As Ryerson University students, we are deeply concerned with the school’s recent decision to impose a COVID-19 vaccine mandate. These are very difficult times, and we understand the University's concern about keeping students safe. Reducing the spread of COVID-19 is top of everyone’s mind; however, this mandatory vaccination policy is neither an effective nor justified way of reaching that goal.

Vaccine Effects on Transmission:

We acknowledge that initial studies found the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines effective at preventing serious outcomes of severe disease, hospitalization, and death from SARS-CoV-2 (COVID-19) [1,2], and we fully support anyone who voluntarily decides, with informed consent, to take the vaccine after assessing medical facts and personal risks.

However, the discussion over mandatory vaccines seems to be missing necessary arguments. While the vaccine has shown to potentially prevent outcomes of severe disease, this does not equate to prevention of disease transmission [3]. While there have been some mostly unpublished studies theorizing some effect on reducing transmission, the most recent data released by The United States Centers for Disease Control and Prevention (CDC) indicates that there may not be any reduction in transmission at all [4]. 

The CDC found that vaccinated people infected with the Delta variant (the most prominent variant in Ontario [5]) carry viral loads similar to those who are unvaccinated [4], which “suggest[s]" an increased risk of transmission and raised concern that, unlike with other variants, vaccinated people infected with Delta can transmit the virus” [6]. CDC Director Dr. Rochelle Walensky stated that while “Our vaccines are working exceptionally well … what they can’t do anymore is prevent transmission” [7]. As the recent outbreak in Israel confirms, even highly vaccinated communities can be hotbeds for new infections [8]. Another clear and recent example of this is the Carnival Cruise ship COVID outbreak. More than 96 percent of passengers were fully vaccinated, and yet infection spread throughout the ship and a passenger recently died. According to the Forbes article, “Everyone who ended up testing positive for the Covid-19 coronavirus had been previously vaccinated.” [26]

Every student, staff, and faculty member at Ryerson wants to avert the dreaded fourth wave and another lockdown. However, the majority of Ryerson students are already protected by the vaccine; students in residence are, or plan to be, fully vaccinated before arriving on campus [9]. As the most recent science indicates, COVID-19 is spreading even among fully vaccinated groups, it is highly unlikely that an even higher vaccination rate would have any effect on reducing transmission. Thus, there is little, to no reason to justify a vaccine mandate. 

Side-Effects and Health Considerations

We are concerned that Ryerson has neglected students’ safety by failing to consider possible adverse reactions and medical reasons to avoid getting vaccinated. There exist several situations when health authorities advise against getting vaccinated; these include being allergic to a vaccine ingredient, having an unstable immune system, or having recently received an unapproved COVID-19 vaccine such as those taken by many international students arriving at Ryerson [10]. In addition, anyone currently ill with SARS-CoV-2 or any infection with a fever above 38 °C is advised to defer vaccination [10,11]. These common circumstances affect many Ryerson students who may feel pressured by the mandate to get vaccinated against medical advice, potentially putting their health at risk.

COVID-19 vaccines also come with a risk of possible adverse side-effects that include myocarditis, a potentially serious medical condition that can lead to a heart attack and permanent heart damage [12,13]. Both the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines have been shown to cause myocarditis, especially in males between 12 and 29 years of age [14], this is a portion of the student population at Ryerson University. These two mandated vaccines are the only ones available in Ontario for this specified age group and the CDC states that all people who take them, especially young males, should be informed of this risk [10]. The concern of vaccine-induced heart damage is serious enough that Singapore’s Ministry of Health advised all vaccine recipients to avoid intense exercise for one week after vaccination [15,16].

In addition, recent studies have found that this post-vaccination myocarditis is occurring at a significantly higher rate than what was initially reported by the CDC and that some patients have shown no improvement weeks after vaccination, continuing to suffer from symptoms such as chest pain and heart palpitations [17,18]. Long-term implications of vaccine-induced myocarditis are unknown [13,18].

Although the mentioned side effects are rare, they nevertheless exist and can have serious consequences; several of our friends have been affected with side effects serious enough to require hospitalization.

