The COVID-19 pandemic has represented a serious global health crisis resulting in devastating levels of serious illness and more than 27,000 deaths in Canada alone. Fortunately, the rapid development of highly effective vaccines has significantly reduced the danger posed by the virus, even with the emergence of the Delta variant. Vaccine certificates have been rolled out across the country with participation from Quebec, British Columbia, and now Ontario. The federal government has earmarked $1 billion for their implementation. Individuals will be required to demonstrate proof of vaccination status in order to access “non-essential” services. While it is an important societal goal to maximize vaccination coverage in adults, it is also important to consider whether the end justifies the means.
1. What is the intent and what are the end points? Vaccine certificates impose a significant burden on the population. There will be ongoing costs to taxpayers to maintain this system, and businesses will bear costs for implementation and oversight, and may be subjected to fines. The additional uptake in vaccination rates in those who are either unvaccinated or without natural immunity from previous infection is unclear. Moreover, it is unclear whether vaccine certificates will impact those at greatest risk of severe disease either directly with increased rates of vaccination or indirectly with reduced rates of hospitalization and death, especially in hard-to-reach groups. In a rush to implement this system, governments have been unclear about how they will measure efficacy, which implies there may not be a clear plan on when to scale back; perceivably, this program could be in effect for years to come. With the precedent for vaccine certificates established, there may be a desire to include other seasonal viruses, excluding increasingly larger segments of society from “non-essential” services.