‘Different virus, same logic’

Canada has long history of requiring vaccine passports, mandating vaccines

When Oonagh Proudfoot and her sister were reminiscing about their now-deceased parents, she pulled out her father’s passport, which she had kept as a memento.

She had always noticed a folded-up piece of paper in the passport, but it wasn’t until this summer that Proudfoot actually examined it.

This paper was a proof of vaccination card that stated he had been inoculated against smallpox – a requirement of his immigration.

Kenneth Proudfoot, born in Northern Ireland in 1930, moved to Newfoundland in 1967, recruited by Agriculture Canada to breed potatoes that would grow in the rocky, not-so-fertile soil of Newfoundland. He eventually settled and raised a family in the Goulds, a rural area of St. John’s, N.L.

Kenneth Proudfoot, left, is shown with his daughter, Oonagh Proudfoot, and his twin brother, Bruce. Born in Northern Ireland in 1930, Kenneth moved to Newfoundland in 1967 and settled in the Goulds.

“Different virus, same logic,” says his daughter, who now lives in Wolfville, noting how relevant this find was today.

HISTORY OF QUARANTINES, VACCINATIONS

Public health measures, vaccination requirements, and quarantine rules have long been part of Canadian history.

Steven Schwinghamer, a historian with the Canadian Museum of Immigration in Halifax, says the first public health measures probably go back to when there were rules for quarantine to prevent the spread of disease in New France in the early 1700s.

By the 1880s, vaccination was an established practice for public health, he says.

Amendments to the Quarantine Act in the 1880s provided for the requirement of two kinds of documentation to prevent the spread of contagious diseases. First, says Schwinghamer, when individuals immigrated to Canada, a “protection card” signed by a ship’s doctor was required.

Every steerage passenger needed to prove to the medical officer that they had either been vaccinated against smallpox in the last seven years or they had survived the disease within that time period, he explains.

Secondly, a document was given to release passengers from quarantine within Canada if their ship had been detained because of fears of or the occurrence of a contagion aboard, he says.

“The nature of the proof or record became more formal over time, but the structures of medical examination and the control of contagious disease were established before the boom years of Canadian immigration from 1896 to 1914,” says Schwinghamer.

Shipping lines had a vested interest in checking these proof of vaccination records, says Schwinghamer. If a passenger arrived in Canada without such documentation, the shipping lines were charged for the care or deportation of inadmissible immigrants.

Shipping lines, therefore, cooperated with the Canadian and foreign governments in health screenings and even offered public health facilities abroad to ensure that people travelling to Canada were free of health issues and were vaccinated, he explains.

“Modern Canadian ocean immigration sites, like Pier 21, required vaccination cards, X-rays, a medical approval from abroad, and passing medical examination upon entry were normal requirements for immigrant admission,” says Schwinghamer.

Hence the need for Kenneth Proudfoot's vaccination record in his passport when he immigrated to Canada in 1967.

PROTECTING CANADIANS FROM DISEASES

Ian Cameron describes an example of such historic immigration practices.

Cameron is a medical doctor with a bachelor's degree in history and was the longstanding president of the Dalhousie Society for the History of Medicine and the founding chairperson of the Medical Museum of Nova Scotia.

In 1899, he says, 2,000 Doukhobors, a small religious group from Russia, immigrated to Canada. During their passage, a child died of smallpox while at sea.

The group was quarantined for the required length of time on Lawlor's Island in the Halifax harbour. Fortunately,

he says, no one else came down with the disease.

All passengers had an antiseptic shower, their clothing was disinfected with steam heat, and they were all vaccinated for smallpox. To continue their trip to Manitoba, Cameron says, they were given a red ticket if their smallpox vaccination took, a white ticket if the vaccination didn't take and they would have to be revaccinated, and a yellow ticket if they and their clothing had been disinfected, he explains.

“This was a case of early public health intervention and documentation,” says Cameron.

Cameron wrote a book on the subject during SARS, a coronavirus like the COVID19 epidemic, that occurred in 2004.

SMALLPOX IN NEWFOUNDLAND

In 2010, Terry BishopStirling, a history professor at Memorial University in

St. John's, N.L., wrote a detailed article in the cultural magazine, Newfoundland Quarterly, about the history of the Spanish Flu and smallpox in Newfoundland and Labrador.

