{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:21:14Z","timestamp":1787062874087,"version":"build-2736575974"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Upon the WHO declaration of Covid-19 as a pandemic, healthcare workers (HCWs) \u2013 unvaccinated by necessity \u2013 were celebrated as \u201cheroes\u201d for their service under difficult conditions. Later, as some of them resisted vaccine mandates, they were reframed as \u201cthreats\u201d, regardless of personal behaviour, workplace setting, or evidence of their harmfulness. This discursive shift and the institutional mechanisms supporting it remain underexamined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Goal<\/jats:title>\n                    <jats:p>This protocol outlines a qualitative multi\u2011method study investigating the implementation of Covid-19 vaccine mandates in medical establishments across Ontario, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This qualitative multi\u2011method planned study includes two phases. Phase 1 is an environmental scan of institutional vaccine mandate policies across a purposive sample of diverse Ontario medical establishments. It will track policy implementation timelines, mandates scope, exemptions eligibility criteria, and supporting scientific evidence presented. Phase 2 is a critical interpretive analysis of documents collected in Phase 1 that draws on Max Weber\u2019s theory of bureaucracy and legitimacy, Carol Bacchi\u2019s \u201cWhat Is the Problem Represented to Be\u201d (WPR) approach, and Brian Martin\u2019s framework on suppression of dissent to identify patterns in the institutional framing and treatment of challenges to mandated vaccination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Expected outcomes<\/jats:title>\n                    <jats:p>The study outlined in this protocol is expected to yield descriptive and interpretive insights into how bureaucratic structures shaped mandate enforcement and dissent suppression. Results are expected to inform academic debates on institutional legitimacy, governance, and public health ethics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0332589","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T17:27:12Z","timestamp":1759512432000},"page":"e0332589","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["How did Ontario healthcare institutions implement and legitimize Covid-19 vaccine mandates? A qualitative multi\u2011method study protocol"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9208-7630","authenticated-orcid":true,"given":"Claudia","family":"Chaufan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"pone.0332589.ref001","unstructured":"Simmons T. 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