Pharmacy vaccine rollout in Ontario leaves hard-hit communities with limited access to vaccines

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Pharmacy vaccine rollout in Ontario leaves hard-hit communities with limited access to vaccines



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A month after Ontario began shipping COVID-19 vaccines to pharmacies across the province, CBC News analysis shows some of the worst affected neighborhoods are still waiting while other communities with higher infection rates. weak have a disproportionate number of pharmacies offering injections.
The disparity suggests a gap in what the province sees as a key pillar of its immunization program.

The Department of Health said by the end of the week it intended to have authorized 1,400 pharmacies in the province to administer the AstraZeneca-Oxford vaccine. It has increased the number of locations by the hundreds at a time since March 10.

The Department of Health has increased the number of pharmacies offering COVID-19 vaccines by the hundreds at a time since March 10. (CBC News)

A CBC News analysis found that in the 10 Toronto neighborhoods with the highest COVID-19 infection rates over the past month, 19% of retail pharmacies are offering the vaccine.

However, in the ten neighborhoods with the lowest infection rates over the past month, 43% of retail pharmacies offer the vaccine.

Additionally, two of Toronto’s 10 neighborhoods with the highest COVID-19 infection rates still don’t have a single pharmacy offering the vaccine: Maple Leaf and Humbermede, both located northwest of the city.

While there are mass vaccination clinics in this part of town, community advocates say for many people a visit to their local pharmacy would be a more convenient and potentially less intimidating option. Many people already turn to their pharmacist for information on the vaccination program.

“It has been extremely difficult for many residents,” said Pablo Vivanco, director of programs and services at the Jane / Finch Community and Family Center, who advocated for better access to the vaccine in neighborhoods in the northwest. “Sure, that’s something someone should answer for. “

Pablo Vivanco, director of programs and services at the Jane / Finch Community and Family Center, says he wants better access to vaccines in neighborhoods in northwest Toronto. (Dave MacIntosh)

Similar differences can be seen across Ontario.

In Ottawa, for example, which also saw an increase in cases during the third wave of the pandemic, only 13% of pharmacies offer the AstraZeneca-Oxford vaccine. The province said on Sunday he plans to make it available in 79 other locations around the city by the end of the week.

In contrast, 64 percent of Kingston’s retail pharmacies are giving away the chance since the start of March. Kingston is not considered a hotspot based on the province’s own confirmed case data.

Pharmacies say they can’t meet program criteria

After initially being criticized by some doctors and residents of Toronto who qualified the distribution of the first 300 vaccination sites unfair, the province has pledged to prioritize pharmacies in vulnerable areas with a high number of COVID-19 cases.

Toronto’s Humbermede neighborhood, which stretches about three kilometers east to west in a northwest corner of Toronto, has just five pharmacies to serve a population of over 15,000 people, many of whom live in one low income areas of the city.

None of the five retail pharmacies in the region offer the AstraZeneca-Oxford vaccine.

CBC News has contacted the five pharmacies to ask them why they do not offer vaccines.

Two said they did not have enough space to deliver vaccines, while two others said their pharmacy did not meet the province’s selection criteria, but would like to start providing vaccines. One did not respond to the CBC’s request for comment.

“I would like to help,” said Hatem Abou El Nile, who is a pharmacist and director of Finch-Weston Medical Pharmacy. “I have the infrastructure to store the vaccine, I am trained to give injections, then I would need the green light to leave. “

Abu El Nile says he initially did not register because his pharmacy did not participate in last year’s flu vaccination campaign, which was one of the province’s conditions for approving the pharmacies to administer the COVID-19 vaccine.

Pharmacies must also commit to administer a minimum average of 40 injections per day, according to the Ontario Pharmacists Association website.

Abu El Nile says he has received frequent inquiries about the vaccine in recent weeks, and has seen a worrying spike in clients reporting COVID-like symptoms.

“Something needs to be done to expand the immunization program to the area where it is really needed,” he said.

His pharmacy has been part of the neighborhood for 25 years. He says many of his clients do not speak English as their first language and do not have easy access to the internet, instead trusting him and his staff to explain the risks and importance of being vaccinated against the disease. COVID-19.

“We encourage them to register,” he said, “but the point is that some of them would also have difficulty making appointments online. Here, the role of the pharmacist is to fill these gaps ”.

These gaps, including the disparity in access to vaccines found in the CRS pharmacy analysis, should have been pointed out earlier in the process, says Ashleigh Tuite, infectious disease epidemiologist and assistant professor at the Dalla Lana School. of Public Health at the University of Toronto.

“We need to look neighborhood by neighborhood, especially in these hot spots, and do exactly what you’ve been doing, which is to reach out and understand what those barriers are and find solutions,” Tuite said. “I don’t think we should just put our hands up and say, ‘Well, we tried this and it didn’t work. Oh good.’ ‘

Pharmacy deserts in low-income communities

Beyond the province’s selection criteria, CBC News analysis highlights a systemic problem that could also make it harder to get vaccines out: many of the most vulnerable neighborhoods don’t have many retail pharmacies.

The Maple Leaf neighborhood, a community of 10,000 people in northwest Toronto, just outside Humbermede, has no pharmacy at all. This means that residents may have to weigh the risks of exposure to COVID-19 associated with a long public transport trip to get to a vaccination location at a pharmacy.

In Toronto, nine of the ten neighborhoods with the most retail pharmacies per capita also reported infection rates well below the city average last month.

According to infectious disease epidemiologist Ashleigh Tuite, it may be time for the province to revamp its vaccine deployment strategy in some hard-hit communities. (Nick Iwanyshyn / University of Toronto)

“If you have a vaccine distribution plan that really relies on using pharmacists, you should start by checking that it can get to the neighborhoods you want to go,” Tuite said.

It is time for the government to rethink its strategy, she said. “One of the things that has become really, really clear is that it’s not a one-size-fits-all approach. “

Tuite says she wants the province to think creatively, perhaps by choosing other stores or community spaces more evenly distributed around the city and bringing in pharmacists.

The Department of Health did not respond to specific questions from CBC News about the vaccination rollout in the province. In addition to pharmacies, the government also distributes vaccines to mass vaccination sites and mobile clinics, and Premier Doug Ford announced on April 13 that the province is exploring other delivery options such as mid-range clinics. job.

METHODOLOGY: HOW DID CBC NEWS ANALYZE THE IMMUNIZATION DATA?

CBC News collected the name, geographic address and other details related to all COVID-19 pharmacies vaccination sites posted on the Government of Ontario website between March 10 and April 12, 2021. We identified the date each pharmacy’s name first appeared by comparing More than 300 pharmacies initially chosen to deploy the vaccine (March 10) to 300+ added later (March 29) and additional slots announced in the last extension (April 11). We then compared the geocoded address of each pharmacy offering the vaccine against all retail pharmacies in the province. Our analysis also took into account the rate of COVID-19 infection per 100,000 population. As the government’s vaccination strategy remains heavily dependent on pharmacies, mass vaccination sites and mobile clinics were not included in this analysis.

(Data analysis: Valerie Ouellet & Dexter McMillan, CBC News)

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