“If all of this was about health, I’d still be working:” Lived experiences of healthcare workers under COVID-19 vaccine mandates in British Columbia, Canada

COVID-19 vaccine mandates for healthcare workers (HCWs) in British Columbia (BC) were implemented in October 2021 and remained effective until July 2024, despite public protests and opposition from some unions. This study explored HCWs’ lived experiences under these mandates, focusing on decision-making processes, personal and professional impacts, and perceived consequences for patient care. We conducted a reflexive thematic analysis of qualitative responses from 90 HCWs, collected through one open-ended survey question and elaborations on closed questions. The survey, conducted in May–June 2024, recruited a convenience sample of 166 HCWs of varying vaccination status, professions, and demographics through social media and professional networks. Findings are reported in accordance with the consolidated criteria for reporting qualitative studies (COREQ) checklist (Table A1). Most respondents were unvaccinated and had lost employment due to non-compliance. Participants reported significant personal losses and expressed overwhelmingly negative views on mandates. Six key themes emerged: (1) conflict with scientific evidence and clinical practice; (2) violations of medical ethics, especially informed consent; (3) dismissed personal and economic hardships; (4) overlooked vaccine-related physical harms; (5) discrimination against unvaccinated HCWs and patients; and (6) negative impacts on care delivery. Our findings suggest that vaccine mandates caused substantial social and economic harm, contributed to staffing shortages, degraded workplace morale, and compromised patient care. Drawing on respondents’ experiences and the scientific evidence available at the time, we conclude that mandatory COVID-19 vaccination for HCWs lacked scientific justification and violated foundational ethical principles in health-care policy and practice.
Anthes, E., & Petri, A.E. (2021). CDC. Director Warns of a “Pandemic of the Unvaccinated.” The New York Times. Available from: https://www.nytimes.com/2021/07/16/ health/covid-delta-cdc-walensky.html [Last accessed on 2025 Aug 08].
Bains, C. (2021). The Ultimate Selfishness”: Doctors Grow Frustrated as Anti-vaxxers Protest Hospitals. Global News. Available from: https://globalnews.ca/news/8164697/covid-coronavirus-doctors-frustrated-anti-vaccination [Last accessed on 2025 May 16].
Bareiß, A., Uzun, G., Mikus, M., Becker, M., Althaus, K., Schneiderhan-Marra, N., et al. (2022). Vaccine side effects in health care workers after vaccination against SARS-CoV-2: Data from TüSeRe: Exact study. Viruses, 15(1):65. https://doi.org/10.3390/v15010065
BBC News (Director). (2021). Germany Bans Unvaccinated People from Shops and Bars. Available from: https://www. youtube.com/watch?v=IorczxPxZ1Y [Last accessed on 2025 May 22].
BC College of Family Physicians. (2023). Statement on Bill 36-The Health Professions and Occupations Act. Canada: BC College of Family Physicians.
BC Government News. (2022). Patients the Focus of New Health Legislation. Ministry of Health. Available from: https://news.gov.bc.ca/releases/2022HLTH0202- 001566#:~:text=The%20act%20enables%20the%20creation,to%20regulate%20lower%2Drisk%20health [Last accessed on 2025 May 15].
BC Ministry of Health. (2021). Plans Further Protect People Living, Working in Long-term Care. Victoria, BC: Government of British Columbia. https://news.gov.bc.ca/ releases/2021HLTH0150-001598 [Last accessed on 2024 Nov 27].
BC Ministry of Health. (2024a). COVID-19 Public-health Emergency Ends, New Vaccine Registry Will Keep People Safe. Victoria, BC: Ministry of Health. Available from: https://news.gov.bc.ca/releases/2024HLTH0115-001204 [Last accessed on 2025 Aug 11].
BC Ministry of Health. (2024b). Provincial Health Officer Rescinds Orders for COVID-19. Victoria, BC: Ministry of Health. Available from: https://news.gov.bc.ca/ releases/2024HLTH0114-001202 [Last accessed on 2024 Dec 09].
BC Nurses Union. (2023). Sustaining Nursing in Canada. Burnaby, BC. Available from: https://www.bcnu.org/news-and-events/update-magazine/2023/spring-2023/sustaining-nursing-in-canada [Last accessed on 2024 Dec 09].
Canadian Nurses Association. (2021). Enough is Enough Professional Nurses Stand for Science-based Health Care. Available from: https://nursesunions.ca/wp-content/ uploads/2017/05/CFNU_Enough-is-Enough_June1_ FINALlow.pdf [Last accessed on 2025 Aug 11].
