Page 229 - GHES-3-3

Global Health Economics and
Sustainability
COVID-19 vaccination decisions and mandate impact

Table 9. Level of agreement with the statements on the impact on patient care
Statement Strongly Disagree Neutral Agree (n, %) Strongly N/A No
disagree (n, %) (n, %) agree (n, %) response
(n, %)
I observed concerning patient care or 5/166, 3 4/166, 2.4 19/166, 11.4 26/166, 16 86/166, 52 15/166, 9 11/166, 7
procedural changes coinciding with the onset
of the COVID-19 crises
I observed concerning patient care changes 3/166, 2 4/166, 2.4 11/166, 7 27/166, 16.3 94/166, 57 16/166, 10 11/166, 7
after the introduction of the COVID-19
vaccines
I observed differential treatment of patients 2/166, 1.2 7/166, 4.2 14/166, 8.4 22/166, 13.3 96/166, 58 14/166, 8.4 11/166, 7
based on their vaccine status
I observed an increase in patient harms 1/166, 1 4/166, 2.4 17/166, 10.2 25/166, 15.1 92/166, 55.4 15/166, 9 12/166, 7.2
associated with the COVID-19 vaccines
I felt free to express any concerns I had about 107/166, 64.5 19/166, 11.4 8/166, 5 1/166, 1 7/166, 4.2 13/166, 8 11/166, 7
patient care or potential vaccine harms with
my employer
If I expressed concerns about patient care or 58/166, 35 25/166, 15.1 23/166, 14 4/166, 2.4 7/166, 4.2 38/166, 23 11/166, 7
potential vaccine harms, these concerns were
documented and acted on by my employer
From the perspective of a potential patient, 118/166, 71.1 19/166, 11.4 9/166, 5.4 1/166, 1 7/166, 4.2 2/166, 1.2 11/166, 7
I am confident that the current healthcare
system will provide adequate and quality care
while respecting my personal preferences and
values
I was coerced into recommending/ 14/166, 8.4 17/166, 10.2 15/166, 9 13/166, 8 25/166, 15.1 72/166, 43.4 10/166, 6
administering COVID-19 vaccines against
my best clinical judgment (e.g., patient
may experience an adverse event, or has
experienced an adverse event post-vaccination
of COVID-19 or other vaccines; patient too
young/old to benefit from vaccination, patient
who had experienced COVID-19 and likely
has strong natural immunity)
I was accused of undermining COVID-19 6/166,4 7/166, 4.2 17/166, 10.2 38/166, 23 70/166, 42.2 16/166, 10 12/166, 7.2
public health response/patient care due to my
views/decisions about vaccination
I was disciplined for undermining COVID-19 12/166, 7.2 9/166, 5.4 13/166, 8 22/166, 13.3 72/166, 43.4 27/166, 16.3 11/166, 7
public health response/patient care due to my
views/decisions about vaccination
Statement (only HCWs who administered Strongly Disagree Neutral (n, Agree (n, %) Strongly N/A No
vaccines) disagree (n, %) %) agree (n, %) response
(n, %)
I am aware that COVID-19 vaccines can cause 0/2, 0 0/2, 0 0/2, 0 1.2, 50 1/2, 50 0/2, 0 0/2, 0
serious or life-threatening injuries, including
death
I felt coerced to administer COVID-19 0/2, 0 0/2, 0 1/2, 50 0/2, 0 1/2, 50 0/2, 0 0/2, 0
vaccines at any point during the vaccination
campaign

Despite regional differences between the current the demographic patterns indicated that vaccination
study and an earlier survey of HCWs that we conducted mandates in the health sector had largely impacted
in the province of Ontario (Chaufan et al., 2024), both the female and experienced workforce of nursing
studies revealed similar demographic trends, vaccination professionals. In both provinces, most respondents (90%
decisions, and personal impacts. In both BC and Ontario, in BC and 89.1% in Ontario) disagreed that they felt free to

Volume 3 Issue 3 (2025) 221 https://doi.org/10.36922/GHES025080014