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I think writing a letter of explanation is the best thing.

Bumping it up for more comments and insights.

Few years before, this is how it used to work. But it is now official that meds won't be needed as a part of application. https://www.canada.ca/en/immigration-refugees-citizenship/services/immigrate-canada/express-entry/documents/medical-exams.html

Hello folks, I have an ITA and will apply for my permanent residence soon. I saw that Canada will no longer need upfront medical examination for PR applications through express entry from October 1st. I was procrastinating with my medicals since I have a severe needle phobia (blood test) and it...