Cayton, H. (2018). An Inquiry into the Performance of the College of Dental Surgeons of British Columbia and the Health Professions Act. Ministry of Health. Available from: https://www2.gov.bc.ca/assets/gov/health/practitioner-pro/ professional-regulation/cayton-report-college-of-dental-surgeons-2018.pdf [Last accessed on 2025 Aug 11].
Chaufan, C., Hemsing, N., & Moncrieffe, R. (2025a). COVID- 19 vaccination decisions and the impact of vaccination mandates: An exploratory cross-sectional survey of healthcare workers in British Columbia, Canada. Global Health Economics and Sustainability, 9:025080014. https://doi.org/10.36922/GHES025080014
Chaufan, C., Hemsing, N., & Moncrieffe, R. (2025b). “It isn’t about health, and it sure doesn’t care”: A qualitative exploration of healthcare workers’ lived experience of the policy of vaccination mandates in Ontario, Canada. Journal of Public Health and Emergency, 9:025080014. https://doi.org/10.21037/jphe-25-13
Chaufan, C., Hemsing, N., & Moncrieffe, R. (2025c). “It isn’t about health, and it sure doesn’t care”: A qualitative exploration of healthcare workers’ lived experience of the policy of vaccination mandates in Ontario, Canada. Journal of Public Health and Emergency, 9:025080014. https://doi.org/10.21037/jphe-25-13
Costantino, C., Graziano G, Bonaccorso N, Conforto A, Cimino L, Sciortino M, et al. (2022). Knowledge, attitudes, perceptions and vaccination acceptance/hesitancy among the community pharmacists of Palermo’s province, Italy: From influenza to COVID-19. Vaccines (Basel), 10(3):475. https://doi.org/10.3390/vaccines10030475
DeRosa, K. (2023a). Here’s why B.C. Doctors are upset about Changes to Disciplinary Colleges. Vancouver Sun. Available from: https://vancouversun.com/news/local-news/why-bc-doctors-upset-about-changes-to-disciplinary-colleges
DeRosa, K. (2023b). Some Rural B.C. Mayors Call for End to Vaccine Mandates to Get More Nurses Working. Vancouver Sun. Available from: https://vancouversun.com/news/local-news/some-rural-mayors-call-for-end-to-vaccine-mandates-to-address-health-staffing-shortages [Last accessed on 2024 Dec 09].
Drisko, J.W. (2025). Transferability and generalization in qualitative research. Research on Social Work Practice, 35(1):102-110. https://doi.org/10.1177/10497315241256560
Faksova, K., Walsh, D., Jiang, Y., Griffin, J., Phillips, A., Gentile, A., et al. (2024). COVID-19 vaccines and adverse events of special interest: A multinational Global Vaccine Data Network (GVDN) cohort study of 99 million vaccinated individuals. Vaccine, 42:2200-2211. https://doi.org/10.1016/j.vaccine.2024.01.100
Farah, S., Hijazi, M., Aoun, E., Boueri, M., Nasr, E., Chlala, W., et al. (2023). Effect of COVID‐19 vaccinations on menstrual cycle and postmenopausal bleeding among health care workers: A cross‐sectional study. International Journal of Gynecology and Obstetrics, 162(2):532-540. https://doi.org/10.1002/ijgo.14809
Filippatos, F., Tatsi, E.B., Dellis, C., Dessypris, N., Syriopoulou, V., & Michos, A. (2021). Association of clinical and epidemiological characteristics with COVID-19 BNT162b2 mRNA vaccine short-term adverse reactions in healthcare workers. Human Vaccines and Immunotherapeutics, 17(12):4755-4760. https://doi.org/10.1080/21645515.2021.1985356
Government of Canada. (2025). British Columbia Sector Profile: Health Care - Job Bank. British Columbia Sector Profile: Health Care Website. Available from: https://www.jobbank. gc.ca/contentjmr.xhtml [Last accessed on 2025 Feb 20].
Hoogerbrug v. British Columbia. (2024). Vancouver BC. Available from: https://www.bccourts.ca/jdb-txt/ sc/24/07/2024BCSC0794.htm [Last accessed on 2025 Aug 11].
Hsiang, Y. (2024). Physicians need to read and understand the Health Professions and Occupations Act British Columbia. British Columbia Medical Journal, 66(8):282.
