Doctors say Sask. vaccine exemption letters not a free pass to avoid COVID shots

Some people in the province are asking their physicians for vaccine exemption letters, but the College of Physicians and Surgeons of Saskatchewan says there might be some misunderstandings when it comes to the term "exemption".

The organization in charge of licensing medical practitioners in the province sent a letter to its members with some guidance on how to deal with requests for COVID-19 vaccination exemptions.

"I think there is an unrealistic expectation," said Dr. Werner Oberholzer, deputy registrar of the College of Physicians and Surgeons of Saskatchewan.

"The College first had to clarify to the physicians and to the public what we mean by this exemption note that has been requested."

According to the letter sent out by the College, getting a note from a physician that someone cannot receive a COVID-19 vaccine doesn't mean that the patient is "free from an obligation or liability due to their unvaccinated status."

Oberholzer said a doctor's note is not an easy way around COVID-19 restrictions for people hoping to travel abroad or visit a football game, just because they cannot receive a vaccine.

An exemption letter cannot override "rules that might be in place for businesses or borders," said Karen Shaw, registrar at the College of Physicians and Surgeons of Saskatchewan.

"It's up to the receiving party whether they accept that letter of contraindications."

Inquiries about vaccine exemption letters.

The College of Physicians and Surgeons of Saskatchewan said they have been receiving questions about these vaccine exemption letters both from doctors and patients. 

According to Oberholzer, there has been a small increase in inquiries reaching the College since the province announced its proof- of-vaccination program starting October, "but these requests have been coming for a while now."

If a physician has a patient who cannot receive a COVID-19 vaccine, the doctor might provide a note to the person, stating that "they have a contraindication to the COVID-19 vaccination," said the College of Physicians and Surgeons of Saskatchewan. 

However, the doctor needs to inform their patient that the letter is not granting them the same privileges that vaccinated people have in Saskatchewan, according to the regulatory organization.

"It's not an exemption," said Oberholzer.

"It's only a letter that a physician can provide to the patient to state that they have these contraindications." 

After that, it's up to the receiving organization to make a decision on how to accommodate the unvaccinated person.

College: Very few recognized absolute contraindications to the COVID-19 vaccination

Besides the limitations of what such an exemption letter can do, it should be only provided to a limited number of people who cannot receive a COVID-19 shot due to medical reasons.

Those "few recognized absolute contraindications to the COVID-19 vaccination" include a confirmed severe allergy or anaphylactic reaction — a serious allergic reaction to an allergen or antigen — to a previous COVID-19 shot.

Another contraindication to the COVID-19 vaccination that a doctor might consider for an exemption letter is a "diagnosed episode of myocarditis/pericarditis after receipt of an mRNA vaccine," according to the College of Physicians and Surgeons of Saskatchewan.

On their note, doctors will have to provide information about the reason why a person cannot be immunized against COVID-19 as well as the applicable time frame, according to the College.

"A physician cannot provide a letter if there is no absolute or severe contraindications to receiving the vaccine," said Oberholzer.

"We're asking that, if possible, an immunologist or an allergist confirms the severe allergy or the anaphylactic reaction, and with a diagnosis of myocarditis and pericarditis, we would likely rely on the information from a cardiologist."

The College of Physicians and Surgeons of Saskatchewan is not the only regulatory organization in Canada which has provided information to its members about vaccine exemption letters. 

According to the College, similar messages have been sent by the College of Physicians and Surgeons of Ontario as well as the Canadian Medical Protective Association.

"I think it is difficult for patients to understand that really, they shouldn't be asking for a note from the doctor unless there's a medical indication," said Shaw.

"Those that are not wanting the vaccination are trying to find ways of avoiding it."