“If all of this was about health, I’d still be working:” Lived experiences of healthcare workers under COVID-19 vaccine mandates in British Columbia, Canada

COVID-19 vaccine mandates for healthcare workers (HCWs) in British Columbia (BC) were implemented in October 2021 and remained effective until July 2024, despite public protests and opposition from some unions. This study explored HCWs’ lived experiences under these mandates, focusing on decision-making processes, personal and professional impacts, and perceived consequences for patient care. We conducted a reflexive thematic analysis of qualitative responses from 90 HCWs, collected through one open-ended survey question and elaborations on closed questions. The survey, conducted in May–June 2024, recruited a convenience sample of 166 HCWs of varying vaccination status, professions, and demographics through social media and professional networks. Findings are reported in accordance with the consolidated criteria for reporting qualitative studies (COREQ) checklist (Table A1). Most respondents were unvaccinated and had lost employment due to non-compliance. Participants reported significant personal losses and expressed overwhelmingly negative views on mandates. Six key themes emerged: (1) conflict with scientific evidence and clinical practice; (2) violations of medical ethics, especially informed consent; (3) dismissed personal and economic hardships; (4) overlooked vaccine-related physical harms; (5) discrimination against unvaccinated HCWs and patients; and (6) negative impacts on care delivery. Our findings suggest that vaccine mandates caused substantial social and economic harm, contributed to staffing shortages, degraded workplace morale, and compromised patient care. Drawing on respondents’ experiences and the scientific evidence available at the time, we conclude that mandatory COVID-19 vaccination for HCWs lacked scientific justification and violated foundational ethical principles in health-care policy and practice.