Officials hope for significantly higher vaccine use among the population as a whole, but especially among the age group most vulnerable to death and serious illness from coronavirus infection. Demand for vaccination appointments among people aged 80 and over in Ontario slowed at such a rate last week that the government opened up access to the next age group earlier than expected.
There are several possible reasons why such a large portion of Ontario’s oldest population has yet to join the queue for their COVID-19 vaccinations, according to interviews with experts:
- Reluctance among some seniors to go to mass vaccination sites for their vaccines, either because of transport or mobility problems, or because they fear that this will increase their contact with others and therefore their risk of contracting the disease. virus.
- Limited opportunity to get vaccinated by their family doctor.
- Language, literacy and technological barriers to making a vaccination appointment.
- Concerns persist about the effectiveness of the AstraZeneca-Oxford vaccine and reluctance to take it due to Health Canada’s initial refusal to approve it for people 65 years of age and older.
- Reluctance to vaccination, especially in older people concerned about the interaction with their prescribed medications.
Nearly 200,000 members of the 80+ group are still unregistered
Figures provided by the Ontario government on Monday suggest that about 71% of people aged 80 and over across the province had received at least one dose of a COVID-19 vaccine or had made an appointment for one. .
This means that nearly 200,000 of the oldest Ontarians have not registered for the vaccine.
The current vaccine adoption among Ontarians 80 and over is “one of the most shocking numbers I have seen in some time,” said Dr Nathan Stall, geriatric specialist at Sinai Health in Toronto.
“We really miss a huge number of individuals. ” he said. “Compared to our peers like Quebec, we are far behind in the vaccination of this population. ”
In Montreal, more than 75% of all residents aged 65 and over had received their first vaccine by the middle of last week, according to local health officials.
“We really need much higher rates of, hopefully 90 to 100% vaccine consumption in the most vulnerable population,” said Sophia Ikura, executive director of the Health Commons Solutions Lab, an organization funded by the province that works in the communities. to improve health outcomes.
“If we are to get back to some version of normal, our ability to vaccinate those most likely to end up in the hospital is the best and fastest strategy. ”
Transportation to the vaccination site is a barrier for some
Stall, Ikura and others are calling for multiple measures to make it easier to get older people vaccinated and a concerted effort to help older people who are hesitant about vaccines talk to health care providers they trust.
After administering vaccines directly to seniors at its long-term care and retirement homes, Ontario now relies primarily on the rest of the population over 80 to visit one of 150 clinics. mass vaccination programs implemented throughout the province.
Ikura took part in door-to-door vaccination campaigns in senior apartment buildings in Toronto last week and found the elderly grateful that they did not have to go to one of the 150 sites to find themselves. get vaccinated.
“I heard things like, ‘Oh, wow, I’m so glad you came to our place because I didn’t even know how I was going to get there (in a mass vaccination clinic), and I didn’t. was not sure how I got in line for so long, ”Ikura said.
She said that a personal approach from someone who people think they can trust can ease vaccine anxiety.
“You have to spend time with them,” Ikura said. “Just slow down the conversation, talk about the different types of vaccines, talk about the choices they can make. ”
A limited number of general practitioners have access to vaccines
Ontario has provided doses of the AstraZeneca-Oxford vaccine to approximately 350 pharmacies in Toronto, Windsor and Kingston for people aged 60 and over. The province has also provided a limited number of primary care providers with vaccines for their elderly patients. However, this currently only includes a fraction of Ontario’s 13,000 family physicians.
Family physicians are getting calls from patients asking if they can get the vaccine at the doctor’s office, said Dr. Samantha Hill, president of the Ontario Medical Association.
“A lot of these patients don’t want to go to a pharmacy or a mass vaccination clinic,” Hill said in an interview. “They want to go to a place where they are comfortable. They want to minimize their travel. They want to minimize their contact with others. ”
Hill says it’s completely understandable that some older people – after being urged for a year to protect themselves by staying at home – don’t want any of the options currently available for getting the vaccine.
“The thought of traveling, often by public transport, to a site that vaccinates hundreds of people a day or to a pharmacy where everyone goes in and out freely, is terrifying to them,” Hill said.
Toronto provides support for seniors
The minister responsible for vaccine distribution defends the government’s approach.
“We’ve made sure there are multiple pathways for people who want to get vaccinated,” Solicitor General Sylvia Jones told reporters at Queen’s Park on Monday.
Jones also said there may be more ways to get vaccinated once the vaccine supply increases. Ontario expects to receive more than 550,000 doses this week, mostly of the Pfizer-BioNTech vaccine.
The City of Toronto is already taking several steps to try to increase the immunization rate of seniors by:
- Bring mobile immunization teams to 23 Toronto Community Housing senior apartment buildings.
- Mobilize librarians to call over 35,000 seniors to offer help registering for vaccinations.
- Provide financial support to organizations serving seniors to intervene in their communities.
Dr. Zain Chagla, an infectious disease specialist in Hamilton and associate professor of medicine at McMaster University, says vaccine fears contribute to low use among older people.
“There is a lot of work to be done on vaccine reluctance,” Chagla said in an interview.
“If you see this level of hesitation about vaccines among people at very high risk of dying, what will happen when you go to the [younger] populations that are not really at high risk? ”