It isn't about health, and it sure doesn't care: A qualitative exploration of healthcare workers’ experience of the policy of vaccination mandates in Ontario, Canada

Background: When COVID-19 vaccines became available, healthcare workers (HCWs) were prioritized for vaccination. Despite debate, vaccine mandates were implemented in most healthcare settings across Canada, including Ontario, with many still in effect.Goal: This study examines Ontario HCWs' perspectives on vaccine mandates, focusing on their decision-making experiences, the mandates' impact on their lives and livelihoods, and their views on the effects of mandates on patient care.Methods: An online cross-sectional survey was conducted among Ontario HCWs of diverse vaccination status, professions, ages, socioeconomic status, races/ethnicities, and genders. Recruitment was through professional networks and snowball sampling. We performed a thematic analysis of responses to one open-ended question and to open-ended options in closed questions. Quantitative results are reported separately.Results: Out of 468 participants, 225 responded to the open-ended question, and 111 provided answers to open-ended options in closed questions. Most respondents were unvaccinated, had been terminated for non-compliance with vaccination mandates, experienced personal losses, and reported negative views on mandates and their impacts on patient care. Six themes emerged: 1) policies conflicting with scientific evidence and professional practice; 2) conflicts with medical ethics; 3) unaccounted for or dismissed personal hardships; 4) unacknowledged for or dismissed physical harms; 5) discrimination against unvaccinated individuals; and 6) negative impacts on patient care.Conclusions: The study indicates significant harm to HCWs and patients due to mandates, and advocates for the cessation of mandated vaccination in favor of evidence-based, ethical policies.