Studies conducted before mass vaccination campaigns began have reported proper and consistent facemasking by students and staff in school settings are associated with reduced incidence of school-associated transmission or seropositivity.
Fewer studies have reported efficacy of facemasking in the post-mass vaccination period in school settings. The studies available report, however, school-associated transmission were lower, less than 1% secondary attack rate in schools.
Studies of school-associated COVID-19 cases find community exposure to SARS-CoV-2 and/or noncompliance with multiple mitigation measures (e.g. facemask policies, distancing, non-isolation, etc) are key factors of clusters and outbreaks in children.
Badea, A; Groot, G; Muhajarine, N; Howell-Spooner, B; Young, C. What is the evidence for the effectiveness of universal mask use in the pediatric population? 2021 Sep 30, Document no.: EOC210901 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 14 p. (CEST rapid review report).
Requiring proof of vaccination for entry into another country is not a new idea. There are regulations that need to be followed to set up a “vaccine passport” in relation to international travel (International Health Regulations (IHR) (2005))
At present the World Health Organization does not recommend vaccine passports for international travel, but they are working on a standard Smart Vaccination Certificate technical specification and standards to allow for harmonised processes to include COVID-19 vaccines into an updated version of the IHR (2005)
Countries around the world are beginning to put vaccine passports into place for international travel, as well as in some countries within country travel and access to services or businesses including Israel, France, Italy, Denmark, and the EU
The Canadian Federal government is supportive of a vaccine passport for international travel but recognize the issuing of vaccine passports will need to be province led
As of May 13, 2021, the province of Quebec has begun issuing a downloadable QR code that individual can keep on their smart phone.
As of June 9, 2021, the Federal government of Canada discussed easing restrictions for fully vaccinated Canadian citizens returning to the country
Ethical considerations in the use of vaccine passports include equitable access to vaccination (domestically and internationally), access to technology (eg. Smartphone passports), marginalization, or stigmatization especially among historically racialized groups, and socially isolated populations
Legal considerations include
o Clarifying who has the legal authority to require proof of vaccination,
o Ensuring that if new legislation is created and implemented it is in line with all pre-existing legislation (Charter of Rights and Freedoms, Human Rights Codes, privacy legislation, employment legislation),
o Ensuring that, if created by the government, there is coordination of the Provincial and Federal governments for international travel with respect to jurisdictional overlap, security of information, fraud
Health care facilities should be able to legally enact vaccination policies for patient-facing employees so long as they allow for exemptions due to medical inability or bona fide religious, or conscientious beliefs
Six in ten Canadians (61%) expect vaccine passports to be widely used in Canada by the end of 2021, the same proportion (61%) of Canadians also agreed that only vaccinated people should be allowed to engage in events involving larger crowds such as public transit, air travel, or attending cultural and sports events
Lashta E, von Tigerstrom B, Reeder B, Groot G; Miller, L; Mueller, M. What are the ethical/legal aspects of vaccine requirements? 2021 Jun 21, Document no.: EOC210503 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 25 p. (CEST rapid review report).
Badea, A; Groot, G; Howell-Spooner, B; Young, C. What is the evidence for the effectiveness of universal mask use by the public? 2020 Dec 1; Document no.: EOC062301v3 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 33 p. (CEST rapid review report)
The evidence to support medical exemptions for mask wearing is limited.
The predominant discourse revolves around a risk-based approach that considers the potential benefits and harms for individuals; few absolute exceptions to masking have been advocated.
Masks are one part of a comprehensive strategy to reduce the spread of SARS CoV-2 infection and should be viewed in the context of other public health measures including physical distancing, hand hygiene and respiratory etiquette.
Williams-Roberts, H; McLean, M; Groot, G; Young, C; Mueller, M; Miller, L. What evidence is there to support medical exemptions for mask wearing? 2020 Sep 17; Document no.: EOC091101 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 20 p. (CEST rapid review report)