Ipsos & Public Health Agency of Canada (PHAC). (2023). National Cross-sectional Survey of Health Workers Perceptions of COVID-19 Vaccine Effectiveness, Acceptance, and Drivers of Vaccine Decision-Making. Available from: https://publications.gc.ca/collections/collection_ 2024/aspc-phac/H14-478-2024-eng.pdf [Last accessed on 2025 Aug 11].
Judd, A., & Stanton, K. (2025). 1.2 Million British Columbians are Currently Waiting to See a Specialist: Survey. Global News. Available from: https://globalnews.ca/news/10987687/ bc-specialist-wait-list-survey [Last accessed on 2025 Aug 11].
Kingston, B. (2024). Campbell River Doctor Says Bill 36 is Driving Doctors, Nurses Away. Available from: https://www. mycampbellrivernow.com/73557/news/campbell-river-doctor-says-bill-36-is-driving-doctors-nurses-away [Last accessed on 2025 Aug 11].
Li, K., Frumkin, A., Bi, WG., Magrill, J., & Newton, C. (2023). Biopsy of Canada’s family physician shortage. Family Medicine and Community Health, 11(2):e002236. https://doi.org/10.1136/fmch-2023-002236
Lindsay, B. (2021). Reports of Assault, Verbal Abuse as Thousands Protest Vaccine Passports Outside Hospitals Across B.C. CBC News British Columbia. Available from: https://www. cbc.ca/news/canada/british-columbia/vaccine-passport-protest-1.6161817 [Last accessed on 2025 Aug 11].
Lush, J. (2023). Comment: Bill Gives Government Sweeping Power Over Your Health Care. Times Colonist. Available from: https://www.timescolonist.com/opinion/comment-bill-gives-government-sweeping-power-over-your-health-care-6366386 [Last accessed on 2025 Aug 11].
Mateos-Nozal, J., Montemayor, J.C.G., Torres, S.L., Barreiro, P., Zamora, A.P., Martínez, F.M., et al. (2021). SARS-CoV-2 B 1.1. 7 Variant outbreak in a fully vaccinated nursing home-Madrid, June 2021. Journal of the American Medical Directors Association, 22(11):2266.
Notice of Civil Claim: Jedediah Ferguson and Terri Perepolkin vs. Dr Bonnie Henry. (2023). Available from: https:// unitedtogether.ca/wp-content/uploads/2023/11/2023-10- 13-filled-notice-of-civil-claim.pdf [Last accessed on 2025 Aug 11].
Office of the Provincial Health Officer. (2022a). Order of the Provincial Health Officer: Hospital and Community Covid-19 Vaccination Status Information and Preventive Measures. Victoria, BC: Ministry of Health. Available from: https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/ covid-19/covid-19-hospital-and-community-vaccination-status-information-preventive-measures.pdf [Last accessed on 2024 Dec 09].
Office of the Provincial Health Officer. (2022b). Residential Care Covid-19 Vaccination Status Information and Preventive Measures. Victoria, BC: Ministry of Health. Available from: https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/covid-19/covid-19-pho-order-vaccination-status-information.pdf [Last accessed on 2024 Dec 09].
Office of the Provincial Health Officer. (2024). Reconsideration Decision-Availability of Section 43 Requests. Victoria, BC: Ministry of Health. Available from: https://www2.gov.bc.ca/ assets/gov/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/ covid-19/reconsideration_decision_-_availability_of_section_43_requests_-_web.pdf [Last accessed on 2024 Dec 09].
Oral Health. (2025). B.C. Dental Association Launches Petition against New Health Act, Warns of Higher Costs for Patients. Available from: https://www.oralhealthgroup.com/news/b-c-dental-association-launches-petition-against-new-health-act-warns-of-higher-costs-for-patients-1003984260 [Last accessed on 2025 Aug 11].
Park, S.Y., Kim, T.H., Lee, E., Loeb, M., Jeong, Y.S., Kim, J.H., et al. (2022). A SARS-CoV-2 outbreak associated with vaccine breakthrough in an acute care hospital. American Journal of Infection Control, 50(9):1006-1012. https://doi.org/10.1016/j.ajic.2022.05.010
Politis, M., Sotiriou, S., Doxani, C., Stefanidis, I., Zintzaras, E., & Rachiotis, G. (2023). Healthcare workers’ attitudes towards mandatory COVID-19 vaccination: a systematic review and meta-analysis. Vaccines, 11(4):880.
Pollard, A., & Angus, B. (2021). Getting Jabs to the Unvaccinated has Never Been more Critical. The Guardian. Available from: https://www.theguardian.com/commentisfree/2021/ nov/23/unvaccinated-people-boosters-covid-jab [Last accessed on 2025 May 18].
