’s not as if you’re stepping out of the herd immunity equation, you’re waiting for another place later in the herd immunity equation so you’re not stepping out of that,” said Bowman.

Making an ethical decision over getting the vaccine now or waiting for more vulnerable populations to get it first is more complicated than simply following the rules.

“Many people think ethics is about following rules,” he said. “Ethics and law are two different things.”

What complicates things further for Bowman, is that administrative hospital staff qualified for vaccines in phase one and for the most part, took them.

“They had people that had literally, literally not set foot in the hospital for eight months. And these were administrative people that were taking vaccines like they set a terrible example,” said Bowman.

“Mostly they were unapologetic and I actually think it was very damaging because they sent a very strong message that, just go for it,” he said.

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