As of today, anyone who is 18 or older is eligible to book a COVID-19 vaccine in Ontario. This is the latest round in a phased rollout that has seen new groups become eligible week to week over the past few months.This phased approach is a strategic response to limited vaccine supply.
In Peterborough, the public health unit has documented a small number of cases where ineligible people have received vaccines, and this information has been released in a transparency report.
The report includes information for all clinics that are coordinated by the health unit, but does not cover vaccines given at pharmacies.
I took a look through the report, did a little more digging, and here’s what I found.
Doses administered out of sequence
As of today, there have been seven incidents where vaccines have been administered out of sequence. The total number of out-of-sequence doses is between 40 and 50, which is remarkably low compared to the 66,045 doses that had been administered in total as of Thursday.
The majority of the incidents were in March, during long-term care home vaccinations or during the first two weeks of mass vaccination clinics, which started on March 19.
All but one of those cases were situations when doses were left over at the end of the day and were given to people who were not eligible in order to avoid wastage. The report notes that “when the vaccine is thawed it cannot be frozen again and is only viable for a few hours after being thawed.”
In six cases in March and April, to prevent wastage of the limited supply of COVID-19 vaccines in our area, clinic staff administered doses to available community members, volunteers or staff at the clinic facilities.
The one exceptional case was due to an administrative error when hospital clinic staff at Peterborough Regional Health Centre (PRHC) mistakenly invited ineligible members of the Peterborough Police Service to receive their first dose.
At the time, March 23, only frontline officers were eligible for the vaccine, and the invitation to sign up for an appointment was mistakenly sent out to non-frontline workers as well. Peterborough Currents has learned that there were fewer than 10 doses administered to ineligible police staff (PRHC declined to give an exact figure in order to maintain confidentiality).
Standby list reduces number of doses administered out of sequence
In late March, the health unit developed a standby list as a means of reducing the number of doses administered out of sequence, and that accounts for fewer incidents reported.
“The residents on the back up list are eligible to receive the vaccine and therefore a report is not required,” writes Dr. Rosana Salvaterra, Peterborough’s medical officer of health, in an emailed statement to Peterborough Currents.
Earlier this month, the health unit opened the standby list up for people to sign themselves up online, though it is currently closed for new submissions.
Dr. Salvaterra says the standby list has been capped at 100 people. ”This is for two reasons,” she writes, “we need people to be able to look at their next two weeks and confirm they will be within 15 minutes driving distance of a vaccine clinic from 3-5 p.m. each day in case they are called. 2) We do not want to have people wait on the list for weeks and by the time we call, they have already received their first dose. It is important that we can count on the majority of the people on our list to answer their phone and be able to get to a clinic and receive their first dose.”
Salvaterra notes that there is no set date for reopening the list but will open as more names are needed and close when it reaches that threshold. She encourages residents to check the site regularly to see if the list is accepting names.
Transparency builds trust, white paper finds
The transparency report is prepared as part of the Peterborough Inter-agency Vaccine Planning Team (PIVPT) which was developed by Peterborough Public Health to coordinate the local COVID-19 vaccination plan.
According to their website, “The goal of the PIVPT is to provide every eligible resident of Peterborough County, City, Hiawatha First Nations, and Curve Lake First Nations with access to the COVID-19 vaccine.”
This inter-agency coordination and transparency is consistent with several white papers on the topic of effective vaccine rollout.
A recent white paper on vaccine acceptance published by the Canadian Vaccination Evidence Resource and Exchange Centre (CANVax) identifies confidence as one of three key factors in whether individuals will be hesitant to accept immunization (complacency and convenience are the other two).
“In Canada,” they write, “over 80 percent of parents choose to vaccinate their children. Although this may appear positive, it is one of the lowest vaccination rates in the western world, and does not meet the 95 percent coverage rate needed to prevent outbreaks of vaccine-preventable diseases such as measles.”
Viral diseases are kept under control through mass immunization which keeps the numbers of new infections low. However, these mass immunization programs require a baseline percentage of the population to be vaccinated in order to be effective.
Vaccine hesitancy is one of the World Health Organization’s top ten threats to global health because it is a risk to those baseline immunization numbers.
In Canada, vaccine hesitancy can be those “who perceive that vaccines are for “mild” diseases, who question the utility of vaccination and lack trust in the information presented on vaccination,” writes the authors of the vaccine acceptance report.
The authors of the report also write that fostering vaccine acceptance happens by building and maintaining trust in immunization. Among other strategies like understanding and addressing concerns, and presenting immunization as the norm – planning ahead and transparently communicating about processes builds trust.
Effectively communicating between sectors and front-line workers, and communicating directly with the public all helps to build trust, they write. And building trust is what improves vaccine uptake figures and brings viral spread under control.