How vaccination status is upending families — or at least family barbecues

You can't see it or feel it, but it's driving a social divide that's upending everything from school rules to international travel to small talk at backyard barbecues.

It's your COVID-19 vaccination status.

As more and more people emerge from isolation, blinking against the sunlight and dusting off the Cheetos crumbs, we're finding socializing to be a challenge - and not just because most of us are out of practice.

This week, Prime Minister Justin Trudeau announced that Canada has enough doses to fully vaccinate all eligible people in the country. That means the vast majority of unvaccinated people will soon be so by choice, rather than due to a lack of vaccine supply.

With jurisdictions around the world grappling with how to boost vaccination rates, whether by stick or by carrot, the question becomes: What do the vaccinated owe the unvaccinated?

It is, after all, those who remain unvaccinated, as many medical experts have noted, who will be most at risk if a fourth wave emerges - yet public health exists to protect the whole community, not just those who've signed up for a vaccine.

So with the vaccinated now outnumbering the unvaccinated, how do public officials walk that line? For that matter, how do neighbours or family members?

They're the ones that complain the loudest and the most about pandemic restrictions and public health guidelines, but won't take the single most important step to stop all those things from happening," Paul Parete, whose child is too young to get vaccinated, says of his growing frustration with people who haven't yet rolled up their sleeves.

I feel like those people are going to hold the rest of us hostage moving forward."

Parete, who lives in the GTA, has recently decided he will no longer participate in family gatherings with close relatives who he says are anti-vaxxers who have spread false information about the pandemic and vaccines.

It's not a decision he takes lightly, he says, but it's one that he's taking in order to protect his own family. As important as that is, he does worry this could be the beginning of a rift that will outlast the virus.

Will we forgive and move on from this? I don't know, maybe? But I'll never forget the position that this family member took in the middle of a public health disaster."

Parete isn't alone. Other people have spoken of vaccination debates spurring tense relationships with family, blowups at backyard get-togethers and even choices to forgo social events altogether.

An Angus Reid study from last week found almost half of people who had been vaccinated said they were either likely" or very unlikely" to spend time in person with people who are unvaccinated.

Some say that sentiment has been distilled into outright hostility in various circles.

Anila Lee Yuen, CEO of Calgary's Centre for Newcomers and co-chair of Alberta's Calgary COVID care table, was recently scrolling through Facebook when she saw a post from a kind, community-minded" friend about how all people who were unvaccinated without a medical reason for being so should be banned from rational society."

There are always going to be people with extreme views on any issue, but she said it stunned her to see it coming from someone she knew to be a kind-hearted person.

It's part of what she says is a concerning new pattern - she's heard people refer to COVID-19 cases among the unvaccinated as Darwinism," and say health-care shouldn't be free for those who don't get the shot, or that if they die, they deserve it.

I think at that point, we've lost our sense of humanity," she says. We've lost what it is that we're actually fighting for, when we've been working so hard to keep people safe during COVID."

Lee Yuen, who helped lead an effort to reverse spiking COVID-19 cases in some of Calgary's hardest-hit neighbourhoods, says she's not yet convinced that declining vaccination rates are solely based on choice. She argues that barriers, including transportation, language and ability to book appointments, continue to hamper those who want to get the shot.

When we start talking about those that are not vaccinated, for whatever reason, as if they don't count, or that they're less than the rest of us, then you're not going to convince that same person to get vaccinated."

When a bunch of Lorie Carty's friends recently gathered for lunch for the first time in over a year she just told them she couldn't come instead of the disclosing the real reason - she hasn't been vaccinated yet and didn't want to risk exposure to the virus.

The retiree from Prince Edward County in southern Ontario often doesn't tell people she hasn't been vaccinated yet - particularly those she knows who are staunchly pro-vaccine who she senses would jump at the chance to interrogate her about her decision.

She's heard from other people who don't yet have the shot who are similarly worried to speak out, lest they be judged.

She's aware, she notes, that as soon as she says anything many people will label her as an anti-vaxxer, when she says she's not against the vaccine - she just wants more time for addition information to become publicly available.

