COVID-19 Vaccination — what we know so far

• Presentation
• Recording of the session is found below!

• Presentation
• Summary – including how to sign up as vaccinators!
• Recording of the session is found below

Presentations:

• About the Ontario Primary Care Vaccination Action Council (PC-VAC) – Dr. Dominik Nowak, co-chair
• COVID-19 Vaccine-Effective Approaches to Build Confidence – Dr. Noah Ivers, co-chair, PC-VAC
• Middlesex-London Health Unit COVID-19 Update – Dr. Alex Summers, Associate Medical Officer of Health
• COVID-19 Vaccination Town Hall Summary – January 26, 2021

A three-phase immunization plan has been developed for Ontario identifying and prioritizing populations to receive the COVID-19 vaccine. The population served by each local public health agency is unique: varying in size, risk for infection, characteristics and geography. Ontario’s three- phase plan will require local adaptation to meet the specific needs of the region’s population.

The Ontario COVID-19 Vaccination Distribution Plan considers a variety of vaccination site types to ensure that targeted populations will have appropriate and effective access to the vaccine. A mix of mass immunization clinics, mobile clinics and on-site clinics will be required.

Coordinating and implementing a rapid vaccination program of this magnitude will require significant planning by the local public health agencies and its partners. It is expected that local public health agencies and local health partners will actively and consistently work together to maximize distribution in a safe, timely and equitable manner.

In alignment with the provincial immunization plan, the Middlesex London Health Unit (MLHU), Southwestern Public Health (SWPH) and Huron Perth Public Health (HPPH) have partnered to build a robust and detailed planincluding an overall approach to the storage and handling of the vaccines, planning and deploying immunization clinics, partnering with stakeholders to support the immunization clinics, and ongoing communications and engagement of partners and eligible populations.

Unfortunately, within the province’s first phase, there is insufficient vaccine to immediately vaccinate all eligible individuals at this time. To address this gap, the province has entrusted public health units to further prioritize within Phase 1 of the rollout. 

Locally a COVID-19 Vaccine Prioritization Advisory Committee has been established. Membership of this committee includes representation from the MLHU, SWPH, HPPH, acute care, primary care, emergency services, long-term care, infectious disease, and medical ethics. This committee first met on Tuesday January 12, 2021. A memo from this committee was released on Wednesday January 13, 2021. 

The London Middlesex PCA created a COVID-19 Vaccination Working Group and met with the MLHU on January 11, 2021. The Vaccination Working Group’s purpose is as follows:

1. To coordinate the London and Middlesex Primary Care sector in the COVID-19 vaccination rollout. 
2. To decrease vaccine hesitancy in the London and Middlesex community.

Residents, staff, and essential caregivers of long-term care facilities and retirement homes have been prioritized by the province to be the first recipients of the COVID-19 vaccine.

However, in the early days of the vaccine roll-out, there will not be enough vaccine for all facilities to receive the vaccine at the same time. Some facilities will go first whereas other facilities will have to go later. The province has specifically indicated that long-term care homes are to be prioritized over all other congregate care settings.

In planning for the deployment of vaccine to facilities in the Middlesex and London region, the MLHU has determined the sequence of facilities that will receive the vaccine using the following criteria: 

• Long-term care homes will receive vaccine before retirement homes, as the residents of these facilities are generally more medically vulnerable. If a retirement home is physically co-located with a long-term care facility, vaccine will be made available to that retirement home on the same day it is provided to the long-term care home.
• Facilities that are currently in outbreak will receive vaccine earlier as there is an acute risk of COVID-19 in those facilities.
• Facilities that have had more than one COVID-19 outbreak during the pandemic will receive vaccine earlier as the risk of a future outbreak is higher.
• The order for all other remaining facilities will be randomly selected.

It is estimated that all long-term care residents will be offered vaccine by the end of this week. Retirement homes and other senior-focused congregate settings will follow if there is vaccine supply.

In Ontario’s plan, all healthcare workers are to be vaccinated in Phase 1 which is targeted to span from January to the end of March. However, as mentioned above, limitations of vaccine supply are creating a scenario where prioritization within Phase 1 has to take place. As increasing number of doses become available and priority sectors with a higher level of urgency and criticality are vaccinated, primary care providers will be offered the vaccination. 

In the current provincial plan, vaccination in primary care practices is scheduled to begin in April with Phase 2, though large primary care practices may be administering the vaccine as early as March. Phase 2 vaccinations would include the following patient groups:

• Older adults, beginning with those > 80 years of age and decreasing in five-year increments
• Individuals living and working in high-risk congregate settings
• Front line essential workers (e.g., first responders, teachers, food processing industry)
• Individuals with high-risk chronic conditions and their caregivers
• Other populations and communities at greater risk of COVID-19

Mass vaccination clinics have been established at the Western Fair Agriplex, the North Optimist Community Centre and the Caradoc Community Centre (Mt. Brydges) to serve the regions of the MLHU, SWPH and HPPA.

One additional mass vaccination clinic is anticipated to open in London as more vaccine becomes available.