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Open letter to Premier Doug Ford providing scientific evidence supporting the right of health care workers

https://uhcwo.com/response-sat

Response: COVID-19 vaccine mandates for Ontario’s hospital workers

October 28, 2021

Open letter to Premier Doug Ford providing scientific evidence supporting the right of health care workers to make an informed decision about their own health. Written and signed by several prominent Canadian scientists and doctors, refuting a recent publication by the Ontario COVID-19 Science Advisory Table released on October 19, 2021.

Dear Premier Ford,

Please accept our response to the recommendations issued by the Ontario COVID-19 Science Advisory Table (SAT). (1) We represent scientists, health experts and professionals, and academics from various disciplines who have closely followed, evaluated, and reported on the province’s handling of COVID-19 since the WHO declared it a pandemic. We write in the spirit of informing your assessment of the policy of vaccine mandates for Ontario’s hospital workers endorsed by the SAT report authors. We also expect that our analysis will inform your decision on vaccine mandate policy in other sectors, such as education.

Like the authors of the SAT report, we have addressed specifically the province’s handling of hospital workers, among which we include frontline healthcare workers, contractors, students, and volunteers. Like them as well, we emphasize the importance of protecting vulnerable patients from SARS-Cov-2 infections in hospital settings, minimizing disruption in our hospitals due to staffing shortages, and protecting the health, safety, and well-being of hospital workers who have been, as the SAT reports rightly points out, the “backbone of the province’s response to COVID-19.” Let us not forget that not so long ago these hospital workers were highly praised for their dedication and sacrifices in support of those most severely ill with COVID-19.

In a stark departure from the SAT report, however, whose authors advise you to require that all healthcare workers receive the COVID-19 vaccine products, we strongly advise against this policy: there is no scientific evidence supporting forced vaccination – rather, there is mounting evidence against it – the policy severely undermines both the well-being of healthcare workers and of the patients who need their assistance, and forced vaccination infringes on the universally accepted principle of informed consent, and may even constitute a crime against humanity with major legal repercussions for those who lead, or collaborate with, its implementation. (2)

The authors of the SAT report base their recommendations on 4 incorrect claims.

  1. That COVID-19 vaccines are safe;

  2. That COVID-19 vaccines are effective;

  3. That general infection prevention and control to reduce the spread of COVID-19 is imperfect whereas vaccines provide safe and effective protection; and,

  4. That efforts to counter ‘vaccine hesitancy’ among the most vulnerable, e.g., racialized workers, through ‘education’ and ‘personalized outreach’, will lead to trust building and will avoid losing ‘valuable members of the workforce’.

None of these claims are based on scientific evidence. Allow us to elaborate:

COVID-19 vaccines are not safe: Phase III trials are the highest level of evidence and our best tool for ascertaining the risks and benefits of a treatment. Results from the phase III trial of the BNT162b2 mRNA COVID-19 vaccine through 6 months were recently reported by Thomas et al. in the New England Journal of Medicine. (3) The study, which compared the mRNA COVID-19 vaccine to placebo in healthy adults, showed an absolute risk reduction (ARR) in symptomatic and PCR-confirmed COVID-19 cases among fully vaccinated individuals of 3.7%, but an absolute risk increase (ARI) of 17.9% in treatment-related adverse effects in that same group. As well, the study reported an ARR in severe COVID-19 cases of 0.1% among the fully vaccinated, but also an ARI in serious adverse events among vaccine recipients of 0.5%. While deaths were relatively comparable across arms initially (15 vs 14 deaths, vaccine vs placebo, respectively), 5 additional deaths were reported in vaccine recipients after cross over, bringing the total death count after vaccination to 20. (Table 1). Of note, there were nearly twice as many deaths due to cardiac events on vaccine arm compared to the placebo arm (7 vs 4 deaths). Results of the BNT162b2 mRNA COVID-19 phase III clinical trial clearly demonstrate at the highest level of evidence that the risks associated with the BNT162b2 mRNA COVID-19 vaccine outweigh the risks of COVID-19 in healthy adults, and do not support claims about the safety of these products, in this or any other population, and regardless of antibody levels.

