The must-have item last fall in my corner of Toronto was a patio heater. Many of my friends and neighbours had either acquired one or were desperately trolling through shopping sites trying to find a retailer with one in stock. I could rest easy; I had purchased mine early, having learned my lesson from the toilet paper aisles at grocery stores in March and the empty shelves at gardening centres last summer.
The must-have item in the spring of 2021 is of course an AstraZeneca vaccine. Since Sunday evening, when the Ontario government announced it was opening up vaccine registration to everyone over the age of 40, the province has seen the health-care equivalent of a Depression-era run on banks. I signed up for an appointment at a neighbourhood drugstore that first night. I put away my computer feeling content: August 20 at a local pharmacy. I wished it was sooner, but hey, I’d be vaccinated.
By morning, texts and social media posts were flying around about Ontarians getting their vaccines the next day, by week’s end, early May. Within a day or two, many of my friends and acquaintances had got or were soon getting their shots. Some people lined up for hours outside pharmacies. Some travelled to hard-hit hot spots in the city—Mississauga, Thorncliffe Park, Scarborough—where appointments were suddenly available. A few people drove from drugstore to drugstore in hopes of finding an appointment. Inevitably, I also heard stories of people fudging birthdays, lying about their age, lying about taking care of a relative at home, trying repeatedly at hospitals till they got a jab, using their connections to upgrade to the more coveted Pfizer shot. This wasn’t confined to Ontario. “Beginning to wonder if I’m the only person in Vancouver over 40 who isn’t fibbing abt being an essential worker or somesuch,” the journalist Ian Young tweeted yesterday.
It took me a day to figure out why my shot is months away. Ontario has a patchwork of pharmacies, grocery stores and retailers providing vaccines, each with its own registration and vaccine supply. The online registrations aren’t reliable—some people got calls while others didn’t. Some phoned around and found cancelled appointments. Many were using Vaccine Hunters Canada, the Twitter account that has become the best source of the latest information on jabs. Vaccine Hunters is marvellous, but many openings I saw were in areas with high COVID rates and populations of essential workers. I ignored them, figuring they weren’t intended for me, a freelance journalist who works from home a half-hour away. And I was reluctant to pester frazzled, overloaded drugstores by phone. So I got on a few waitlists and left it at that.
I have a more fundamental objection, though. Getting a vaccine should not rely on a kind of alchemy involving copious free time, ingenuity, a flexible work schedule, a car, the research skills to manoeuvre through a chaotic sign-up system, technological resources including internet on demand, and, ideally, loads of social capital—friends and connections with good intel. That seems a terrible way to get jabs into the arms that need them most.
Most people lining up their vaccines likely assumed front-line workers are being taken care of by the government—a reasonable premise. But while essential workers are eligible for vaccines, there appears to be no process in place to give them priority or ensure they can actually access vaccines. Those trying to sign up before the AstraZeneca rollout encountered an even more convoluted system: the provincial site, individual public-health-unit portals, separate rules for each pop-up vaccination site. Many didn’t know if or where they were eligible to get the jab.
When I called my local pharmacy Monday to ask if they had vaccines, a woman with a strong accent—Middle Eastern? Eastern European?—told me, “No, I need one too. I don’t know where to go.” I gave her a URL, feeling guilty for not passing on better advice.
I also called the grocery store where I shop to see if workers there were getting their vaccines. I knew a few were anxious to get vaccinated. The employee who answered was hesitant—“you know, privacy concerns,” she said—but eventually she told me it’s not about where you work, but about postal codes, and that grocery workers are not a priority group for the government, so they have to wait. My heart sank. She was half-right; they are technically a priority group, but her reply reflected a very real gap between what people are allowed and what they can reasonably access.
By Tuesday, the CBC reported, Walmart and Costco, along with other major retailers, had run out of vaccines. St. Michael’s hospital in Toronto, which has been vaccinating under-served priority groups, had run out too. As of Wednesday, West Park Healthcare Centre, in a hot spot, was struggling to keep up with demand. One essential worker who was eligible for a shot there couldn’t get one because the vaccines were all gone; when her employer called clinics in Rexdale on her behalf, it turned out they were only vaccinating people over 40, and had run out anyway. Access, not vaccine hesitancy, was the barrier; as both The Local and Toronto Star reported, people lined up for hours at pop-up sites in the Jane and Finch area to get their shots.
By mid-week many of the newly available vaccines were gone. Like tomato seeds and swimming pools and patio heaters and skis last year, they had been scooped up—only this item was of the life and death variety, particularly for higher-risk people who work in grocery stores, warehouses and factories, or live in apartment buildings, or take public transit to get to work. This was their shot at protection—or it should have been.
I don’t blame my vaccinated friends and neighbours, who were answering what amounted to a civic call to duty: Your country needs YOU to get your jab! That message was everywhere—and rightly so. We do need vaccinations for all. Moreover, the province has been in COVID freefall, with cases climbing and lockdowns on top of untenable lockdowns. People were doing their part. Many were not breaking any rules. Vaccines were available, and like parents dutifully rising at 6 a.m. to sign their kids up for swimming lessons or summer camps before the spots are all gone, the people who had the time and resources used them.
