Immigrants. The working poor. Essential workers. Third doses lag in Toronto’s most vulnerable areas; Let’s celebrate Toronto’s vaccine success story

Not that surprising as they lagged with earlier doses as well.

Throughout the COVID-19 vaccine rollout, Torontonians have watched as neighbourhoods home to those experiencing some of the harshest outcomes of the pandemic have had among the lowest vaccination rates

Now, as public health and community organizations work on the ground to improve third-dose uptake, new data from the Gattuso Centre for Social Medicine at University Health Network lays bare the stark demographic differences between the Toronto neighbourhoods with the highest rates of third-dose vaccination and those with the lowest. 

What it shows in granular detail is that many of our most vulnerable citizens — immigrants, the working poor and essential workers in trades and manufacturing — live in areas where third-dose vaccinations just aren’t happening anywhere near the rates seen in some of Toronto’s richest and least-racialized neighbourhoods. 

For example, 71 per cent of the population is racialized in the bottom 20 per cent of Toronto neighbourhoods ranked by third-dose uptake. That compares to just 24 per cent in the top 20 per cent of neighbourhoods with the highest rates of third-dose vaccination. 

Similarly, the percentage of the population that meets low-income thresholds in the areas with the lowest third-dose vaccination rates is nearly double that in neighbourhoods with the most administered. 

“It doesn’t need to be this way. There was great success in narrowing the access gap for the rollout of Dose 1. It can be done again. We can’t afford not to,” said Dr. Andrew Boozary, executive director of the Gattuso Centre.

“If we don’t address the pathologies of poverty, if we don’t shift more public investment into these neglected neighbourhoods, we will continue to see worse health outcomes and wider health disparities than we’ve ever seen.”

The Gattuso Centre’s analysis also shows that neighbourhoods with the lowest third-dose uptake have higher proportions of essential workers in manufacturing, utilities, trades, transport and equipment operation — sectors that don’t conform to regular nine-to-five workdays and that are not conducive to allowing workers to take time off to get vaccinated during clinic hours.

Indeed, the percentage of the population working in manufacturing and utilities is 10 times higher in areas with the lowest rates of third-dose vaccination than in those with the highest rates. Likewise, the percentage of people employed in the trades, transport and equipment operation is more than four times higher in the bottom 20 per cent of Toronto neighbourhoods by third-dose vaccination than in the highest 20 per cent. 

“If racialized community members are getting their third doses at a third of the rate compared to non-racialized communities, we need to make specific, targeted interventions that are going to provide information in a culturally appropriate and safe way for these communities,” said Michelle Westin, senior analyst for planning, quality and risk at Black Creek Community Health Centre who has been leading mobile vaccination clinics in northwest Toronto.

“We need to be having ambassadors that are representative of these communities to help build that trust. We have to have vaccinators that are representative of these racialized communities. We need to make sure that vaccinations are accessible to people who are low income, so ensuring that they are in spaces that they can get to easily, assist with providing transportation if needed, ensuring that hours of the clinic work with folks that are having to work different hours of the day and multiple jobs,” she added.

The city of Toronto has been waging a three-pillared operation to get shots into arms in the neighbourhoods with the lowest uptakes. This includes hyperlocal clinics in malls, transit stations, workplaces and schools; outreach around these clinics through 155 community agencies and more than 400 neighbourhood vaccine ambassadors; and a get-out-the-vote style campaign, dubbed “VaxTO,” using text messages, phone calls, emails and town halls to get information out.

“We know that when we announced our target to reach 90 per cent of residents for their first dose, people told us it was impossible in a city as large and diverse as ours. We proved that it was possible when you commit to equity and you don’t stop,” said Coun. Joe Cressy, chair of the Toronto Board of Health. “You literally have to go door-to-door, building-by-building in every language with trusted local leaders. It’s not quick because tackling inequity is never quick. But it works.”

To date, 60 per cent of eligible residents in Toronto have received a third dose. 

But there is still a long way to go. The Gattuso Centre found that the gap between the neighbourhoods with the most and least third dose-uptake has widened substantially over the past seven weeks. In Kingsway South, for example, 68 per cent of eligible residents have received a third dose, compared to just 27 per cent in Mount Olive-Silverstone-Jamestown — a gap of 41 percentage points.

“The gap is striking, especially given what we’ve learned throughout the pandemic. We’ve seen real success in earlier stages of the vaccine rollout when community leadership has been supported with the resources and focus to ensure there is true access. It obliterated many notions of vaccine hesitancy early on,” Boozary said.

“But if we stray from that, we will continue to see this widening of a gap and it will not be recoverable if we do not ensure that those same investments and resources and supports are there for everyone.”

Luwam Ogbaselassie, implementation lead with the Gattuso Centre who has been supporting the vaccination effort in the Humber River-Black Creek region, said the involvement of community leadership is key to narrowing the third-dose uptake gap. 

