Mass vaccination strategies have highlighted the importance of two drivers – high throughput and high touch. Large civic centres provide the high throughput that will help immunize large, often healthy segments of the population. But it is only through primary and community care that we will be able to provide the high touch needed to reach segments that are neglected and/or mistrustful of the health-care system.
As deliveries finally resume, it is time to ramp up our vaccination programs and improve our global standing in vaccinations per capita. As of Feb. 20, 1.75 per cent of Canada’s population had received the full vaccine schedule compared to 13.5 per cent in the U.S. and 20 per cent in the U.K.
Supply issues haven’t been the only hitch. A significant contributor has been the lack of a clear, well-communicated national plan. Existing plans have been piecemeal as the federal government defers to the provinces, which then defer to certain hospitals. Other hospitals and their staff are then left to plead for vaccinations for their frontline staff.
Vaccination plans in the U.K. and Australia (two countries with similar health-care systems) have demonstrated how important nationally administered plans are for facilitating efficient and equitable vaccine rollouts. For example, the U.K.’s National Health Service coordinated deliveries with the military and the inoculations with primary care workers and volunteers, while Australia applied a detailed national vaccination strategy that was communicated to the general public. South of our border, West Virginia has undertaken a remarkably successful vaccination program by mediating partnerships between health authorities, local pharmacies and community physicians to administer vaccines.
All of the above jurisdictions have set up large vaccination centres that accommodate a high throughput of people. These centres have web portals or telephones for booking appointments and rely on self-motivated, technologically savvy individuals to get their vaccinations. Yet they have simultaneously engaged primary care to drive a complementary, high-touch approach to target underserved, medically complex and vaccine-hesitant segments of the population.
Meanwhile, in provinces like Ontario, family physicians have been calling continuously to be involved and engaged in the vaccine rollout, particularly as the province continues to bumble its way through the rollout and focus on pilots for vaccinations at pharmacies without any mention of primary care. Campaigns such as #ReadyToVaccinate clearly demonstrate the willingness of family physicians to dedicate time and expertise toward vaccinating patients in their respective communities.
Family physicians and pharmacists also have thorough insight on which members of their community are at higher risk of developing severe COVID-19 and are therefore capable of ensuring that those members are prioritized. Given that not every Canadian has reliable internet access nor is capable of navigating government websites, our community physicians and pharmacists are a reliable medium in ensuring that the vaccine rollout is as efficient and equitable as intended. As noted by Sohail Gandhi, Ontario’s Medical Association Immediate Past-President, family physicians in Ontario alone are capable of delivering 1 million doses per week.
Overall, our current vaccination strategy has not been ideal. We must now learn from both our own systemic shortcomings and from the success of other countries to ensure our nation’s health security. We must improve communication and transparency between the public health authorities and the general public and provide clear insight to individuals in high-priority groups about when and where they will be vaccinated. Importantly, we must bolster our infrastructure by involving family physicians and pharmacists in the rollout plan. Together, this can ensure success in vaccination plan while reducing the potential for inequities.