As you are aware, the COVID-19 response is changing rapidly.
As mentioned earlier this week, the Primary Care COVID-19 Vaccination Action Council* is very active in provincial advocacy efforts. We are meeting regularly with many partners including the Ontario Hospital Association, Public Health, Ontario Medical Association, Ministry of Health staff and Vaccine Task Force representatives.
Thank you very much for your quick response to our survey from Monday. As of yesterday, 2000+ primary care professionals across the province responded to indicate interest and availability to support rapid vaccination in long term care and retirement homes, should we be called on in the weeks or months ahead.
We also had 20 Indigenous Primary Health Care Council members and associates respond with their readiness to participate with vaccination supports. We are working closely with Public Health Units across the province who will have access to this data and supporting PHUs to partner with their local primary care leaders.
There is a lot of confusion and concern in primary care about a variety of things including the lack of information, who is making decisions about primary care’s role in vaccination, when primary care will get vaccinated and who is leading the efforts.
The following information is what we know so far, but keep in mind that the plan continues to evolve:
- Public Health will be taking the lead role in local vaccination distribution. They have acknowledged that their leadership in vaccination needs to happen in partnership with others including primary care. The 34 Public Health Units are identifying primary care vaccination leads in each of their regions. We are sharing our vaccinator volunteer list with each local PHU to facilitate connections.
- Decisions about vaccine distribution are ultimately made by the Ministry of Health. As you know, the COVID-19 Vaccine Distribution Task Force, led by retired General Rick Hillier, is making recommendations to the Ministry and Premier. There are several other tables that also provide input, but ultimately, the decisions are made by the Minister of Health.
- An approach to prioritizing Health Care Workers for vaccination has been developed and it is anticipated that guidance documents will be available on Friday or Monday. Health Care Workers and staff, depending on the setting, the population served, and their risk factors will be vaccinated in Phase 1 (now until March) or in Phase 2 (after March). Vaccine supply will dictate how quickly each group can be offered the vaccine. We are hearing that there has been an inconsistent approach by hospitals regarding vaccination of hospital staff and community clinicians. We have raised this as a concern, and once the guidance documents are released this issue should be resolved.
- It is anticipated that Primary Care will not have access to vaccines until after Phase 1. With the exception of those participating in outreach teams for high-risk individuals in congregate settings, the main role of primary care for now is to communicate with patients about the vaccine. Numerous webinars and practice tools are planned to support you.
- The database being used for vaccination documentation is called COVAX. Plans are starting to get all Primary Care Physicians, Nurse Practitioners and Pharmacists registered and trained on how to use the database. Health cards are not required to enter patient information into the database and the Ministry has indicated additional fields are continuing to be added, including those that address SDOH.
- Hospitals, Public Health, and the Ministry are working, together with the Primary Care COVID-19 Vaccination Action Council, to develop protocols for rapidly getting the vaccine into ALL long-term care and retirement homes.
- There has been a commitment made for Federal and Provincial bodies to work together on vaccination efforts for Indigenous, First Nations, Metis, and Inuit communities to reduce the amount of confusion and mixed messages. A separate sub-table was created by Indigenous Affairs Ontario for this purpose and the Indigenous Primary Health Care Council participates on the table.
- There has been some confusion about who can administer the vaccine. It has been confirmed that all primary care clinicians, including Physicians, Nurses, Nurse Practitioners and Pharmacists will be providing vaccinations. It was also confirmed that only regulated health providers will be administering the vaccine unless they are already able to vaccinate as per their scope of practice (e.g., EMS, PAs).
- Updated clinical guidance for special populations was released this morning. In short, benefits of the vaccine are felt to outweigh risks for most people that are pregnant, or that have auto-immune conditions or compromised immune systems.
This week we are seeking the following:
- Role clarity between hospitals, public health, and primary care, with emphasis on primary care partnership in PHU vaccine plan.
- Weekly communication that is clear, transparent, and consistent to health organizations with specifics around forthcoming vaccine supply and distribution at provincial and regional levels.
- A standardized approach, while taking into account local rollout, PHUs need transparent and consistent approaches across the province using a health equity framework.
- Tuesday, January 12 at 12:00pm: The College of Family Physicians of Canada is hosting a COVID vaccines update for primary care. Panelists include Drs. Caroline Quach-Thanh (NACI Chair), Gerald Evans (ID physician at Queens University) and Mike Kolber (family physician in Alberta who is part of the PEER/Tools for Practice team). Space is unlimited as it will be hosted on YouTube. Join here.
- COVID-19 Vaccine-Relevant Information and Planning Resources posted on the Ministry of Health website (includes updated vaccine, immunization, and health care provider education documents)
- The Centre for Effective Practice (CEP) website has a section on vaccines that is continuously updated.
- 19 to Zero contains resources for healthcare workers.
- The following are links to letters that you can revise and send to patients to proactively address vaccine hesitancy:
- Answering Patient Questions about COVID-19 Vaccines, Ontario College of Family Physicians.
- Communication to community members and families, Ontario Primary Care COVID-19 Vaccination Action Council.
The primary care associations are committed to communicating with you on a weekly basis to keep you informed. If you have any questions or concerns, please let us know.
Yours in good health,
The AFHTO Team
*Ontario Primary Care COVID-19 Vaccination Action Council:
- Alliance for Healthier Communities
- Association of Family Health Teams of Ontario
- Indigenous Primary Health Care Council
- Nurse Practitioner-Led Clinic Association/Nurse Practitioners’ Association of Ontario
- Ontario College of Family Physicians
- Ontario Medical Association Section on General and Family Practice
- Ontario’s Academic Chairs of Family Medicine