Rights Violations

All COVID-19 vaccines offered in Canada are still undergoing trials ending in late 2022 at the earliest [19] and have only been approved by Health Canada under an emergency Interim Order [20], which is not a full authorization. According to Article 1 of the Nuremberg Code, to which Canada is a signatory, “the person involved… should be so situated as to be able to exercise free power of choice... without ulterior form of constraint or coercion” [21]. Yet Ryerson is forcing and coercing students to receive the vaccine if they want to attend classes on campus, live in residence, or take part in sports or extracurricular activities.

A vaccine authorized under an Interim Order has never before been mandated in history. Unlike traditionally mandated vaccines, the long-term safety profile of the COVID-19 vaccines is unknown. Safety data is currently missing for several population groups including pregnant and breastfeeding women, and Health Canada advises that the risks should be considered before vaccinating [22,23].

Ryerson University has ignored this guideline while expressing no interest in assuming liability or providing accommodations for students who suffer a side effect as a result of the mandate. If the university is enforcing the vaccine the liability should fall on them if something should happen to a student's health or well-being as a result of an adverse effect or reaction.  

While Ryerson states that it will offer testing as an alternative as well as exemptions, no guidelines have been presented with less than two weeks until classes begin. With no strong plan to offer exemptions, students are feeling pressure to get vaccinated. Consent to an experimental medical treatment should not be influenced by non-medical or non-scientific factors that compromise post-secondary education. This not only violates the principle of informed consent based on medical grounds, but also a person’s right to security under s. 7 of the Canadian Charter of Rights and Freedoms (CCRF) [24]. With a large percent of students having already been vaccinated voluntarily, the decisions of those who chose to opt out no longer comprise the common good of Ryerson University. This means that the limitation is not justified under s.1 of the CCRF. 

In addition, people who choose to not get vaccinated risk being ostracized from the community, which includes people with disabilities or members of religious or cultural groups that are opposed to experimental treatments. Given that Ryerson - situated in the most culturally diverse city in Canada - claims to strongly value equity, diversity, and inclusion, it is disappointing to see that it is pushing a policy that’s in line with none of those values.

Ultimately, the vaccine mandate is highly unethical. The Health Care Consent Act of Ontario states that before receiving medical treatment, consent must be given voluntarily [25]. Ryerson University does not qualify as a substitute decision-maker as defined by the Act and thus has no right to attempt to make this medical decision for its students. The right to bodily autonomy should not be compromised under any circumstance, especially not by educational institutions whose purpose is to educate and inform, rather than segregate and persecute. Consent to any medical treatment should be solely made in consultation with one’s physician and under no external pressures.

Conclusion 

In light of the most recent science indicating that vaccinated people can still transmit the virus, and given students' legitimate fears and concerns about possible vaccine side effects, this mandate is neither necessary nor ethical. We strongly urge Ryerson University to reconsider its decision.

References

[1] Polack, Fernando P., et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. New England Journal of Medicine (2020). https://www.nejm.org/doi/full/10.1056/nejmoa2034577

[2] Baden, Lindsey R., et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. New England Journal of Medicine (2021). https://www.nejm.org/doi/full/10.1056/nejmoa2035389

[3] Vaccines FAQ. Johns Hopkins University of Medicine. https://coronavirus.jhu.edu/vaccines/vaccines-faq

[4] Brown, C. M. Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings—Barnstable County, Massachusetts, July 2021. MMWR. Morbidity and Mortality Weekly Report, 70.  https://www.cdc.gov/mmwr/volumes/70/wr/mm7031e2.htm?s_ci

[5] COVID-19 Variants.  Ontario.ca.                          https://www.ontario.ca/page/covid-19-variants

[6] Statement from CDC Director Rochelle P. Walensky, MD, MPH on Today’s MMWR. Centers for Disease Control and Prevention, 30 July 2021.https://www.cdc.gov/media/releases/2021/s0730-mmwr-covid-19.html

[7] Rochelle P. Walensky, MD, MPH. Television interview with Wolf Blitzer. CNN. 5 August 2021. https://www.realclearpolitics.com/video/2021/08/06/cdc_director_vaccines_no_longer_prevent_you_from_spreading_covid.html

