Background: Since vaccination policies were introduced in the healthcare sector in the province of Ontario, Canada, most establishments implemented vaccination or termination requirements, with most enforcing them to this day. Researchers have shown a strong interest in the perceived problem of vaccine hesitancy among healthcare workers, yet not in their lived experience of the policy or in their views on the impact of the policy on the quality of patient care in the province. Goal: To document the experience and views on mandated vaccination of healthcare workers in the province of Ontario, Canada. Methods: Between February and March 2024, we conducted a cross-sectional survey of Ontario healthcare workers, recruited through professional contacts, social media, and word-of-mouth. Findings: Most respondents, most with 16 or more years of professional experience, were unvaccinated, and most had been terminated due to non-compliance with mandates. As well, and regardless of vaccination status, most respondents reported safety concerns with vaccination, yet did not request an exemption due to their experience of high rejection rates by employers. Nevertheless, most unvaccinated workers reported satisfaction with their vaccination choices, although they also reported significant, negative impacts of the policy on their finances, their mental health, their social and personal relationships, and to a lesser degree, their physical health. In contrast, most respondents within the minority of vaccinated respondents reported being dissatisfied with their vaccination decisions, as well as having experienced mild to serious post vaccine adverse events, with about one-quarter within this group reporting having been coerced into taking further doses, under threat of termination, despite these events. Further, a large minority of respondents reported having witnessed underreporting or dismissal by hospital management of adverse events post vaccination among patients, worse treatment of unvaccinated patients, and concerning changes in practice protocols. Close to half also reported their intention to leave the healthcare industry. Discussion: Our findings indicate that in Ontario, Canada, mandated vaccination in the health sector had an overall negative impact on the well-being of the healthcare labour force, on patient care, on the sustainability of the health system, and on ethical medical practice. Our study should be reproduced in other provinces, as well as in other countries that adopted comparable policies. Findings from this and similar studies should be seriously considered when planning for future health emergencies, to protect health systems in crisis due to severe labour shortages, as well as the right to informed consent of healthcare workers and members of the public.

中文翻译：

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Covid-19 疫苗接种决定和疫苗规定的影响：对加拿大安大略省医护人员的横断面调查


背景：自从加拿大安大略省医疗保健部门引入疫苗接种政策以来，大多数机构都实施了疫苗接种或终止要求，其中大多数机构至今仍在执行。研究人员对医护人员对疫苗犹豫不决的问题表现出浓厚的兴趣，但对他们对该政策的生活经验或对该政策对该省患者护理质量影响的看法并不感兴趣。目标：记录加拿大安大略省医护人员强制接种疫苗的经验和观点。方法：2024 年 2 月至 3 月期间，我们对通过专业人士、社交媒体和口碑招募的安大略省医护人员进行了横断面调查。调查结果：大多数受访者（大多数具有 16 年或以上的专业经验）未接种疫苗，并且大多数因不遵守规定而被解雇。此外，无论疫苗接种状况如何，大多数受访者都报告了疫苗接种的安全问题，但由于雇主拒绝率很高而没有要求豁免。尽管如此，大多数未接种疫苗的工人对自己的疫苗接种选择表示​​满意，尽管他们也报告了该政策对其财务、心理健康、社会和个人关系以及较小程度的身体健康产生的重大负面影响。 相比之下，少数接种疫苗的受访者中的大多数受访者表示对自己的疫苗接种决定不满意，并且经历过轻度到严重的疫苗后不良事件，该组中约有四分之一的人报告说被迫进一步接种疫苗。尽管发生了这些事件，但还是威胁终止合同。此外，绝大多数受访者表示，他们目睹了医院管理层对患者接种疫苗后不良事件的漏报或忽视，未接种疫苗患者的治疗更差，以及有关实践方案的变化。近一半的人还表示打算离开医疗保健行业。讨论：我们的研究结果表明，在加拿大安大略省，卫生部门强制接种疫苗对医疗保健劳动力的福祉、患者护理、卫生系统的可持续性以及道德医疗实践产生了总体负面影响。我们的研究应该在其他省份以及采取类似政策的其他国家进行复制。在规划未来的突发卫生事件时，应认真考虑这项研究和类似研究的结果，以保护因劳动力严重短缺而陷入危机的卫生系统，以及医护人员和公众的知情同意权。