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Businesses must check more than QR codes

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Newfoundland and Labrador’s vaccine passport system kicks in Friday, but many residents will have to show printouts of their vaccination records — and possibly more explicit personal health information — rather than flash QR codes to enter non-essential businesses and public venues.

The process for downloading QR codes was launched two weeks ago, but it left many people out of luck for a variety of reasons, from not having a valid MCP number to not being able to transfer out-of-province records in time.

Many residents are also finding that errors in their vaccination records, such as an incorrect name, are holding up the process.

“If you don’t have a QR code, the after-care sheet and immunization record in this province is a document that shows what you had and when you had it, and is regarded by us as proof of vaccination for businesses, organizations and government bodies,” Health Minister Dr. John Haggie said during a COVID-19 briefing Wednesday, Oct. 20.

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But what about those who can’t get a vaccine?

As of Wednesday, there were still no clear instructions posted online for applying for a medical exemption, and the types of medical conditions that qualify for a medical exemption remains hazy.

The latter problem has caused major headaches for one St. John’s family.

David Pike says his wife has a rare form of blood cancer and had a stem cell transplant in August.

Because patients are given high doses of chemo and radiation before stem cell transplants to kill as many existing blood cells as possible, they are unable to mount a sufficient immune response to vaccines.

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The Pikes were originally told she shouldn’t get any vaccines for six months, but they’ve since been told the latest guidance recommends a wait of three months for one of the mRNA vaccines.

That still means she has to wait until December to be considered fully vaccinated.

“The current government plan is she has to carry around a piece of paper explaining she is sick,” Pike said on Twitter. “After mustering up the energy to get a toddler ready, take her 20-plus pills, cover up her Hickman line (chest catheter), put on a wig — she has to explain why she is unvaccinated at every business she enters.”

Pike later told The Telegram his wife’s health providers still had no idea as of Tuesday what the procedure was to prove her exemption.

“They have no further information and can only offer her a letter stating she is unable to get a vaccination at this time,” he said in a message. “They have no idea what she has to do with it or even if that is acceptable to use at a business as an alternative to a vaccination record.”

On Wednesday, Haggie said the letter should be all that’s needed, and insisted the process for obtaining an exemption is clear.

He said a physician or nurse practitioner has to fill out a form and provide a letter stating that the patient is exempt.

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However, there was some confusion Wednesday over what conditions qualify for an exemption.

“These are determined as a practice issue by the College of Physicians and Surgeons of Newfoundland and Labrador (CPSNL),” Haggie said. “They have provided thus far only two medical reasons: severe allergy or anaphylaxis to a previous dose or to a component of COVID-19 (vaccine), or a diagnosed episode of myocarditis or pericarditis after the receipt of an mRNA vaccine.”

That’s what is stated on the government’s COVID-19 website, too, but a memo sent to doctors by the college is a little less definitive.

“Generally speaking, there are very few acceptable medical exemptions to the COVID-19 vaccination (e.g., an allergist/immunologist-confirmed severe allergy or anaphylactic reaction to a previous dose of COVID-19 vaccine or to any of its components that cannot be mitigated; a diagnosed episode of myocarditis/pericarditis after receipt of an mRNA vaccine),” the Sept. 9 memo states. “Given the rarity of these exceptions, and in light of the fact that vaccines have been proven to be both safe and effective, any notes written for patients who qualify for a medical exemption need to clearly specify: the reason they cannot be vaccinated against COVID-19 (i.e., document clear medical information that supports the exemption); and the effective time period for the medical reason (i.e., permanent or time-limited).”

When contacted Wednesday, CPSNL registrar Linda Inkpen said the two cited reactions are the only exemptions recognized by the Public Health Agency of Canada.

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“However, many patient circumstances can have issues on which specialists must opine and defend,” she said in response to a query, without clarifying what those may be.

Haggie said the department and the college are also in talks to see if some mental-health issues might qualify for exemptions.

In any case, he said anyone who qualifies for an exemption can simply present a letter or form from their physician stating they are exempt, without declaring why.

“For those people with a medical exemption, the form simply specifies that you meet the criteria. It doesn’t specify what particular reasons.”

It’s unclear how that relates to the documentation needed for an exemption to be approved in the first place.

As for other bumps in the road toward getting QR codes, Haggie said extra staff have been added to handle the increase in requests to update MCP cards.

However, he rejected a suggestion the province’s advance planning was insufficient, and blamed the MCP card delays on the fact too many residents had let them expire.

“I think the planning was proportionate to the size of the task ahead of us,” he said. “I think what it has shown to us is that there is very much a laissez-faire attitude about MCP cards, quite frankly.”

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