Medical exemptions to Ontario's vaccine passport should be rare, doctor says

Ontario's COVID-19 forthcoming vaccine passport system is sparking a growing conversation on what counts as a medical exemption.

People who want to eat indoors at a restaurant orgo to a gym, nightclub or movie will need to provide proof of vaccination or a medical exemption as of Sept. 22.

Until medical exemptions can be worked into the digital passport system, the province says a doctor's note will be sufficient to gain entry to these places.

The head of the College of Physicians and Surgeons of Ontario has already asked doctors in the province to be judicious when handing out exemptions.

Dr. Elizabeth Muggah,a family doctor with Bruyre Family Medicine Centre in Ottawa and the president of the Ontario College of Family Physicians, said she's seen a few requests for exemptionsbut not a "deluge."

"We're seeing this opportunity to answer those questions that people have maybe been holding on to for a very, very long time," she told CBC's Ottawa Morning.

Two main medical exemptions

At the moment, there are two main medical exemptions: being allergicto something in the vaccine, or having an adverse reaction to the first dose.

For an allergy to qualify, it would need to be a potentially life-threateninganaphylactic allergy, Muggah said, one that would cause trouble breathing and would be similar to asevere allergy to bees or nuts.

Having an anaphylactic allergy to something else, Muggah clarified,does not mean a person is more likely to be allergic to a component of the vaccine.

The vaccine ingredientmost likely to cause a reaction is called polyethylene glycol (PEG),a common chemicalfound in cough syrups, some prescription medications and even skin care products, Muggah said.

It's in the mRNA vaccines Pfizer-BioNTech and Moderna to keep them functioning. Most people will already have come in contact with PEG at some point in their lives, she said.

The second exemption would be granted after someone who's had one dose of an approved vaccine developsinflammation in their heart or its lining, myocarditis or pericarditis respectively.

"We actually know that in some cases, those reactions may be mild enough that you can receive your second dose," Muggah said.

Anyone with reservations should reach out to their family doctor, pharmacist, or someone with knowledge of their medical history for advice, Muggah said.

She emphasized that vaccines are very safe for anyone who is eligible, including those who are pregnant or trying to get pregnant.

Being immunocompromised is not a reason for a medical exemption, she said, but instead areason to get vaccinated as it puts people at elevated risk ofcontracting COVID-19 and developing a serious infection.