Health units scramble to implement 18+ vaccine strategy shift

Health units scramble to implement 18+ vaccine strategy shift

Public health units say they're still working on how to get vaccines to adults aged 18 and up in "hot spots," days after the provincial government announced the shift in priorities.

Last week, the Ministry of Health announced 13 Ontario postal codes where anyone aged 18 or over will be able to get vaccinated soon. The plan for how to do that — including timing, locations and when each population can get doses — is left up to each local health unit, and appears to have taken some of them by surprise.

Toronto was the first to open an 18+ pop-up, in the Thorncliffe Park neighbourhood over the weekend. It saw long lineups, as residents took to social media to let each other know that they could get a shot. Mayor John Tory has said the city is working with the province to allow 18+ adults to use the provincial vaccine booking system, to help smooth things out.

Torontonians have kept a Reddit post updated with locations of 18+ vaccine clinics in the city.

Many public health units told QP Briefing they were still trying to figure out how to implement the plan. Some will opt for booked time slots, while others will use Toronto Public Health's strategy of true "pop-up" clinics where people wait in line for a shot.

Southwestern Public Health, which has one hot spot in its region — the N5H postal code in Aylmer — said it plans to use bookings to avoid the physical distancing challenges that come with lineups, but it doesn't know when that will happen.

"We are currently working with our health-care partners in the N5H postal code to identify opportunities that will be accessible and safe for those who wish to get the vaccine right in their home community. People from this region may also be served at the mass immunization clinics we’re currently operating in St. Thomas and in Woodstock," Southwestern spokesperson Megan Cornwell said in an email. "We do not yet have a launch date for these vaccination efforts as we’re still working on the details with our health-care partners."

A spokesperson for Waterloo Public Health said it will announce the location of mobile clinics in its hot spot neighbourhoods — concentrated in the N2C postal code in Kitchener — "in the coming days."

York Region said it would begin 18+ vaccinations this week for employees in high-risk workplaces only, in Vaughan and Markham, if vaccine supply allows. It still doesn't know whether that's feasible.

"Individuals in these age groups (18–45) are asked to please wait for further communication from York Region Public Health about when and how they can get a vaccine," said Patrick Casey, the region's director of corporate communications, in an email.

Peel Public Health said it is "looking forward to working through implementation details with the province and our community partners," but that "details are still unfolding."

The health unit said the province "may be in a better position to provide details on the initiatives they announced last week."

Ottawa said it plans to keep pop-ups as quiet as possible, as it "does not currently have enough vaccine supply confirmed to accommodate additional bookings."

"These clinics will not be widely promoted to ensure the targeted approach for the identified community is successful. These pop-ups will not be available to book by phone or online at this time in an effort to ensure those most disproportionately impacted by COVID-19 in these areas receive access to the appointments," the city said in a release.

Word has spread on social media that two Toronto clinics are accepting 18+ bookings, even though their site says it's only open to those 50 and up.

"We have heard from community that two vaccine clinics in TorCen, the Wellesley Community Centre and 40 Oak St in Regent Park, have been accepting bookings for folks 18+," NDP MPP Suze Morrison wrote on Facebook on Saturday. "However, all slots are currently full. It is upsetting that this hasn't been clearly communicated — I learned about it on social media from a community member."

One Torontonian said three of his family members aged 18–49 were able to book appointments but were turned away. Scott Reid said on Twitter that a public health official at the clinic told him the Ministry of Health didn't actually permit local health authorities to open up vaccines to that age range.

The province has only allowed those 18–49 to get vaccinated in mobile clinics specifically set up in hot spots, said Toronto Fire Chief Matthew Pegg, who is serving as Toronto's COVID-19 immunization task force lead.

“The province did not make vaccine available by other means, including through city-operated vaccine clinics, to that age category, yet,” he said. “We know that in due course, and at some point, hopefully in the near future, that will change.”

Tory said Greater Toronto and Hamilton Area mayors and chairs met today and asked the province to set out eligibility parameters on a region-wide basis.

“Because there’s so many different governments and public health agencies, and others, hospitals, involved in delivering all of this, that there‘s been some understandable lack of clarity sometimes, in people’s minds,” he said.

NDP Leader Andrea Horwath said Premier Doug Ford appears to have made up the strategy "on-the-fly," and now local health units have to scramble to implement it.

"I feel so badly for Ontarians who are being told one thing by the government and then not being able to access vaccines. It's pretty chaotic out there. The government had a year to plan for these vaccines. I mean, they should've been planning a lot sooner than they did," she said. "Everything is pretty upside-down around the province. People have no idea — particularly people in hot spots — how to access vaccines, where the pop-ups are supposed to be. I mean, public health didn't even know that the premier was going to make the announcement that he made last week."

Liberal health critic John Fraser also said local health units appear to have been caught by surprise.

"The premier essentially gave the impression that mobile clinics are out there vaccinating, when in fact they weren't," he said.

Green Leader Mike Schreiner said the "chaos and confusion around the vaccine rollout is completely unacceptable."

The confusion comes amid questions about how hot spots were designated.

A CBC analysis found five postal codes designated as hot spots that are doing better, COVID-wise, than many others — four of which are represented by Progressive Conservative MPPs.

Opposition leaders wouldn't assume anything untoward but called for more transparency on how the postal codes were chosen.

"I certainly think that the government needs to explain why the anomalies exist with their list of postal codes," Horwath said. "I have two in my riding that should have been on the list and weren't."

QP Briefing was not selected to ask a question at Ford's press conference on Monday, and Health Minister Christine Elliott's office, and the ministry, both did not respond to a request for comment.

In question period, Elliott said the hot spots were identified by "based on historical data and on transmission records and hospitalizations" but gave no further details.

See the chart below for an analysis of the postal code areas defined as hot spots, represented by coloured dots, and how they compare to the other postal codes in the province when it comes to the rate of hospitalizations and deaths among the residents, as well as their vaccination uptake so far. All data from ICES

Jack Hauen


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