Ponticelli, D., Madotto, F., Conti, S., Antonazzo, I.C., Vitale, A., Della Ragione, G., et al. (2021). Response to BNT162b2 mRNA COVID-19 vaccine among healthcare workers in Italy: A 3-month follow-up. Internal and Emergency Medicine, 17:481-486. doi: 10.1007/s11739-021-02857-y
Public Health Agency of Canada. (2022). COVID-19 Daily Epidemiology Update: Outbreaks [Datasets; Statistics; Education and Awareness]. Government of Canada. Available from: https://health-infobase.canada.ca/covid-19/ outbreaks.html [Last accessed on 2022 Nov 16].
Seneff, S., Nigh, G., Kyriakopoulos, A.M., & McCullough, P.A. (2022). Innate immune suppression by SARS-CoV-2 mRNA vaccinations: The role of G-quadruplexes, exosomes, and MicroRNAs. Food and Chemical Toxicology, 164:113008. https://doi.org/10.1016/j.fct.2022.113008
Shepert, E. (2021). “You have Made us Feel Deeply Disrespected”: Health Care Workers Respond to Massive Vancouver anti- Vaccine Protest. Vancouver is Awesome. Available from: https://www.vancouverisawesome.com/local-news/you-have-made-us-feel-deeply-disrespected-health-care-workers-respond-to-massive-vancouver-anti-vaccine-protest-4299012 [Last accessed on 2025 Aug 11].
Shrestha, N.K., Burke, P.C., Nowacki, A.S., Simon, J.F., Hagen, A., & Gordon, S.M. (2023). Effectiveness of the coronavirus disease 2019 bivalent vaccine. Open Forum Infectious Diseases, 10(6):ofad209. https://doi.org/10.1093/ofid/ofad209
Shuster, E. (1997). Fifty years later: The significance of the Nuremberg code. New England Journal of Medicine, 337(20):1436-1440. https://doi.org/10.1056/NEJM199711133372006
Singanayagam, A., Hakki, S., Dunning, J., Madon, K.J., Crone, M.A., Koycheva, A., et al. (2021). Community transmission and viral load kinetics of the SARS-CoV-2 delta (B.1.617.2) variant in vaccinated and unvaccinated individuals in the UK: A prospective, longitudinal, cohort study. The Lancet Infectious Diseases, 22(2):183-195. https://doi.org/10.1016/S1473-3099(21)00648-4
Stahl, C. (2021). As Vaccine Mandates Spread, Protests Follow- Some Spurred by Nurses. NBC News. Available from: https://www.nbcnews.com/tech/social-media/vaccine-mandates-spread-protests-follow-spurred-nurses-rcna1654 [Last accessed on 2025 Aug 11].
Stewart, A. (2021). Medical Groups Denounce Bullying, Attacks on Health-Care Workers as Protests Target Hospitals. CBC News. Available from: https://www.cbc.ca/news/ canada/toronto/anti-vaccine-protests-health-workers-toronto-1.6164215 [Last accessed on 2025 Aug 11].
The Editorial Board. (2021). Globe Editorial: The Pandemic is, more than Ever, a Pandemic of the Unvaccinated. The Globe and Mail. Available from: https://www.theglobeandmail. com/opinion/editorials/article-the-pandemic-is-more-than-ever-a-pandemic-of-the-unvaccinated [Last accessed on 2024 Oct 21].
UNESCO. (2005). Universal Declaration on Bioethics and Human Rights. Available from: https://www.unesco.org/ en/ethics-science-technology/bioethics-and-human-rights [Last accessed on 2024 Feb 18].
Weichel, A., & Daflos, P. (2021). B.C. Makes COVID-19 Vaccines Mandatory for Workers in Long-term Care, Assisted Living Facilities. CTV News Vancouver. Available from: https://www.ctvnews.ca/vancouver/article/bc-makes-covid-19-vaccines-mandatory-for-workers-in-long-term-care-assisted-living-facilities [Last accessed on 2025 Aug 11].
Wong, D. (2022). B.C. Releases COVID Vaccination Rates by Health Profession. CityNews. Available from: https:// vancouver.citynews.ca/2022/05/10/bc-covid-vaccination-rates [Last accessed on 2025 Aug 11].
World Medical Association. (1964). Declaration of Helsinki. New England Journal of Medicine, 271(9):473-474.
Yamamoto, K. (2022). Adverse effects of COVID-19 vaccines and measures to prevent them. Virology Journal, 19(1):100. https://doi.org/10.1186/s12985-022-01831-0