Additionally, vaccine safety reporting systems are revealing a record number of injuries. As of October 15, 2021, reported adverse events worldwide had surpassed 2,344,240 in the WHO reporting system Vigiaccess. (4) VAERS, the US reporting system, recorded 122,833 serious adverse events, 17,128 of which ended in death, post administration of COVID-19 vaccine products. For context, the combined serious adverse events, including deaths, reported upon administering all (over 30) vaccines, except for COVID-19 vaccine products, since 1990 when the system was established, was 103,767 and 9,054, respectively. (5) Put another way, about 50% of serious adverse events ever recorded in the over 30 years of the existence of VAERS were associated with three COVID-19 vaccine products (AstraZeneca’s product was not distributed in the USA) administered within less than one year. In fact, these numbers underreport the true adverse events post COVID-19 products by a factor of 10 (6) and likely as high as 41. (7)

Concerningly, these reports do not even include adverse events in the long run, critical to assess the safety of any medical product, not only vaccines. If the history of drug development – such as that of thalidomide, dengue vaccine, and swine flu vaccine – teaches us anything is that the harm caused by implementing “remedies” that have not been properly tested can be significantly greater than that caused by the “disease” these remedies are designed to treat. (8–10)

COVID-19 vaccines are not effective: unlike smallpox vaccines, “sterilizing” because they provide full immunity, COVID-19 vaccine products are “leaky”, meaning that they do not prevent infection nor stop transmission. (11, 12, 13) The most recent system-wide study of vaccine-induced and natural immunity is a retrospective observational study conducted in Israel – one of the most vaccinated countries in the world – comparing SARS-CoV-2-infected individuals who received a two-dose regimen of the Pfizer mRNA vaccine to previously infected, unvaccinated individuals. The study showed that SARS-CoV-2-naïve vaccinees had a 13-fold greater risk of breakthrough infections with the Delta variant compared to those previously infected with the virus. Study authors concluded that natural immunity confers longer-lasting and stronger protection against infection, symptomatic disease, and hospitalization caused by the Delta variant of SARS-CoV-2, compared to the Pfizer 2-dose vaccine-induced immunity – and with none of the adverse effects. (14) Another study conducted in Dane County, Wisconsin, USA, with among the highest rates of vaccination in that country, indicated equally high viral loads among vaccinated (84%) as among unvaccinated (83%) individuals – in other words, an equal capacity of both vaccinated and unvaccinated to spread infection. (15)

General infection prevention and control to reduce the spread of COVID-19, and very critically, early treatment, are far superior to COVID-19 vaccine products mandated by Ontario’s current policy. There exists abundant evidence indicating that COVID-19 is a highly treatable disease, and that safe, effective, and inexpensive, generic drugs can be administered in combination for successful early treatment, and even prevention. A systematic review of 15 clinical trials indicated that the Nobel Prize winning antiparasitic drug Ivermectin (IVM) can be successfully applied to the treatment of viral diseases, including COVID-19, and reduces infection by an average of 86%. (16) A more recent report of 64 clinical trials, 30 of then randomized and controlled, indicated 67% effectiveness in prophylaxis, 84% in early treatment, and 20% in late treatment in protocols including IVM at different doses and for different periods of time. (17)

In a pathbreaking study of 1,195 healthcare workers in Argentina in the pre-vaccine era, none of the 237 cases of COVID-19 occurred in the treatment group, receiving IVM and wearing PPE, compared to the control group wearing PPE, where all cases occured. (18) Another meta-analysis of 18 Randomized Controlled Trials of IVM in COVID-19 found large, statistically and clinically significant, reductions in mortality, time to clinical recovery, and time to viral clearance. (19) Finally, many examples of IVM distribution campaigns – in Mexico City, several states in India, and several Argentinian provinces – leading to rapid population-wide decreases in morbidity and mortality, indicate the safety and effectiveness of this oral agent in all phases of COVID-19. (20)

In light of the wealth of data supporting treatment modalities that can help to overcome the current public health, social, and economic crisis in Canada, the suppression and gross misrepresentation – by leading regulatory agencies and mainstream media (21) – and the efforts of medical colleges to criminalize doctors who choose to treat COVID-19 patients with IVM and other repurposed drugs (22) , is unjustified and nothing short of extraordinary.

