Open letter: Migrants with precarious legal status and individuals without MSI coverage continue to face barriers to vaccination in Nova Scotia

o: The Honourable Zach Churchill, Minister of Health and Wellness,  

The decision taken by the Government of Nova Scotia to make Covid-19 Vaccines available to all people in the Province, regardless of residency status and MSI coverage is aligned with the recommendations offered by the National Advisory Committee on Immunization that “COVID-19 vaccines will be made available to everyone in Canada for whom it is approved and recommended for use…This applies to all persons in Canada whether or not they are citizens.” This decision confirms the rights of those with precarious legal status—that is, non-permanent residents whose ability to remain in Nova Scotia is dependent on a third-party such as an employer, the state, or a post-secondary institution—to the vaccine when and as it becomes available.

Providing access for migrant workers, refugee claimants, and international students within their first year of study, as well as those whose status may have lapsed, is key to ensuring an authentically universal and encompassing vaccine rollout and therefore, to safeguarding the public from extended and future Coronavirus outbreaks. And yet, there remain a number of significant barriers to meaningful universal access. This is despite important changes to the Province’s Covid-19 website clarifying that individuals without provincial health care coverage are eligible for the vaccine.

On April 6th, 2021, your office received a letter signed by physicians, front-line workers, migrant rights advocates, migration researchers, and health policy experts requesting a series of procedural adjustments to facilitate vaccine access for those individuals residing in Nova Scotia with precarious legal status. We received no response.
Since April 6th, our community partners, working alongside migrants without permanent residency status, have encountered a number of significant barriers to vaccine access. We would like to draw your attention to these, and we would encourage you to take into serious consideration our recommendations, particularly as the risk of Coronavirus infection increases.

• Despite some additional clarity on the website, those without MSI coverage remain largely unaware of their right to access the vaccine
• Individuals calling to book immunization appointments are being told that they require MSI to do so
• In more than one instance, clients have been informed that there will be a charge for Covid-19 testing if they do not have MSI
• The phone line remains inaccessible, particularly for those with low levels of English proficiency

In addition, then, to the recommendations offered in the letter from April 6th, we would encourage your department to consider adding an online registration option for those without MSI. This will allow many migrants to book vaccination appointments more easily, and it will limit the circulation of incorrect and misleading information.

811 agents and others acting on behalf of Public Health must have up-to-date, accurate information concerning the testing and immunization rights of individuals without MSI coverage. This information needs to be communicated clearly and consistently to migrants and their supports.

We would strongly encourage the department of Health and Wellness to designate the Newcomer Clinic as a vaccine site. The Clinic (http://www.nshealth.ca/content/newcomer-health-clinic) is a vital resource for newcomers in the province and we firmly anticipate that vaccine accessibility and uptake will be improved if migrants and newcomers are able to access the vaccine in a safe, supportive, and familiar environment.

Finally, where Temporary Foreign Workers are concerned, we ask the Department of Health and Wellness to re-prioritize these workers, who live and work in large group settings. Often central to our food systems, these essential workers are especially vulnerable to infection, serious illness, and death as evident at numerous sites across Canada.

Further to this, we ask that you consult with migrant rights advocates to develop a robust vaccine protocol that is responsive to the unique needs of temporary foreign workers, including those who live and work rurally and in isolated locations and do not speak English. This entails the provision of accurate, accessible information, transportation to and from the vaccine site, and guarantees that workers will not be penalized for taking time off to access the vaccine and/or recuperate from any side-effects, nor face reprisals if they decide not to be vaccinated.

Given how competitive vaccine access has become in Nova Scotia, migrants with precarious legal status and individuals without MSI coverage are at a significant disadvantage. The barriers encountered by migrants over the last month reflect pervasive and protracted gaps in health care provisioning for those in the Province without permanent residency status. And yet, they are easily remedied. We ask your office to commit to redressing these barriers by putting in place the supports necessary to ensure equitable access and an authentically universal vaccine rollout.

With thanks, 

This letter, written by Catherine Bryan, Stacey Gomez, and Gillian Smith, is a follow up to the letter sent on April 6, 2021.

See also: Too many barriers to vaccine access for migrants, open letter states