Exemptions from COVID-19 requirements

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Updated: May 2023

As public health requirements evolve in response to changing circumstances, consider your professional obligations and rights.


CMPA assistance is generally available for medico-legal matters arising from a member’s medical-professional work. Members who conduct a proper clinical assessment and provide a medical exemption from the COVID-19 vaccination in an established doctor-patient relationship will generally be eligible for CMPA assistance with related medico-legal difficulties. Members who provide COVID-19 vaccine exemptions without doing proper clinical assessments and outside of an established doctor-patient relationship may not be eligible for CMPA assistance and will need to retain their own private counsel to assist them with any associated medico-legal matters. Members may also find themselves personally liable for damages in a related legal action.

Am I required to comply with requests from patients to complete notes that exempt them from wearing a mask, being vaccinated, attending school or work and/or engaging in any other activities?

Physicians should exercise clinical judgment on a case-by-case basis in determining whether an exemption note is warranted based on the patient’s medical condition and circumstances. Although physicians have a general obligation to help patients by providing medical reports or certificates when warranted, they are also responsible for giving sound medical advice.

Physicians should generally only complete these documents if the request is clinically indicated and in keeping with published guidelines. Any statements made should be truthful and based on objective clinical information.

It is reasonable to decline completing exemption notes if the request is not clinically indicated or you do not have the sufficient knowledge or expertise to opine on the issue. You should explain to the patient in a compassionate and professional manner why the request cannot be granted. An appropriate notation in the medical record of the discussion with the patient, including the basis for providing or refusing the exemption note, will be invaluable in responding to any later challenge of your decision.

Do I have an obligation to be vaccinated against COVID-19? What are the repercussions if I do not comply with my facility’s or government’s mandatory vaccination policy? Will the CMPA assist me with College or hospital matters arising from my refusal to be vaccinated?

The CMPA generally encourages physicians to be aware of any mandatory vaccination programs applicable to their practice setting. Physicians will want to reasonably consider any mandatory vaccination policies that apply to them, bearing in mind their ethical, professional and legal obligations. Failure to comply with mandatory vaccination policies could lead to discipline. In particular, non-compliance with any applicable policy may result in remedial and/or disciplinary action by the hospital or health authority and may lead to an investigation by the College.

The CMPA generally assists members with College and hospital matters relating to the professional practice of medicine; however, CMPA assistance will not generally be available for matters primarily arising from business or personal issues. The CMPA does not generally extend assistance to members to assist them in advocating for changes to government, hospital or College policies.

Members are encouraged to contact their provincial/territorial medical association or federation for more information regarding policy initiatives and measures with respect to mandatory vaccine policies.