Page 214 - GHES-3-3

Global Health Economics and
Sustainability

ORIGINAL RESEARCH ARTICLE
COVID-19 vaccination decisions and the impact

of vaccination mandates: An exploratory cross-
sectional survey of healthcare workers in British

Columbia, Canada

Claudia Chaufan* , Natalie Hemsing , and Rachael Moncrieffe
Faculty of Health, School of Health Policy and Management, York University, Toronto, Canada

Abstract
British Columbia implemented some of Canada’s strictest COVID-19 workplace
vaccination mandates in the healthcare sector. Despite opposition from some
healthcare worker (HCW) unions, most health establishments, policymakers, and
academic researchers supported these mandates, which remained in effect until July
2024. While the perceived problem of vaccine hesitancy among HCWs has generated
much research, HCWs’ experiences and views on vaccination mandates have been
Academic editor: relatively neglected. Our study, conducted between June and July 2024, explored
Mihajlo Jakovljevic M.D. Ph.D. MAE these experiences and views. We surveyed 166 HCWs recruited through social media
*Corresponding author: and snowball sampling, regardless of vaccination status, age, gender, ethnicity,
Claudia Chaufan socioeconomic background, or health profession. Nearly half of the respondents
(cchaufan@yorku.ca)
had over 16 years of work experience, most were unvaccinated, and most had been
Citation: Chaufan, C., Hemsing, N. terminated for non-compliance. Both unvaccinated and vaccinated respondents
& Moncrieffe, R. (2025). COVID-
19 vaccination decisions and the expressed concerns about vaccine safety, coercion, and mental health impacts,
impact of vaccination mandates: An including suicidal thoughts. Most unvaccinated respondents were satisfied with their
exploratory cross-sectional survey vaccination decision, but they reported financial losses, mental health struggles, and
of healthcare workers in British conflicts with colleagues and loved ones. The vaccinated respondents – a minority in
Columbia, Canada. Global Health
Econ Sustain, 3(3):206-231. our sample - were largely unsatisfied, with most experiencing post-vaccination adverse
https://doi.org/10.36922/ events, and over half feeling pressured by their employers to accept further doses
GHES025080014
despite these effects. Regardless of vaccination status, HCWs observed concerning
Received: February 21, 2025 changes in practice protocols and discrimination against unvaccinated patients.
Revised: March 22, 2025 We argue that even if neglected by the literature, the multiple negative impacts of
vaccination mandates identified in our study – on HCWs’ well-being, patient care, and
Accepted: March 31, 2025
ethical healthcare practices – are extremely worthy of consideration. They indicate the
Published online: April 22, 2025 importance of prioritizing informed consent, engaging competing scientific evidence,
Copyright: © 2025 Author(s). and ensuring healthcare sustainability, particularly during emergencies.
This is an Open Access article
distributed under the terms of the
Creative Commons Attribution Keywords: COVID-19 workplace vaccination mandates; Healthcare workers’ vaccination
License, permitting distribution, decisions; Informed consent; Cross-sectional survey; British Columbia
and reproduction in any medium,
provided the original work is
properly cited.
Publisher’s Note: AccScience
Publishing remains neutral with 1. Introduction
regard to jurisdictional claims in
published maps and institutional On August 12, 2021, the Provincial Health Officer (PHO) of British Columbia (BC)
affiliations. announced the Residential Care COVID-19 Vaccination Status Information and

Volume 3 Issue 3 (2025) 206 https://doi.org/10.36922/GHES025080014