There should be no shame in this for citizens. People who get vaccinated, wherever they do it, are helping to build herd immunity. Vaccine hesitancy, not overzealousness, is the concern of our times. The problem isn’t with citizen behaviour; it’s with the policy making. The haphazard way in which vaccines were rolled out this week exacerbates terrible patterns of the past year when it comes to disadvantaged Canadians.
How did we go from last Friday, when vast numbers of front-line workers were still awaiting their vaccines, to Sunday, when everyone over 40 was eligible to navigate this mess? How would an overburdened shift worker compete with a 40-year-old accountant or lawyer to navigate the “Gogolian morass” that is Ontario’s vaccine sign-up, as The Globe and Mail’s Adrian Morrow put it? Would they have time to scroll Twitter relentlessly, looking for a vaccine site they could get to? Could they check that “get to a clinic in one hour” box to take advantage of a cancellation? Would they have time to sign up on 10 different waitlists, as many people I know did? Or the time off to line up for a shot, and recuperate from the side effects?
Even the rules were confusing. I had indicated on my form that I was under 55, it being true and all. “I think you’re supposed to attest you’re over 55,” a friend who has still not registered told me Tuesday. She’d seen a pharmacist on social media advising people to do this because pharmacies hadn’t updated their websites yet. “If you are pissed off at how many different pharmacy chains/locations you have to register with to wait for #AZ vax,” University of Carleton professor Jennifer Robson tweeted Wednesday, “… you should want governments to invest in their own digital service capability.”
The bigger issue is that Ontario’s vaccine rollout is failing the same group that was failed with partial lockdowns and pleas to “Stay Home.” The government told Ontarians to stay home when it was clear a swath of vulnerable residents couldn’t; now it is telling us to get vaccinated, even as its convoluted system means many of those vulnerable residents can’t access vaccines.
The AstraZeneca rollout has only compounded an existing problem. For months, Ontario’s Science Table had advocated vaccination priority based on hot spot areas in addition to age, Sabina Vohra-Miller, co-founder of the South Asian Health Network, pointed out in an interview. “And we’ve had modelling data that showed that prioritizing essential workers gives us community protection for everyone. That didn’t happen.” When the AZ rollout began, said Vohra-Miller, “what we should have done is put more AstraZeneca into [pharmacies in] areas that have higher COVID transmission. But we didn’t do that.” The hot spot of Brampton had eight pharmacies per 100,000 offering AZ vaccines; meanwhile, Kingston, with famously low COVID rates, had 26 per 100,000. “Northwest Toronto had barely any pharmacies giving out vaccinations in the initial days of the pharmacy,” said Vohra-Miller. “And there were zero in Peel, completely zero.”
Some pharmacists, including Toronto’s Kyro Maseh, have taken up the challenge, inviting front-line workers to bring proof of employment and get a shot, no appointment needed. A few drugstores are offering extended hours, which Vohra-Miller considers vital. Not all shift workers can come in during regular hours, and some, she notes, work multiple jobs. Municipal health units, too, have stepped into the breach. Toronto is launching a mobile program to triple the number of vaccinations in the city’s hottest hot spots in the coming weeks. But that’s not a system-wide response. “The only way you reach the communities that are hard to reach as if you take that very thoughtful, very intentional approach to making sure that they are not left behind,” said Vohra-Miller. This rollout “has not been intentional from the get-go. It’s been haphazard. It’s been deeply inequitable.”
Nevertheless, days after announcing draconian lockdown measures that ignored the recommendations of experts—such as closing non-essential workplaces and mandating paid sick leave, which Premier Doug Ford finally pledged today—Ontario had changed the channel. The province was on the brink of mutiny; but vaccine hunting is an excellent distraction. Who’s still thinking about that brief experiment with shuttered playgrounds and police stops? We’re too busy trying to get the last of the scraps before Canada moves back into vaccine famine, or dealing with the side effects of the vaccine, or celebrating that hard-won jab.
The moment of celebration is understandable, and overdue. My Twitter feed overflows with pictures and notes from happy vaccinated people. More than 125,000 Ontarians a day are getting vaccinated—great progress. But which Ontarians get to celebrate is a question worth asking. Some of us are at far greater risk of getting sick and dying from COVID. Shouldn’t that group be protected first? For everyone else, shouldn’t the joyous moment of getting vaccinated come untarnished by guilt or regret?
I have a friend who cancelled her appointment this week; she discovered the vaccine site was in a hot-zone postal code and decided she couldn’t live with that. But this is a problem for governments, not individuals, to tackle. And beyond the obvious moral obligations, there will be consequences if governments don’t. Dr. Michael Warner, director of Critical Care at Michael Garron Hospital in Toronto, made a startling point Wednesday: “For teachers/staff to be fully vaccinated when class resumes in September,” he tweeted, “they need their 1st shot in the next 2.5 weeks.” That’s saying nothing of child-care workers, who are equally vulnerable and equally important for many families—and who are not yet on the priority list.
This won’t be the last cycle of abundance and supply Canada will face when it comes to vaccines. More than six million Canadians over the age of 40 are still waiting for their jab. Nobody knows when the next shots will come. But when they do, the people at the front of the line should be the workers who’ve kept our world functioning, at great personal risk to themselves. And the people ensuring this shouldn’t be individual citizens forgoing vaccine appointments or guiltily getting a jab, but the government, with an equitable, accessible system that’s fair to everyone.