He's had 3 COVID-19 shots. So why does he have to isolate before seeing his Canadian grandkids?

The first chance Sergio Capozzi had to get vaccinated against COVID-19 in Brazil, he took it.

The 75-year-old cares for his wife Elena Capozzi, 70, who was diagnosed with breast cancer last December. So, earlier this year he rolled up his sleeve for what was available in one of the hardest hit countries in the world — two shots of China's Sinovac and then a booster shot of Pfizer.

All-in-all, Capozzi said he feels well protected against COVID-19 — he also recovered from a mild case of COVID-19 in April — and he's eager to visit his two children and grandchildren in Toronto for the first time since before the pandemic began.

But the Canadian government doesn't see it that way.  

Unlike the World Health Organization (WHO), Health Canada hasn't approved Sinovac. That means Capozzi is technically considered unvaccinated and upon arriving at Toronto's Pearson Airport on Nov. 14, will have to quarantine for 14 days before he can see his family.

"It's not reasonable at all," Capozzi told CBC News over Zoom last week, Elena sitting next to him, sharing a pair of headphones. 

He will also be separated from Elena for the first time in at least 10 years.

They live in the small coastal city of Caraguatatuba, 175 kilometres from Sao Paulo, and didn't have any choice in the type of vaccine they received. By chance, Elena got two shots of AstraZeneca and is therefore allowed to enter Canada and not quarantine as long as she tests negative for COVID-19. 

"I'm hoping they will change ideas in Canada in accepting his vaccination," said Elena, now remission from her cancer. "We need to go. It's a long time for me not to see children or grandchildren." 

Their daughter Liv Capozzi, a Toronto resident, described the situation as "cruel," cringing at the idea of dropping off food for her father outside the door of a rented apartment without seeing or hugging him.

She said she also worries about Capozzi's mental health. He'll be alone inside for two weeks — a stark contrast to his life in Brazil where he lives near the ocean and spends every day with Elena.

"A 75-year-old man who's who had to support my mom through cancer, who's had COVID himself, who is fully vaccinated, is going to be made to quarantine for two weeks and not see his grandchildren," Liv said.

"He's probably the most protected of all of us." 

Health Canada says its aware of challenges

The family is hopeful Health Canada will accept WHO-approved vaccines like the U.S. did earlier this month, "and stop discriminating," said Liv. But so far the agency hasn't shown any signs of budging. 

Health Canada did not answer questions from CBC News as to why Canada won't follow the WHO's lead, instead sending a link to its website's list of travelling and quarantining rules. The ministry noted the makers of Sinovac haven't applied for approval in Canada.

"The list of vaccines accepted in Canada is evergreen and may expand in the future as evidence becomes available," said spokesperson Anne Génier. " We are aware that the current list may pose challenges for Canadians living and vaccinated abroad, as well as foreign nationals eligible to travel to Canada."

Transparency is key

What Health Canada's decision likely hinges on is reliable and transparent clinical trials by Chinese vaccine manufacturers, like Sinovac, which so far haven't been forthcoming, said Jillian Kohler, director of the WHO Collaborating Centre for Governance, Accountability and Transparency in the Pharmaceutical Sector and a University of Toronto professor. 

"Unless there's more openness coming from the producers of the various vaccines, I think we're going to continue to see some pushback," Kohler said. "Some governments are being a little more cautious than others."

But Dr. Kerry Bowman, a bioethics professor at the University of Toronto, said Health Canada is creating a "bureaucratic impasse" and if it has a good reason for not accepting WHO-approved vaccines, it needs to make that public. 

"Transparency is incredibly important from an ethical point of view," Bowman said. "If they're going to make these decisions that affect people's lives, it's not just what decision they make, but how they make that decision." 

He is concerned that people visiting or moving to Canada, including some of his own international students, are getting third and fourth shots of other brands to "keep bureaucracy happy." 

Liv doesn't know if Sergio would be allowed to get a second Pfizer shot and fourth vaccine dose in Brazil to qualify him as fully vaccinated in Canada, but said it's unlikely given there's not enough research available on the safety of administering that much vaccine.

And morally, she said, it doesn't seem right.

"There's a vaccine shortage in the rest of the world," she said.

"Should we be giving extra vaccines to people just because Health Canada doesn't approve of a WHO-approved vaccine? That seems really unethical."