Beginning in 1905, certain health regulations were in place to control infectious diseases. St. John's had a permanent medical health officer who supervised quarantine, sanitation and vaccination, and advised the government on public health matters for the whole country, writes Bishop-Stirling.

When the Spanish Flu hit in 1918, the Newfoundland government found itself desperately trying to spread limited medical resources throughout the hundreds of settlements across the island, she writes. In the end, 1,128 residents died, with another 773 deaths attributed to complications of influenza.

More than 400 people are also recorded to have died in Labrador, which is believed to be an underestimation, according to Bishop-Stirling.

To help limit the spread of the disease, in 1918, the Newfoundland government closed all churches, clubs, theatres and public meeting places and banned the gathering of more than 12 people for two weeks.

Similar problems arose in 1920, said Bishop-Stirling, with an outbreak of smallpox. This strain of smallpox was not deadly but kept people sick for a long time and was around for about five years. Bell Island was the epicentre of the outbreak and a mobile work crew from Conception Bay offered support to residents, says Bishop-Stirling. The disease threatened to spread to the rest of the colony.

After trying to control smallpox for several years, she said, public officials concluded that widespread preventative measures would be more effective and ultimately cheaper than treatment.

Quarantine rules for smallpox had been expensive on Bell Island, and practically all workers there were in debt to the local stores. As soon as quarantine was imposed on a man's family, his credit was cut off, so the local government had to provide quarantined families with food and fuel. If these supplies were too low, people broke quarantine. The largest expenses quickly became food rather than medicine.

Newfoundland's prime minister at the time, Richard Squires, resisted physicians' advice that compulsory vaccination was needed to stop the spread of smallpox. So, instead of enforcing immunization, authorities offered free vaccinations and sought the help of clergymen, employers and physicians to convince people to accept the offer. If people got sick without immunization, however, they would not get free treatment.

“Remember,” says BishopStirling, “this was long before state Medicare.”

Many people at the time would not take the mild strain of the disease seriously and even refused to believe it was smallpox. Others worried they would get sick from the vaccination and lose time from work.

So, instead of making vaccinations compulsory, the government put the onus on employers to compel their employees to get vaccinated. For example, writes BishopStirling,

it was said that any vessel leaving for the annual seal hunt would refuse to take any man unless he could prove immunity to smallpox. This was also the case for the mining company, DOSCO.

There is nothing in the files to show that the captains or companies agreed to this, however, says BishopStirling.

“The rumours and the threats seemed to have done the job and the government did throw a good pot of money into a widespread vaccination campaign, involving a lot of negotiation with doctors,” says BishopStirling, noting this is how they finally got the disease under control.

Routine smallpox vaccination stopped in Canada in 1972, says Cameron. The last case of smallpox globally was reported in 1978 by the World Health Organization and the smallpox vaccination for travel was no longer required in 1980, he says.

VACCINATIONS THEN AND NOW

Prior to 1916, smallpox vaccination material was not monitored for quality or effectiveness, which gave the anti-vaxxers of the day justifiable cause to complain, says Cameron.

After that, in 1916, Connaught Labs in Toronto began producing an enduring and uniform smallpox vaccination product. The company continued to make vaccines today, including the Salk polio vaccine, he says.

In the 1950s, the Canadian government made what Cameron calls "a very courageous decision" to use the new, relatively untested, Connaught polio vaccine. The entire at-risk Canadian population was immunized, and polio was no longer the dire threat it had been.

“The Connaught Labs were acquired by the Canadian government, but in 1982 were sold to a company with French interests, which is why Canada doesn't have the infrastructure to produce our COVID vaccine today,” explains Cameron.

IMPLICATIONS TODAY

Looking at Canada's past, there is a long history of vaccination passports and public health measures being used to control infectious diseases are nothing new.

This was Proudfoot's impetus for sharing her father's passport on Facebook recently.

“I wanted to show people that having a vaccine passport is no big deal, and not a new concept, in the hopes that folks would get on board,” she says.

Cameron adds: “The most interesting story in this COVID plague is that we have the means to control the virus except for the intransigence of the antivaxxers.”