Some GTA health units get ahead of others in the COVID vaccine race, to start offering shots to people 75 and up

Seniors age 75 and up in some parts of the GTA are already getting appointments for coveted COVID-19 vaccines, while their peers in Toronto and Peel are still waiting, as part of a rollout that has resulted in a handful of public health units racing ahead.

Dr. Karim Kurji, the medical officer of health in York Region, said the health unit was already “out of the gate” two weeks ago, vaccinating seniors 80 and older. Now that they have inoculated the majority of that age group, York has been left with excess capacity that can be filled by allowing those 75 and up (born in 1946 or earlier) to start booking slots, he said.

They planned ahead and had their own booking systems ready to go, he said, adding they’ve learned bookings start to slump once 60 per cent of a priority group has been vaccinated.

“We thought OK, we don’t want to keep wasting clinic capacity, and then decided to move into the next group, which is a very important group,” he explained, adding that those 75 and older have a high chance of death and hospitalization if infected.

Since opening up bookings to that age group March 18, they’ve had 12,000, he said.

Premier Doug Ford said at a press conference on Thursday that over 133,000 appointments were booked through the provincial portal for people 80 and up Monday, when it launched, despite “a couple bumps in the road,” and close to 400,000 appointments have been made so far in total.

He added as of Wednesday evening, nearly half of Ontario residents 80 and up have received their first dose, as capacity in mass vaccine clinics, pharmacies, doctors’ offices and mobile clinics ramps up, dependent on supply. Some health units are using the provincial portal, others their own sites, and some both.

Halton Public Health also announced Thursday it was opening up appointments for over-75s.

Meanwhile in Toronto, appointments at city clinics can be booked through the provincial web portal only for those 80 and up (born in 1941 or earlier). Some hospitals and Ontario Family Health Teams are also booking through their own registration systems for this age group, Indigenous adults, and adults who get chronic home care.

Peel has developed its own online booking system. William Osler and Trillium Health Partners are also making appointments on their websites. But so far none are open to 75-79 year-olds.

Toronto Public Health spokesperson Dr. Vinita Dubey said in an email the city is following the provincial vaccine prioritization plan, and that Phase 2, when people over 60 can get vaccines starting with those 75 and up and working down, is supposed to start in April.

“As the largest city in Canada and with a corresponding proportionally higher population of seniors 80 years of age and older, in addition to a higher health care worker population, it may require more time to vaccinate this group in Toronto compared to other jurisdictions,” said Dubey, associate medical officer of health. There are about 136,842 people 80 and up in the city, and as of Wednesday, 51,802 Toronto residents in that age group have received at least one dose, she added.

Kurji recommends other public health units use their own vaccination portal as opposed to the province’s site, to be more “nimble” with planning. He also advises units to start booking for the next priority group as soon as reservations begin to taper off for the current group, avoiding wasted clinic capacity, and gaps in reservations.

The next challenge is when to open registration for those with health conditions. Kurji said it’s important to vaccinate the older age groups as quickly possible because many of them have underlying medical issues as well.

Chronic conditions will also require an additional layer of verification, while age can be confirmed on a health card, he added.

Further down the 401 in the Wellington-Dufferin-Guelph Public Health unit, about 81 per cent of the over-80 population (8,226 out of 10,161) has now been vaccinated, said spokesperson Danny Williamson.

They are now moving on to “preregistering” everyone over 60, as well as people with high-risk conditions such as those who’ve gotten organ transplants, and essential workers, including teachers. They’re not booking yet for these people, and it could be as long as six weeks before they get slots, Williamson said in an email..

“But some are receiving calls much sooner. As vaccine supply increases these timeliness will continue to shrink,” he said.

Region of Waterloo Public Health has begun notifying 70-79-year-olds who have preregistered when they can book appointments, although they are still vaccinating 80+ in clinics, said spokesperson Sharon Ord.

People 75 and up started getting vaccines at Brant County Health Unit clinics Tuesday. The unit also has a wait list for cancellations, open to people aged 70-74, spokesperson Ryan Spiteri confirmed.

The kind of approach taken by York and a handful of other units seems to ensure the next most vulnerable people get the vaccine, instead of having unfilled bookings, and rushing to find people to fill the spots, said Ashleigh Tuite, an infectious disease epidemiologist and assistant professor at the University of Toronto.

Being able to respond quickly to a fluid situation, in terms of supply, seems to be paramount to success, she said. “This ability to ramp things up when needed is going to be important.”

Health units may need further guidance on priority groups as they continue to have to choose who they should open up appointments to next, she said.

“Ideally, that should be something that is harmonized across the province. Because otherwise I think it will be difficult.”

Focusing on older populations first needs to be the priority as age is a strong predictor of higher hospitalizations and death with COVID. When health units get to groups that have other illnesses but are younger, it will be more difficult to prioritize, said Tuite.

“It’s frustrating because you want to get to everybody but you can’t. You have to make those decisions.”