Efforts to coerce ‘vaccine hesitant’ Canadians with mandates will fail. Like the authors of the SAT report, we note that healthcare worker shortages pose serious risks to patient health. (23) Unlike these authors, however, we believe that shortages that existed well before COVID-19 (24) are being exacerbated by vaccine mandates. Like others members of the public, many health workers enjoy, according to the US National Institutes of Health, significant natural immunity due to prior infection (25) . Oftentimes this infection has been caused by exposure to the COVID-19 patients whom they courageously assisted when there were no vaccines. However, these workers are now being forbidden to treat those same patients according to their best clinical judgement, and are even being coerced, by all levels of government – first and foremost Prime Minister Trudeau – (26) into accepting these vaccine products as a condition of employment.

This unprecedented measure overwhelmingly affects the very segments of the healthcare labour force that the policy purports to protect, as shown by the thousands of laid off workers who are sharing their stories with organizations such as the United Health Care Workers of Ontario. (27) The clear message to these healthcare workers is that their training, experience and dedicated services are not as important as the unexplained desire for universal vaccination with failing, experimental vaccines, with increasingly evident risks of serious harms and even death.

In closing, while, as the SAT report asserts, vaccine mandates are not new, coercing Canadians to accept, against their best judgement, experimental medical products whose trials will be completed in May 2023 (28), is unprecedented. This imposition is especially troubling considering that our healthcare workers risked their lives in the frontlines during the darkest of times. The Guide for Canadian Physicians warns about the illegality of delivering medical treatments without full patient consent, (29) following the tradition established by the Nuremberg Code that, upon the “doctors’ trials” in Nazi Germany, declared that the consent of human subjects, voluntary by definition, is essential when implementing experimental medical procedures. (30)

This principle is also enshrined in the 1964 Declaration of Helsinki and has been reaffirmed in every single update since. 31 Your efforts to force healthcare workers to overcome their extremely reasonable, evidence- based “hesitancy” will only lead to further staffing disruptions, extraordinary distress among frontline health workers, and worse health outcomes among the most vulnerable. Vaccine mandates are not evidence-based policy and do not protect Ontarians. The policy ignores scientific evidence, ethics in medical practice, and basic principles of justice, human rights, and equity, precisely those that our Constitution and Charter are built upon.

We thank you for taking the time to read our analysis. We will very much appreciate the opportunity to support your efforts to keep Ontarians safe and prosperous by engaging and collaborating with you and members of your team. We look forward to your reply and to your favourable consideration of our recommendations.

Respectfully,

Claudia Chaufan, MD PhD (1)

Signatories

Stephen Pelech, PhD (2)
Deanna McLeod, HBSc
Denis Rancourt, PhD (3)
Daphene Francis PhD, RN (4)
Olga Collins, BSc (5)
Julie Ponesse, PhD (6)
Jan Vrbik, PhD (7)
Maximilian Forte, PhD (8)
Anton de Ruiter, PhD (9)
Jeffrey Graham, PhD (10)
Keren Epstein-Gilboa, PhD (11)

  1. Associate Professor, Health Policy and Global Health, York University

  2. Professor, Biochemistry and Immunology, University of British Columbia

  3. Researcher, Ontario Civil Liberties Association

  4. Professor, Nursing Leadership, Equity Diversity & Inclusion, Georgian College

  5. Research Technician, Molecular Biology, United Healthcare Workers of Ontario

  6. Ethics and Ancient Philosophy, former Western University affiliated Huron University College

  7. Professor, Mathematics, Brock University

  8. Professor, Sociology and Anthropology, Concordia University

  9. Professor, Aerospace Engineering, Ryerson University

  10. Associate Professor, Psychology, University of Toronto

  11. Individual, Couple &; Family Psychotherapy and Development

Download the PDF version

References

  1. COVID-19 Vaccine Mandates for Ontario’s Hospital Workers: Response to the Premier of Ontario. Ontario COVID-19 Science Advisory Table. doi:10.47326/ocsat.2021.02.49.1.0

