Now that I have your attention, this post is about public management, not immunology. Please read on anyway.
In my undergraduate public management course, I gave an open-book final exam (MGSC03 final exam 2020) in which half the points were based on a two-part question on Covid vaccinations. (Open-book was necessary due to social distancing). The first part assumed that, in June 2021, Canada receives 3,000,000 doses of the new Covid vaccine and cannot expect any more for at least 6 months. The government’s challenge is to decide who among 37 million Canadians should receive the initial doses. The question asks Health Minister Patty Hajdu whom she should consult, within a week, and, regardless of the results of the consultation, whom she thinks should receive doses. Finally, the question asks her to draft an announcement for the Prime Minister about the new vaccine and who will initially be receiving it.
The second part of the question flips the first part. It assumes that by January 2022, the vaccine is available for any Canadian who wants it. However, a major anti-vaxxer organization, which claims to have 300,000 members among 14 million Ontarians, announces it will advise its members and all Ontarians to refuse the vaccine. The question reminds students that the Immunization of School Pupils Act allows parents to exempt their children from vaccination if they sign a statement of conscience or religious belief. The question asks Ontario Health Minister Christine Elliot to advise Cabinet on how to respond to the anti-vaxxers, bearing in mind that the next election will be in June 2022.
In the first part of the question, students should have realized that a week isn’t enough time for widespread public consultation. Health Minister Hajdu could consult internally (her own ministry, the Public Health Agency of Canada, and other federal departments) and with provincial health ministries and medical officers of health. Broader consultations could involve medical associations, academics, and bioethicists. Students suggested vaccinating either the most vulnerable (with several definitions of vulnerability) or health care professionals. Because they exam was open-book, they were available to determine the size of the different groups. A few students suggested vaccinating key political decision-makers. I can understand an argument for vaccinating the federal cabinet, but the definition of key political-decision makers could become elastic and include MPs, MPPs, senior federal and provincial public servants, etc., etc. This smacks of an elitism that won’t play well in Peterborough.
As for the announcement by the Prime Minister, I can’t do any better than quote that drafted by Amira Ali, one of my wonderful students, who captured Justin Trudeau’s rhetorical style perfectly, and also took advantage of online information about the size of various groups in the population:
“Fellow speakers and presiding officers, distinguished guests, I would like to begin by offering my condolences to the families who have had loved ones pass away from this virus. I would also like to thank the front-line workers, the nurses, doctors, grocery store employees and those who have been helping Canada function during this difficult time. Given the shipment of the 3 million COVID-19 vaccines to Canada, deciding who would be given these vaccines was a very challenging task. However, we have outlined certain groups of people who we feel that are of top priority right now. We will begin with the health care workers who have shown tremendous courage and bravery as they risk their lives daily to treat sick Canadians. Roughly 500,000 vaccines will be distributed to hospitals specifically for doctors and nurses. The remainder of the vaccines will be distributed to the most vulnerable population; the elderly. Given that in 2019, there were a reported 6.5 million Canadians over 65, we will give the vaccine to those with pre-existing medical conditions which will make them vulnerable to the virus. We understand that we all want the vaccine however we need to make sure that we are helping those who are in need of it first. We will try our best to ensure that the next batch of vaccines will be enough for every Canadian.”
The most common answer for the second part of the question was to use social marketing to encourage adults to get vaccinated and have their children vaccinated, and not to antagonize the anti-vaxxers, particularly because they are likely to be well-represented within Ford Nation. Interestingly, no one suggested entirely ignoring the anti-vaxxers’ campaign because, if herd immunity is achieved either through previous infection or vaccination, its membership base is small enough to ignore. Other students suggested taking a harder line, including amending the Immunization of School Pupils Act to remove exemption on the basis of religion or conscience completely or to make it inapplicable to Covid vaccination. Some suggested mandatory vaccination for adults and one advocated invoking the notwithstanding clause to override any objections based on The Charter of Rights and Freedoms. Finally, students who took these positions argued that good policy is also good politics, because majority opinion even among Ford Nation has now swung to favour widespread, even compulsory, vaccination.
All told, the students’ answers were fascinating, and certainly foreshadow debates we will be having in the coming months.