“Wherever there are resources being allocated towards vaccines, it should be guided by community leaders around how best to structure those clinics and how best to reach the people who have been the hardest to reach and continue to be the hardest to reach,” she said, noting that she has seen first-hand the meaningful impact of community ambassadors who live in the same buildings and in the same neighbourhoods as those who may harbour mistrust of the health care system. 

“I’ve always said as a hospital partner, we bring the vaccines, we bring the clinical teams, but we look to our community partners to guide us on how to set up the clinics, how to engage with people who live in the community.

“Community leadership makes all the difference.

Source: Immigrants. The working poor. Essential workers. Third doses lag in Toronto’s most vulnerable areas

On a more positive note:

It’s a snowy Thursday afternoon in Toronto and the vaccination clinic at the Woodbine Mall is getting ready to welcome its first visitors of the day. The news is full of the demonstrations in Ottawa against pandemic restrictions. Similar protests are about to come to Toronto. But at the clinic, the mood is purposeful, unruffled, even buoyant.

Nurses sit at tables filling syringes with vaccine and loading them into trays. Helpers lay out colouring sheets to amuse kids coming in for their jab. One greeter brandishes a little Canadian flag that she waves to show visitors when a booth is free.

As opening time approaches, operations manager Simone Richards gathers everyone for the daily huddle, a combination of pep talk, check-in session and revival meeting. Smiling behind her mask, she warns the group: “We are running low on teddy bears.” The local police station donated a pile of the toys to soothe nervous kids and there are only a few left.

After singing a rousing Happy Birthday for their clinical manager Arturo Villasan, staffers put their hands in, like athletes before a game, for a go-team cheer – except that, pandemic style, their hands don’t actually touch. Then they open the doors to let people through. They get hundreds a day, most of them happy to get the protection offered by the vaccines against COVID-19.

The scene at the Woodbine clinic tells a different story than you see in the headlines. In a week in which all the oxygen was consumed by noisy and sometimes obnoxious protesters, it is worthwhile to remember that most Canadians don’t feel their rights are being trampled by a despotic government. Most believe in vaccines and are eager to get jabbed. Most wear their masks and obey the rules on gathering and distancing. Though it will disappoint the Russell Brands of the world, Canada is not in revolt. Quietly, capably mustering all the available tools of technology, science and human collaboration, the country is getting on with the task of combating a deadly and insidious virus.

Toronto’s vaccination campaign, the biggest in its history, is an impressive success story. More than 6.5 million doses have been administered. Ninety per cent of residents 12 and older have one dose and 87 per cent two. Sixty percent of eligible residents have a booster, the result of a stepped-up Team Toronto drive to meet the threat from the Omicron variant. More than half of kids have one dose and a quarter have two.

To inoculate all those people in a city of 180 languages, dozens of cultural groups and scores of neighbourhoods has been a staggering task. To reach the hesitant, the disadvantaged and the disengaged, the city has hired hundreds of community ambassadors and translators to get the word out. It has dispatched mobile clinics from one end of the city to the other. It has bombarded residents with text messages, robocalls and flyers.

On the same afternoon that Ms. Richards and her team were greeting visitors to their big clinic in a Hudson’s Bay store at Woodbine, workers were going door to door in a Parkdale seniors’ building and soothing nervous kids at a Mount Olive school. At a small clinic in a mall at Jane and Finch streets, they don’t just wait for people to walk in. They recently persuaded the busy lady at the local roti joint to sit for a vaccination right in her shop. Every vaccination counts.

Leading me on a clinic tour, Joe Cressy, a city councillor who is chair of the city’s board of health, called it a brilliant example of breaking down silos and bringing everyone together in a common cause: pharmacies, hospitals, public-health workers; community and neighbourhood associations; cops and firefighters; care homes and schools.

Though we hear a lot these days about conflict and anger, what really stands out is the way all these groups are working arm in arm. As Mayor John Tory puts it, “the city has been united.”

Of course, it’s taking a while. It’s only natural that people are frustrated with the persistence of this virus and the annoying, limiting measures put in place to control it. If some believe that governments are to blame for much of the misery, they have a perfect right to say so, as long as they do it peacefully and lawfully. But while thousands are taking to the streets, hundreds of thousands of others are still lining up to get their shots and do their bit to quell the virus.

Ms. Richards and her Woodbine crew are standing ready to help them, with kindness, efficiency and good cheer. More teddy bears are coming.

Source: Let’s celebrate Toronto’s vaccine success story

About Andrew
Andrew blogs and tweets public policy issues, particularly the relationship between the political and bureaucratic levels, citizenship and multiculturalism. His latest book, Policy Arrogance or Innocent Bias, recounts his experience as a senior public servant in this area.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: