Canadian ethics paper offers criteria for future use of vaccine certificates
Researchers propose a three-factor framework to judge when proof-of-vaccination policies are justified, and urge public deliberation on trade-offs with liberty.
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By Torontoer Staff
A new Canadian paper sets out specific conditions under which vaccine certificates should be considered in future pandemics, proposing a three-factor framework to weigh public health benefits against infringements on individual liberty. The authors say the framework could clarify when certificates are justified and when they are not, and they call for public engagement on the value judgements involved.
The proposal comes after the 2021 rollout of provincial vaccine certificates in Canada, measures that helped reopen restaurants, bars and theatres but also sparked intense public opposition, including the 2022 Freedom Convoy protests in Ottawa.
The three-factor framework
Lead author Maxwell Smith, director of Western University’s Centre for Bioethics, and co-authors argue that justification for vaccine certificates increases as three factors rise: pathogenicity, which is the degree of harm the pathogen causes; prevalence, the level of community transmission; and vaccine effectiveness against infection and severe outcomes. Lower values on those factors reduce the case for certificates.
- Pathogenicity: how severely the pathogen harms individuals.
- Prevalence: how widespread the infection is in the community.
- Vaccine protection: the extent to which vaccines prevent infection, transmission and severe disease.
The authors emphasise that these three conditions alone do not settle the issue. Policy makers must also ask whether certificate use represents a proportionate and tolerable balance between collective health aims and individual autonomy.
If you look at some of the language used even during the convoy, it was ethics language. It was informed consent; it was around freedom and liberty and coercion. These are profoundly ethical ideas. We need to confront that these are the sorts of concerns that people have and motivate things like the convoy.
Maxwell Smith, Western University
What the evidence says about impact
Evaluating the population-level effects of vaccine certificates during COVID-19 is challenging because they were implemented alongside multiple other measures. One study estimated 290,168 additional first doses in Canada in the seven weeks after provinces announced proof-of-vaccination policies, a 17.5 per cent increase compared with expected uptake without the policies. The increase was short lived, with uptake reverting to pre-announcement levels within about six weeks.
Quebec and Ontario, which introduced passports in September 2021, saw first-dose administrations rise by about 23 per cent and 19 per cent respectively over an 11-week window. Overall coverage increased modestly, by 0.9 percentage points in Quebec and 0.7 points in Ontario, in that period.
It is probably impossible to judge, in the setting of a pandemic, because there was so much going on at the same time. Teasing apart what was the effect of travel bans versus vaccine certificate requirements is really hard to do.
Dr. Allison McGeer, University of Toronto
The evidence shows vaccines reduced severe outcomes, but they did not provide sterilizing immunity. Vaccinated people could still become infected and transmit the virus, and immunity waned over months. That limitation weakens, though does not eliminate, the case for certificates according to the paper.
Liberty, coercion and legal context
Opponents framed certificates as coercive and discriminatory, arguing they created social divisions and infringed individual rights. Supporters argued certificates helped protect public health and allowed partial reopening under constrained health-system capacity, particularly during Delta-driven waves when hospitals faced severe strain.
Canadian courts generally upheld government authority to impose vaccine requirements during the pandemic. The authors stress that infringement on liberty is not automatically unjust. The key question, they write, is whether an infringement was proportionate and necessary to protect others, especially the most vulnerable.
I think infringing on liberty is one thing. But I think the more important question is whether it was an unjust infringement on liberty. If we care about the most vulnerable people in society, we need to think about what sort of reductions of my own freedom might be necessary in order to protect other people’s freedom.
Maxwell Smith, Western University
Mandates and high-risk settings
The paper did not apply its framework to the COVID experience and stops short of declaring whether past certificates were justified. The authors note the framework could also inform vaccine mandates. They caution, however, that mandates for health-care workers or other high-contact professions require different moral calculations because workers have stronger obligations to protect patients.
During COVID, mandates extended beyond public venues to hospital staff, federal public servants including members of the RCMP, post-secondary students, and cross-border truckers. The authors say considerations such as role-specific duties and vulnerability of those served can lower the thresholds for prevalence and pathogenicity needed to justify requirements in particular settings.
Policy implications and next steps
The paper concludes that decisions about vaccine certificates are not purely technical. They depend on value judgements about which outcomes matter and how to balance collective health with individual rights. The authors urge governments to adopt clear criteria and to engage the public before future crises, to reduce confusion and polarisation.
Their central recommendation is procedural: establish thresholds for pathogenicity, prevalence and vaccine protection, and then socialise those thresholds through public deliberation so that policy choices are transparent and legitimised in advance, rather than improvised under crisis conditions.
Canada’s pandemic response will remain subject to debate, the authors write, but clearer frameworks and earlier public engagement could limit repeat conflicts and make future decisions easier to justify.
vaccine-certificatespublic-healthbioethicspandemic-planningMaxwell-Smith