  2. Jarmusik N. The Nuremberg Code And Its Impact On Clinical Research. Accessed October 26, 2021. https://www.imarcresearch.com/blog/bid/359393/nuremberg-code-1947

  3. Thomas SJ, Moreira ED, Kitchin N, et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine through 6 Months. N Engl J Med. 2021;0(0):null. doi:10.1056/NEJMoa2110345

  4. World Health Organization. VigiAccess – WHO Collaborating Center for International Drug Monitoring. Published October 10, 2021. http://vigiaccess.org/

  5. Search VAERS Database. Accessed October 26, 2021. https://medalerts.org/

  6. Lazarus R, Klompas M. Harvard Pilgrim Study – Lazarus Final Report 2011 | PDF | Electronic Health Record | Adverse Effect. Grant Final Report ID R18 HS 017045. Accessed September 24, 2021. https://www.scribd.com/document/434088983/Lazarus-Final-Report-2011

  7. Kirsch S, Rose J, Crawford M. Estimating the number of COVID vaccine deaths in America. Trialsite News. Published online October 26, 2021:57.

  8. Vargesson N. Thalidomide-induced teratogenesis: History and mechanisms. Birth Defects Res Part C Embryo Today Rev. 2015;105(2):140-156. doi:10.1002/bdrc.21096

  9. Su S, Du L, Jiang S. Learning from the past: development of safe and effective COVID-19 vaccines. Nat Rev Microbiol. 2021;19(3):211-219. doi:10.1038/s41579-020-00462-y

  10. Sencer DJ, Millar JD. Reflections on the 1976 Swine Flu Vaccination Program. Emerg Infect Dis. 2006;12(1):29-33. doi:10.3201/eid1201.051007

  11. Shitrit P, Zuckerman NS, Mor O, Gottesman B-S, Chowers M. Nosocomial outbreak caused by the SARS-CoV-2 Delta variant in a highly vaccinated population, Israel, July 2021. Eurosurveillance. 2021;26(39):2100822. doi:10.2807/1560-7917.ES.2021.26.39.2100822

  12. Chau NVV, Ngoc NM, Nguyet LA, et al. Transmission of SARS-CoV-2 Delta variant among vaccinated healthcare workers in Vietnam. :31.

  13. Hetemäki I, Kääriäinen S, Alho P, et al. An outbreak caused by the SARS-CoV-2 Delta variant (B.1.617.2) in a secondary care hospital in Finland, May 2021. Eurosurveillance. 2021;26(30):2100636. doi:10.2807/1560-7917.ES.2021.26.30.2100636

  14. Gazit S, Shlezinger R, Perez G, et al. Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections. medRxiv. Published online August 25, 2021:2021.08.24.21262415. doi:10.1101/2021.08.24.21262415

  15. 15. Riemersma KK, Grogan BE, Kita-Yarbro A, et al. Vaccinated and unvaccinated individuals have similar viral loads in communities with a high prevalence of the SARS-CoV-2 delta variant. medRxiv. Published online July 31, 2021:2021.07.31.21261387. doi:10.1101/2021.07.31.21261387

  16. Bryant A, Lawrie TA, Dowswell T, et al. Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines. Am J Ther. 2021;Publish Ahead of Print. doi:10.1097/MJT.0000000000001402

  17. Ivermectin for COVID-19: real-time meta-analysis of 64 studies. c19early.com. Accessed October 26, 2021. https://ivmmeta.com/

  18. Carvallo H, Roberto H, Psaltis A, Contreras V. Study of the efficacy and safety of topical ivermectin + iota-carrageenan in the prophylaxis against COVID-19 in health personnel. J Biomed Res Clin Investig. 2020;2(1). https://media.marinomed.com/8b/7a/c7/nota-journal-of-biomedical-research-safety-adn-efficacy-iota-carrageenan-and-ivermectin.pdf

