by Dr. Nell Thomas

For the past few weeks, approximately 500 people have been vaccinated daily in each of Minden and Haliburton arenas.

These are primarily people older than 60 years, receiving Pfizer and Moderna.

Pharmacies are immunizing eligible people 40 years and up with AstraZeneca, as is the Haliburton Family Medical Clinic. The EMS paramedics are now providing Moderna for housebound individuals. Pregnant women are now able to receive Moderna vaccines as of this week, giving a powerful shot of antibodies to their infants in the process. Patients with kidney failure are receiving vaccines through their dialysis specialists. Cancer patients are getting vaccinated and are encouraged to book their second shots sooner.

As the Ontario three phase vaccine rollout picks up steam, adding more eligible categories almost daily, our heads are swirling with all the different groups, locations and booking instructions.

And, as of April 13, the strategy has taken another turn. In direct response to high infection rates, scientific analysis has dictated that vaccines be moved to Ontario’s hotspots and to essential workers (bank tellers, food service, police, education, transportation, shipping, trades, sales and services, utilities, construction …).

These are people whose jobs are critical to society’s functioning. These are people who cannot work from home. It turns out that COVID is being spread most by these essential workers.

Until April 8, vaccine eligibility in Ontario was based on age, health conditions, high risk congregate living (LTC homes), and status as a health care worker. Analysis of this approach has revealed that communities and neighbourhoods with high numbers of essential workers have been least likely to receive vaccines using this method. It is now believed that by more rapidly vaccinating people in hotspots, and targeting essential workers, it will prevent considerably more SARS-CoV-2 infections, hospitalizations, ICU admissions and deaths, as compared to Ontario’s initial mass vaccination strategy.

Ontario’s COVID-19 Science Advisory Table is a group of scientific experts and health system leaders who evaluate and report on new evidence relevant to the COVID-19 pandemic and then guide the best response. They provide weekly summaries of evidence, integrating scientific sources and determining the best overall approach. They have shown that the hotspot-accelerated strategy would decrease COVID hospitalizations between April 9 and June 7 by 14 per cent more than the current vaccination approach (6,272 vs 8,003). It would decrease COVID-19 ICU admissions by 14 per cent more (933 vs 1,191), and deaths by 11 per cent more (2,228 vs 2,745) in people 16 years and older, compared to the existing strategy.

As of April 28, 2021, 30.8 per cent of Ontarians had received at least one dose of a COVID-19 vaccine. Evidence is showing that vaccinated people are not only protected directly from getting sick with COVID-19 but are also protected against asymptomatic SARS-CoV-2 infection, and against spreading it to others. Therefore, there is an indirect benefit to people who are not yet vaccinated, as they are protected by those who are. Considering that essential workers are, out of necessity, traveling on public transit, sharing public places, work environments, and taking their community and work exposures home to their families, it is not surprising that the benefit of vaccinating this group is considered to be very high.

In Toronto, neighbourhoods with the highest proportion of essential workers have a threefold higher incidence of SARS-CoV-2 infections compared to neighbourhoods with fewer essential workers. Accelerating the vaccination of essential workers, their families, and other residents living in COVID-19 hotspots is projected to prevent considerably more infections in those aged 16 to 59 years.

They say vaccination of Ontario’s 74 hotspots would be completed within 25 days, assuming vaccine coverage of 80 per cent in those 60 years and above, and 70 per cent in those 16 to 59 years. The remaining vaccines would be distributed equally.

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