During the spring rush for vaccines, each day brought a new crowd of people to Humber River Hospital’s vaccine clinic, all of them eager to get protection from COVID-19.
The clinic at Downsview Arena remained busy through the summer as waves of residents from Toronto’s northwest corner became eligible for a shot.
And in September, another crush of people seeking first doses queued up at the hospital’s new clinic in a Weston shopping plaza after vaccine passports rolled out across the province.
Now, two months later, that steady stream of people arriving for their first shots has slowed to a trickle.
But Sudha Kutty and her staff aren’t discouraged. They are digging in and working harder to reach the unvaccinated in their community, knowing how much first shots still count in the final leg of the COVID vaccine race.
“Wherever you want to be vaccinated, we will try to accommodate you,” said Kutty, vice-president of strategy and external relations at Humber River Hospital.
“This is still very meaningful work. Even if we only give 40 first doses a day, those are 40 more people that are on their way to being protected. It all makes a difference.”
Across the province, many of the mass COVID vaccine clinics that bustled through the spring and summer have scaled down or shuttered.
Clinics are now smaller and often mobile, with hospitals and public health units bringing them to neighbourhoods with lower vaccine rates, opening them everywhere from shopping malls to community centres, public schools to places of worship, even TTC subway stations and plaza parking lots.
Experts say it is these “last mile efforts” that will help push Ontario to its goal of having 90 per cent of the eligible population vaccinated, a critically important target as the province tries to stave off another pandemic wave.
On Thursday, the province reported 642 new COVID cases, 204 more than what was logged on Nov. 4, and a test positivity rate of 2.1 per cent. The day before, citing an increase in COVID cases, the province announced it would hold off on lifting capacity limits in high-risk venues, such as nightclubs, wedding venues and strip clubs.
While 85 per cent of Ontario’s eligible population is now fully vaccinated — a number that inches higher every day — data shows there are still areas in the province with low vaccination coverage, putting them at higher risk of outbreaks.
In Toronto, about 88 per cent of eligible residents have had their first COVID shot and 85 per cent are fully vaccinated. And while third doses are being rolled out to those who now qualify, and plans are underway to vaccinate the city’s 200,000 kids later this month, experts overseeing local vaccine efforts say they remain focused on first shots.
Even now, eight months after Toronto opened its first vaccine clinics to the public, hundreds of people are getting their first shot every day. During the first week of November, roughly 29,300 COVID vaccines were given in the city, 6,322 of which were first doses.
At Humber’s vaccine clinics, staff are seeing workplace vaccine mandates driving people to get their first dose, Kutty said. A construction worker who needs to be vaccinated to work inside a building, for example, or a personal support worker who needs two shots to provide care in a nursing home.
“Recently we had a DJ come in to get vaccinated because he wanted to work at a nightclub again,” she said.
Earlier this fall, people arriving for a first dose often noted they had waited to see how friends had coped with the vaccine, only getting a shot once confident it was safe.
“People were saying ‘I know people who got vaccinated and it was fine, so now I’m here,’ ” Kutty said. “Our vaccine journey is constantly evolving.”
Working with community partners, Humber has run vaccine clinics in apartment buildings, schools and places of worship. The hospital also partnered with the TTC and Toronto Public Health to set up clinics in subway stations, including Finch West, Lawrence West, Sheppard West and Downsview.
Between Sept. 10 and Oct. 23, the hospital ran 18 subway clinics, giving a total of 1,605 vaccines, 40 per cent of which were first doses.
“In this phase of the last-mile vaccinations, that’s how you reach people,” Kutty said. “I call it ‘in-the-moment’ vaccination. You’re right there in front of them. They’re walking right past you. They know that they should be vaccinated and this is their moment to get it.”
In Peel Region, vaccine efforts have moved out of convention centres and conference halls and into the community, said Paul Sharma, co-lead of COVID vaccination at Peel Public Health.
“We don’t have those mass clinics anymore, where we were pumping out 5,000 to 10,000 people a day,” he said. “Now our clinics are doing anywhere from a couple hundred up to 1,000 people a day.
“What we’re seeing now, in our last-mile strategy, is a lot of people coming to the clinics who’ve waited for a variety of reasons. And they’re asking a lot of questions when they come in.”
The smaller vaccine clinics, such as those in schools and places of worship, or in parking lots with the mobile team, offer quieter, calmer spaces for those who were fearful of mass clinics, Sharma said.
And because they are not as busy, staff at the clinics can take the time to talk with hesitant people, he said, noting primary care and pharmacies are also involved in Peel’s vaccine efforts.
“A lot of people want to know if the vaccine is safe. We tell them asking questions is the right thing to do and that we don’t judge people. We say there’s no wrong question to ask.”
In Peel, where 85 per cent of the eligible population is fully vaccinated and 89 per cent have gotten a first dose, people are still coming for their initial shots for a variety of reasons, including workplace mandates. But Sharma says some of those lining up say they haven’t yet got the vaccine because it’s hard to find the time while working multiple jobs, often shift work with irregular hours.
That’s why mobile and pop-up clinics have been crucial in Peel’s COVID response, he said. On Wednesday, Peel Public Health parked its Vax Van mobile clinic outside Westwood Mall on Goreway Dr. in Mississauga, to catch the attention of anyone still needing vaccines.
Working with community and neighbourhood groups has also been critical to tailor vaccine education and outreach materials in Peel, Sharma said.
“You have to go into a neighbourhood to understand what information is meaningful to people in that local community,” he said. “It’s not a message on social media, it’s not a tweet. It might be a flyer, or it might one of the religious or community leaders saying something like: ‘Hey, we have this clinic here, come and join us.’ ”
Dr. Maria Muraca, medical director of the North York Family Health Team, said vaccine clinics in North York are now smaller and more community-focused and appeal to those who were hesitant to enter crowded mass clinics. Often, the clinics are in areas with lower vaccination rates.
“We’re trying to reduce any barriers patients have to getting the vaccine,” she said. “They are drop-in. We’ve had them in local parks and community centres. They’re open in the evenings. Anywhere patients can access the vaccine more easily.”
People arriving now for first doses say it’s because of mandates in workplaces or for travel, with some relaying that they want to feel safe as they return to the office or school, Muraca said. Another group seeking first doses are those who have recently seen a family member or friend get ill with COVID, she said.
“They saw the impact and it opened their eyes to the severity of COVID and how they were risking their health.”
Jessica Lau, a nurse practitioner and COVID-19 vaccine lead with the North York Family Health Team, which serves approximately 100,000 patients, has seen how one-on-one conversations with vaccine-hesitant patients can help them feel confident in getting their first dose. Part of her work is to train physicians in the family health team to give COVID vaccines should patients insist their shots be given by their own doctor.
In some cases, Lau allows hesitant patients to watch her draw up their vaccine so they can confirm it is their preferred brand or that it’s not expired, to help ease their fears.
“They liked the transparency of that … it gave them the comfort to get the vaccine.”
Muraca says these targeted efforts, from mobile clinics to individual shots in family practice, each matter to get the city and province to its vaccine goals.
“Some people ask, how can you have a clinic for just 20 patients? But those are 20 people protected, potentially lives saved. And they spread the word to their family and friends who maybe haven’t yet been vaccinated. At this point, no number is too small.”
Article From: The Star
Author: Megan Ogilvie
