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Your Voice: Dr. Henry's vaccination status order 'egregiously fails as a credible evidence-based policy'

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Dear Sir/Madam,

Dr. Henry’s new Public Health Order (PHO) states that an unvaccinated healthcare provider is a health hazard and therefore must disclose their vaccination status.

The mandate allows patients to know the vaccination status of their provider and “have confidence that when they receive care … they are not putting their health at risk.”

It is pitched as an extra layer of protection against COVID-19 transmission and attempts to substantiate a simple message: a vaccinated provider is safer to see than an unvaccinated provider.

However, vaccination status is not a binary method of quantifying risk and believing the contrary is the true health hazard. But Dr. Henry doesn’t want you to know that.

Experts often state that if one cannot contract the virus, one cannot transmit the virus; it oversimplifies viral transmission but illustrates why vaccines could be used as a tool to reduce transmission.

<who> Photo credit: Colin Smith/NowMedia

The term “protection against symptomatic infection” can also be used as a surrogate measure of transmission because of similar aforementioned reasoning.

This protection can be scientifically quantified based on someone’s immune status (e.g. natural immunity, vaccine immunity and hybrid immunity) to help delineate the “optimal” protection.

Unfortunately, Dr. Henry disregards this science and attempts to define “protection” using vaccination status alone.

This egregiously fails as a credible evidence-based policy. But Dr. Henry doesn’t want you to know that.

Both “vaccinated” and “primary series” are defined as a two-dose or one-dose vaccine series (e.g. Johnson & Johnson). Hospital-based employees only require a primary series and are considered “safe” for direct patient care. Paradoxically, the BC Centre for Disease Control COVID Therapeutics Committee (BCCDC CTC) deems a primary series as “under immunized” while Dr. Henry refers to it as safe for direct patient care.

One would argue that despite being under immunized, a healthcare worker can still be considered safe. Right? Wrong. But Dr. Henry doesn’t want you to know that.

According to the BCCDC, the primary series effectiveness against Omicron infection was “less than 10-15 per cent”.

Public Health Ontario concluded it was only 36 per cent effective 7–59 days and 0 per cent effective 180 days after the last vaccine dose, respectively. This latter statistic of 0 per cent effectiveness has been reproduced worldwide.

Therefore, if your healthcare provider is greater than six months after completing their primary series, their risk of contracting COVID-19 is equal to that of an unvaccinated provider. But Dr. Henry doesn’t want you to know that.

Both “fully vaccinated” and “full series” are defined as a primary series with the addition of a booster dose. According to the UK COVID-19 Vaccine Weekly Surveillance Reports, the full series effectiveness against symptomatic Omicron infection is 50-75 per cent 0–3 months and 40-50 per cent 3-6 months after the booster dose, respectively.

As such, a provider may have 0-75 per cent protection against symptomatic Omicron infection, depending on the timing of their vaccinations. How can such a wide range of protection provide any reassurance to a clinically vulnerable patient not wanting to put themselves at risk? These populations would unanimously choose a provider with 75 per cent protection over one with 0 per cent protection but the mandate does not allow such clarity. But Dr. Henry doesn’t want you to know that.

A study by the CDC found natural immunity superior to a primary series in protection against symptomatic Delta infection with no statistical difference between those with hybrid immunity (primary series plus natural immunity).

A study in the New England Journal of Medicine showed the protection of natural immunity against symptomatic Omicron infection was 64 per cent 3–8 months, 47.2 per cent 9–14 months and 59.6 per cent greater than 15 months after infection, respectively.

As such, natural immunity is similar to full vaccination and superior to a primary series in protection against symptomatic Omicron infection.

The evidence proves the least protected immune healthcare provider is one with a primary series yet Dr. Henry portrays this immunity status as some grandiose shield of public protection.

She would rather a healthcare provider with 0 per cent protection take care of your vulnerable, high-risk family member than one with 50 per cent protection from natural immunity. But Dr. Henry doesn’t want you to know that.

The science and evidence of protection depends on one's timing since their vaccinations and/or previous COVID-19 infection. These nuances determine one's protection, not the illusion of a misleading and divisive “vaccinated” versus “unvaccinated” label.

But Dr. Henry doesn’t want you to know that.

Dr. York Hsiang (professor of surgery), Vancouver

Dr. Ralph Behrens (retired), Fruitvale

On behalf of BC Doctors for Science and Ethics

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