Allergists hit with surge of vaccine exemption requests, but rarely grant them

Allergy clinics across Ottawahave seen an increase in vaccine exemption referrals, and some doctors say the demand is time-consuming, stressful and, at times, staff become victims to physical and verbal abuse.

"Those [seeking] exemption are asking ... tobe seen as soon as possible either to get benefit from going to restaurants, or being able to have removal of all the restrictions they have," said Dr. Ahmed Ahmed, a pediatrician who practises at the Kanata Allergy Clinic.

Ahmed says exemption seekers are "pushing" to be seen within a few days, while he simultaneously has a two-to-three-month waiting list for patients with food and other allergies.

"This leads sometimesto verbal abuse with my staff," Ahmed said."It can be sometimes a hassle ... convincing them over the phone and answering their questions again, again and again."

Ontarians haveto show proof of vaccination to dine-in at restaurants, go to gyms and other venues. When this policy was first instituted, employers also began announcing mandatory vaccine rules for workers to stay employed. Now, travellers must also have proof of vaccination.

A specialist can issue medical exemptions, butthe government says there are"very few actual contraindications" that would qualify, such as severe allergies and other complications like myocarditis.

The Ministry of Health currently requires vaccine exemptions for allergic reactionsbe administered by an allergist/immunologist.

Ahmed describes seeing "a surge" in COVID-19 vaccine exemption referrals around that time a common situation among his Ottawa colleagues.

He estimates about 60 patients have been seen for exemption referrals in the past couple of months each one has walked out empty-handed.

Some people can be allergic to components of the mRNA vaccines currently available in Canada(Pfizer-BioNtech and Moderna) such as Polyethylene glycol or PEG(a laxative),polysorbateandtromethamine, explained Ahmed.

The latter two ingredients are additives already found in antibiotics, as well as vaccinesand painkillers.

He finds most patients come to him for testingwithout having anyprior reaction to these ingredients.

"Not everyone referred is really an anti-vaxxer, but many don't know that allergy to penicillin, for example,has nothing to do with allergy to the vaccine," he said.

"Some of them ... simply they're asking, 'we want to take that letter and we don't care what you think.'"

Ahmed says he now sees parents seeking exemptions for childrenas children aged five to 11 becameeligiblelast month for their first dose of the COVID-19 vaccine.

Reacted to 1st dose? 2nd dose often no issue

Dr. Tim Olynychisthe only allergist in the greater Ottawa area who's working with Ottawa Public Health to administer the COVID-19 vaccine to those at risk of a severe allergic reaction.

Many of the allergists are getting burnt out, are getting overwhelmed, and getting overrun by referrals.- Dr. Tim Olynych, allergist with Yang Medicine

So far, he's given out about 80 doses to patients who either reacted to the first dose, or had previous allergies to PEG.

"I have vaccinated some people in my clinic who otherwise would not have been vaccinated due to fear and anxiety," he said.

Olynych,who works at bothYang Medicine and The Ottawa Hospital, says a "big wave" of exemption referrals startedin the late summer when mandates were introduced.

He'sonly signed off on two exemption letters.

Olynych addedthere's growing data that even those who've had severe anaphylaxis to their first dose can tolerate a second without having another reaction.

"I've re-vaccinated many people who've had severe reactions to their first dose, and I've had to treat very, very few of them."

WATCH |Ottawa allergists 'overwhelmed' by residents seeking vaccine advice, exemptions, doctor says

Ottawa allergists overwhelmed by residents seeking vaccine advice, exemptions, doctor says

3 years ago

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Dr. Tim Olynych, an allergist in Ottawa, says hes seen an increase in the number of people seeking advice about the COVID-19 vaccine or an exemption from vaccine requirements, including some demanding exemption letters without a valid reason.

Olynychsaid some patients have legitimate concerns over previous experiences with vaccines and ingredients. Others, however, seeka letter for "non-appropriate reasons" and can become physically abusive to staff.

"It's been very stressful on the allergistcommunity here in Ottawa. Many of the allergists are getting burnt out, are getting overwhelmed, and getting overrun by referrals of patients who are hesitant or are these more aggressive exemption seekers."

Family docs also in a tough position

Ahmed saysthe allergist community has tried to curb the number of illegitimate referralsby providing a formal letter tofamily doctors that explains what is exempted and what's not from an allergy standpoint.

However, Ahmed says it's difficult to reach all family physicians in the Ottawa area, andhe admits they're also in a difficult position.

"I feel bad for them also because ... they are the first line that are facing those requests," he said. "We can't say don't send to us. When you face such [a demanding] patient, what do you do?"

Ultimately, Ahmed and Olynychsaid they hope referrals slow down with more data and a larger section of the population getting vaccinated.