  19. Kory P, Meduri GU, Varon J, Iglesias J, Marik PE. Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19. Am J Ther. 2021;28(3):e299. doi:10.1097/MJT.0000000000001377

  20. Chamie J. The Latest Results of Ivermectin’s Success in Treating Outbreaks of COVID-19. FLCCC | Front Line COVID-19 Critical Care Alliance. Accessed October 26, 2021. https://covid19criticalcare.com/ivermectin-in-covid-19/epidemiologic-analyses-on-covid19-and-ivermectin/

  21. Commissioner O of the. Why You Should Not Use Ivermectin to Treat or Prevent COVID-19. FDA. Published online March 12, 2021. Accessed July 2, 2021. https://www.fda.gov/consumers/consumer-updates/why-you-should-not-use-ivermectin-treat-or-prevent-covid-19

  22. White R, Reporter/Producer Ctvn ca D, Contact F|. Alberta’s colleges of physicians and pharmacists voice concerns over ivermectin prescriptions. Calgary. https://calgary.ctvnews.ca/alberta-s-colleges-of-physicians-and-pharmacists-voice-concerns-over-ivermectin-prescriptions-1.5597861. Published September 23, 2021. Accessed October 26, 2021.

  23. Beattie S. Ontario health-care workers warn of “brutal” nurse shortage as hospitals brace for 4th wave | CBC News. CBC. https://www.cbc.ca/news/canada/toronto/ontario-health-care-workers-warn-of-brutal-nurse-shortage-as-hospitals-brace-for-4th-wave-1.6150255. Published August 24, 2021. Accessed October 26, 2021.

  24. Brandie Weikle · CBC Radio ·. Canada was already desperately short of nurses before COVID-19. Now nurses say they’re hanging on by a thread | CBC Radio. CBC. https://www.cbc.ca/radio/whitecoat/canada-nursing-shortage-covid-pandemic-1.6174048. Published September 15, 2021. Accessed October 26, 2021.

  25. NIH. Lasting immunity found after recovery from COVID-19. National Institutes of Health (NIH). Published January 25, 2021. Accessed October 26, 2021. https://www.nih.gov/news-events/nih-research-matters/lasting-immunity-found-after-recovery-covid-19

  26. Trudeau J. Prime Minister announces mandatory vaccination for the federal workforce and federally regulated transportation sectors. Prime Minister of Canada. Published October 6, 2021. Accessed October 26, 2021. https://pm.gc.ca/en/news/news-releases/2021/10/06/prime-minister-announces-mandatory-vaccination-federal-workforce-and

  27. UHCWO. United Health Care Workers of Ontario. United Health Care Workers of Ontario. Accessed October 26, 2021. https://uhcwo.com

  28. BioNTech SE. A PHASE 1/2/3, PLACEBO-CONTROLLED, RANDOMIZED, OBSERVER-BLIND, DOSE-FINDING STUDY TO EVALUATE THE SAFETY, TOLERABILITY, IMMUNOGENICITY, AND EFFICACY OF SARS-COV-2 RNA VACCINE CANDIDATES AGAINST COVID-19 IN HEALTHY INDIVIDUALS. clinicaltrials.gov; 2021. Accessed October 17, 2021. https://clinicaltrials.gov/ct2/show/NCT04368728

  29. Canadian Medical Protective Association (CMPA). Consent: A guide for Canadian physicians. CMPA. Published 2021. Accessed October 1, 2021. https://www.cmpa-acpm.ca/en/advice-publications/handbooks/consent-a-guide-for-canadian-physicians

  30. Shuster E. Fifty Years Later: The Significance of the Nuremberg Code. N Engl J Med. 1997;337(20):1436-1440. doi:10.1056/NEJM199711133372006

  31. World Medical Association. Declaration of Helsinki. N Engl J Med. 1964;271(9):473-474. doi:10.1056/NEJM196408272710913

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