Currently caught between a rock and a hard place, she worries about the dangers posed by the virus but also the risk from the vaccine. But it's the permanence of the vaccine that she currently can't shake - once it's in my body, I can't get it out."

She's made several vaccination appointments only to cancel them, overwhelmed by what she sees as conflicting information about a brand new vaccine.

It's not like I'm saying, No, I'll never get it. I'm totally against it.' It's just that I want a little bit more science and proof behind it, I think, before I choose to take that step."

She still feels the need to protect her neighbours and grandchildren, she adds. She mostly stays at her rural home and hasn't been back to the gym where she once taught since the pandemic began.

People do have a tendency to get a bit more emotionally involved, I think, because of the way it has affected the world," she says.

I don't understand that because, you know, it's your body. So people should respect the choice you make. Either way."

In some places in the world, getting the jab does confer privileges. Israel was an early adopter of what they called a Green Pass, which allowed fully vaccinated people to eat inside or go to the movies.

More recently, France has led the charge in Europe in pushing vaccination, giving health workers until mid-September to get the shot or face sanctions or fines, while issuing special vaccination passes that will be required in order to go to the mall or get on a train or plane. The move prompted a spike in vaccinations.

Even in the famously freedom-loving U.S., some governments and health authorities have moved to require it of their front-line workers.

But here in Canada, where vaccination has generally trended higher than south of the border, governments have been largely reluctant to make vaccines mandatory even for health-care workers, and passes have remained a controversial topic.

Manitoba was the first province to require people to provide documentation of vaccination in order to eat in restaurants, among other things - a move that has already resulted in a fair bit of fraud - while other provinces have come out firmly against the idea.

In Ontario, scientific advisers have argued in favour of vaccine certificates while the government has rejected the idea, but school kids will face different rules this fall depending on their vaccination status. Fully immunized students will face little interruption if exposed to COVID-19, while their unvaccinated peers would be sent home.

But as tired as many people are of public health measures, the goal of policy going forward should still be focused on the unvaccinated, experts say.

In other words, as much as some vaccinated people are beginning to chafe at the idea of wearing masks despite having received the shot, public health is still designed to protect the vulnerable, not necessarily the rights of the vaccinated to go and resume normal life.

When we're thinking about public health ethics, when it comes to possibly restricting a person's liberty, whether that the ability to not be vaccinated or liberty to not wear a mask, we want to do so in the least restrictive way possible," says Andria Bianchi, an assistant professor at University of Toronto's Dalla Lana School of Public Health.

But if vulnerable people are still at risk, it's defensible to strengthen the measures. It is a really delicate balancing act," she says.

Going forward, measures should be designed to continue to nudge people to get vaccinated, says Colin Furness, an infection control epidemiologist and assistant professor at the University of Toronto. But there's a big difference between mandating and encouraging it, he says.

I'm staunchly opposed to mandatory vaccination because I think it actually accomplishes the opposite. It creates a lot of hate and a lot of anger and a lot of anti-vaxxer sentiment," he says.

But you make life more convenient, when you're vaccinated, you make life less convenient when you're not. And then you cause a shift in behaviour."

Even as the vaccinated and unvaccinated camps become seemingly more polarized, our fates are still tied when it comes to the virus, he notes.

The vaccines not 100 per cent effective, and there will always be some people who can't get vaccinated for medical reasons, he says. Meanwhile, data from the U.K. suggests older vaccinated people or those with comorbidities might be slightly more susceptible to infections from the Delta variant.

As frustrated as Parete, the father with a child too young for vaccination, is at the prospect of people remaining unvaccinated, he agrees people should continue to wear masks and obey public health orders, even if it's largely to protect those who haven't yet chosen vaccination.

Whether people believe it or not, like it or not, we're all living with other human beings, and we rely on each other. You rely on your mechanic, you rely on your banker, you rely on your teachers, you rely on these people," he says.

And if you don't care about their health, then what are we doing?"

Alex Boyd is a Calgary-based reporter for the Star. Follow her on Twitter: @alex_n_boyd