this post was submitted on 29 May 2025
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"So, look Indigenous and other marginalized folks... I know we've had some less than great history about mandatory government programs. And yes, childhood education is essential, but if you don't agree to this mandatory medical program we will not allow your child in school."
It's a tricky balance but this article doesn't even attempt to explore reasons we might not be making these mandatory, which to my mind is criminally poor reporting and one of my major issues with the Tyee.
That’s not really a tricky balance, there is a clear right direction to pick
I am curious, though. Did First Nation consultation result in any voiced resistance against vaccination?
I love that you "know" the right direction without even knowing how margjnalized folks might feel about it.
Just to be clear, your opinion is that the government should just force marginalized folks to do what we think is the right thing regardless of their feelings or experiences?
(And if your second paragraph is a serious question, you could literally just google Canada First Nations vaccine hesitancy and learn a whole boatload.)
No
Indeed, TIL
This was a pretty interesting read: https://afn.ca/wp-content/uploads/2021/10/Dr.-Valerie-Gideon-Presentation_EN.pdf
Sorry, I'm clearly not understanding your position... Vaccines should be mandatory but also not?
Yes. Just like they already kind of are in a bunch of ways. At the very least they should be opt-out instead of opt-in, with immunization campaigns deployed in the spirit of increasingly making opt-out more exceptional
They already are opt out, not opt in.
How so? Encouraging people to vaccinate their kids and making the vaccine free is still an "opt in" system. What I mean with an opt out system is that it would demand effort and a processual review to not vaccinate (at some level, even if at the community level), like filing for being excused of immunization and having that file as part of the immunization record.
Maybe you should learn more about how the system functions before demanding changes?
Vaccines are largely done in schools with parents having to opt out.
All you've prosed is to add a weird layer of bureaucracy with no discernible benefit.
Edit: And yes, refusals to vaccinate are already part of someone's record. (This system is already used to contact people who have refused and to offer another round of immunizations etc.)
But that bureaucracy is what I mean with friction that defines what opting out means. Being invited to immunization and having ease to refuse is still opt in to me.
Maybe I am just unaware but what I understood from what goes into the record is that someone saying “no thanks, vaccines are a lie” is indistinguishable from “the healthcare system wronged my community so I don’t feel safe with this”. If those cases are indeed already distinguishable and I'm just mistaken, then I'll be gladly corrected because it means that we are already equipped to to make vaccination mandatory, because all we need is to have the due process to accommodate the concerns of the second group.
Sorry, was responding to someone else and realized I'd forgotten about this over the weekend.
But yeah, if you've met an anti vaxxer, you'd know yet another form or whatever isn't really the friction that's going to get them to vaccinate. Right now, you're proposing setting up some sort of, I dunno, interview process where we figure out how much trauma or marginalization allows someone to exempt themselves. (Is being Jewish and having family members who were experimented on enough? How about being Black but in Canada? Or having relatives from any number of autocratic regimes where government trust is not really a thing? And then how are we going to check this?)
This proposal is at a time when we don't have enough nurses or doctors and you want to spend a silly amount of money on adding more bureaucracy to make things slightly more difficult for a group that already went through way harsher just a few years ago? Really? And then spend however much more to lose in court?
I get that not everyone thinks through the rammifications and anti-vaxxer = bad so punish them but this doesn't seem particularly practical or beneficial no matter how laudable the goal of more vaccinations is.
That's not really it, and I didn't say anything of sorts. It just has to be something more than not showing up or just saying "no thanks" without any extra information. Nothing is going to be foolproof and that's not the point either, after all any anti-vaxxer can always self identify as First Nations for a day just to escape vaccination and healthcare workers won't have the tools to crosscheck information. So by all means have a "I don't trust the vaccine" as an option to opt out to make sure data is as clean and trustworthy as possible.
I'm also not talking about punishments, and I don't really know what kinds of vibes you've been reading into all of this but I'm defending the most benign and widespread healthcare mechanisms ever: add a little bit more fiction to make it opt out, use that opt-out process to collect more data, use this data to move forward with campaigns to boost confidence and adoption, and continue to increase the expectations of vaccination for access to public infrastructure in which non-vaccinated people are putting others at risk.
Saying that this would aggravate healthcare worker shortages and trigger court cases is a bit dramatic
It really seems like you're trying to pivot now from this:
Where the goal was to create friction.
If your position now is that the friction in opting out is actually just recording "why are you opting out" then that's a pretty silly definition of creating friction . You either have friction with a burdensome process that involves government spending, employees and processes or not.
It really seems like you started talking without really knowing how the system works and have now gone into "okay, I don't actually want a mandatory system, which was what the article was about and now instead I'd just like some more actionable data." Which, fine but that is absolutely not making it a mandatory system, nor is is a substantial departure from what we have.