[8] Aspen Pflughoeft. A look inside Israel’s recent coronavirus outbreak. Deseret News. 20 July 2021. https://www.deseret.com/coronavirus/2021/7/20/22584134/whats-going-on-in-israels-outbreak-among-vaccinated-people

[9] Residence Updates and Information. Ryerson University Residences. 12 August 2021. https://www.ryerson.ca/housing/covid-19/

[10] Prevaccination Checklist For COVID-19 Vaccines. The Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/covid-19/downloads/pre-vaccination-screening-form.pdf

[11] Coronavirus vaccine - Information for Healthcare Professionals. Norwegian Institute of Public Health. https://www.fhi.no/nettpub/vaksinasjonsveilederen-for-helsepersonell/vaksiner-mot-de-enkelte-sykdommene/koronavaksine/

[12] Myocarditis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/myocarditis/symptoms-causes/syc-20352539

[13] Health Canada updates Pfizer-BioNTech and Moderna COVID-19 vaccine labels to include information on myocarditis and pericarditis. Health Canada advisory. https://www.healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2021/75959a-eng.php

[14] Gargano, Julia W., et al. Use of mRNA COVID-19 vaccine after reports of myocarditis among vaccine recipients: update from the Advisory Committee on Immunization Practices—United States, June 2021. Morbidity and Mortality Weekly Report 70.27 (2021). https://www.cdc.gov/mmwr/volumes/70/wr/mm7027e2.htm

[15] Advisory: Avoid Strenuous Activities One Week Post Vaccination. Singapore Ministry of Health. https://www.moh.gov.sg/docs/librariesprovider5/advisories/advisory-on-strenuous-activities_v1d(sites).pdf

[16] Updated Advisory on COVID-19 Vaccination. Singapore Ministry of Health. July 5th 2021. https://www.moh.gov.sg/news-highlights/details/updated-advisory-on-covid-19-vaccination

[17] Diaz, George A., et al. Myocarditis and Pericarditis After Vaccination for COVID-19. JAMA (2021).  https://jamanetwork.com/journals/jama/fullarticle/2782900

[18] Jain, Supriya S., et al. COVID-19 Vaccination-Associated Myocarditis in Adolescents. Pediatrics (2021). https://pediatrics.aappublications.org/content/early/2021/08/12/peds.2021-053427

[19] ModernaTX, A. A study to evaluate efficacy, safety, and immunogenicity of mRNA-1273 vaccine in adults aged 18 years and older to prevent COVID-19. ClinicalTrials.gov (2020). https://clinicaltrials.gov/ct2/show/NCT04470427

[20] Interim Order Respecting the Importation, Sale and Advertising of Drugs for Use in Relation to COVID-19. Health Canada. https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-treatments/interim-order-import-sale-advertising-drugs.html

[21] The Nuremberg Code. Law, Medicine and Health Care 19.3-4 (1991): 266. https://www.cambridge.org/core/journals/law-medicine-and-healthcare/article/abs/nuremberg-code/86E2ACF5ECB579E23E7AADB6F9D529BE

[22] Pfizer-Biontech COVID-19 Vaccine. Product Monograph. Health Canada. https://covid-vaccine.canada.ca/info/pdf/pfizer-biontech-covid-19-vaccine-pm1-en.pdf

[23] COVID-19 Vaccine Moderna. Product Monograph. Health Canada. https://covid-vaccine.canada.ca/info/pdf/covid-19-vaccine-moderna-pm-en.pdf

[24] Canadian Charter of Rights and Freedoms, Part 1 of the Constitution Act, 1982, being Schedule B to the Canada Act 1982 (UK), c 11. https://publications.gc.ca/collections/Collection/CH37-4-3-2002E.pdf 

[25] Health Care Consent Act, 1996, S.O. 1996, c. 2, Sched. A. https://www.ontario.ca/laws/statute/96h02#BK12 

[26] Carnival Cruise Covid-19 Outbreak: 27 Vaccinated People Test Positive For Coronavirus.  https://www.forbes.com/sites/brucelee/2021/08/15/carnival-cruise-covid-19-outbreak-27-vaccinated-people-test-positive-for-coronavirus/?sh=1f3dd0ae320f