After agreeing that mandatory vaccination probably wasn't going to work, you then wanted an opt out system, which is what we have, so you wanted it to be harder to opt out and now it's gone to "okay, you need to tick an extra box and then we'll act on that data down the road."
It seems like that because you’re reading to disagree instead of reading to understand.
Yes, the point is to add more friction, which defines an opt out system. But this doesn’t necessarily mean a half hour long interview either. Yes, it should be eventually made mandatory, that’s the right direction to go even if it’s not something that can be done immediately. No we don’t need a substantial departure from what we already have.
Lol, okay, what is your meaningful friction that is meaningful but not just a checkmark but also not an interview?
And come on,
Brings us right back to the beginning:
It doesn't have to be exactly like this, but a trial of this would probably help us understand which knobs to dial: an example of a little friction that countries tend to use to make voting mandatory/opt-out without major negative consequences for those who are dead set on not participating. A campaign is held for some time, e.g. a few weeks, and folks are expected to come in and participate. If you want to opt out, two options: 1) show up during the campaign to receive one last 10-15 minutes pitch from a community worker, after which if the person still desires to opt out, this community worker helps them fill a detailed form explaining why; or 2) don't show up during the campaign, and get flagged in the system as AWOL, which requires visiting a community worker to seek that pitch/form on a later date (does not need to be a doctor/nurse, social worker or any other desk job is enough). In this system, the "worst punishment" for someone not attending the campaign is that this person will have to go somewhere, listen to some stuff, and fill a form. The kind of thing that takes a day, which is not life-altering but it is annoying enough that folks will tend to prefer doing this during the campaign period because it should be quicker. And as for the consequences of becoming AWOL, it depends on how widespread that is. I couldn't guess because implementation is key, and good public health policies badly implemented are sometimes worse than no policies at all. But ideally, after perhaps years of work in this system, the government can add more consequences to a record pending rectification, like access to tax credits and other incentives, then moving on to more critical individual stuff like insurance, then later moving on to public services like healthcare and education.
So yes, this brings us back to te beginning. Vaccination should become mandatory. How fast we can make it happen, I have no idea. Maybe not in my lifetime. But we should take steps in the direction of making it mandatory. This will involve increasing the burden on people who choose to not vaccinate. How much and how fast we increase that burden is something that public policy researchers will discover over time, as they'll have to pay attention evolving this in a way to not create yet another system of oppression - but the original point, is that this is the general direction we have to head towards to eradicate some diseases.
Okay, so now we're back to interviews and actually pulling resources out of the medical system in an attempt to increase friction and maybe move a handful of folks? This seems like a piss poor allocation of resources. Consider that the immunization schedule is generally chosen to be the most advantageous in terms of seasonality etc, so to keep maximum efficacy you'd need government employees (who are expensive) in a communities all across this giant province. So, in a world without infinite money, that means we either don't get extra nurses, support staff or whatever else we need, or we redirect them from useful front line work.
But to the larger one:
Nope, absolutely not. I may agree with the vaccine schedule now but I cannot ever imagine supporting a government actually going and making its choice of vaccines mandatory. If you have even a casual understanding of history or you've been paying any attention to global politics for the last decade, it should be apparent that the government you want to win will not always win. And just because I trust our government now does not mean it will always be so and powers like mandatory vaccination are very hard to take away.
It kind of works in the opposite direction in this case as he's an anti vaxxer but would you want a nut like RFK being able to compel you to take medicine you didn't trust?
Yes doing extra things costs money. And if we don't have the budget, it's understandable to deprioritize this. But I'm not defending a particular timeline or prioritization, just that it should eventually evolve into that. Like many things in universal healthcare, a bunch of things that should be will take a long time to materialize. We barely have universal dental care... and we don't have the resources to just give it, but we should, eventually.
Indeed, my worldview is not compatible with being prepared for deranged individuals rising to power like it's happening in the US, which is one of the major reasons I consciously discarded the US as a place to live.
I don't know what you get out of being like this. It's so tiring to talk to someone who is actively seeking the extreme interpretations of my words. So I'm just going to say it one last time and then I'll block you - unfortunately that's the most effective method I have to take care of myself in this kind of forum.
A pitch is the literal opposite of an interview, and the point of having supervision to fill the form is not to treat it like an interview, but to make sure this person understands the purpose of the process and fills the form in good faith. The personal touch of a community worker is super valuable, specially to someone who has concerns with the campaign. So no, not an interview. Not "back" to interviews because it was never about interviews. Sure it will cost 30 minutes of a government employee, which costs dollars from healthcare, like literally any other outreach and education work regarding immunization.