Ontario's vaccine program needs to shift focus to high-risk populations, expert says

Vaccine rollout across the country is targeting people by age and high-risk health condition, but one expert says it’s time to move away from prioritizing age and focus instead on essential workers and people living in COVID-19 hotspots.

Using age as a guide worked early in the pandemic when long-term care homes and elderly people were bearing the brunt of the COVID-19 pandemic, but now frontline workers and other high-risk populations are being left unprotected due to age restrictions.

“I think the problem is that we've been going about this on a somewhat granular level with using age as the primary criteria,” infectious disease specialist Dr. Abdu Sharkawy told CTV’s Your Morning on Wednesday.

Using age as an indicator is a good starting point since increased age is associated with increased risk of mortality, he says, but it’s time to ditch that model.

“What's been missing here is the important nuance of, you know, communities in particular that are harder hit, of high-risk occupational exposures, essential workers, teachers, that sort of thing,” he said.

While that’s largely the case across Canada, Sharkawy thinks the Maritime provinces are handling the vaccine rollout better than most.

“You can't just use a blanket template with age alone and be comfortable that that's going to take care of things and frankly I don't think anyone has done that in an ideal manner across Canada,” he said.

It’s not too late to change course and adjust who qualifies for vaccines he said, and teachers should be at the top of that list.

“It's absolutely reasonable, and in my opinion important, to target teachers and everybody working in school environments,” he said. “I think we can all agree how important it is to keep schools safe and to try and keep them operational for as long as possible.”

Officials should look to the data, says University of Toronto bioethicist Kerry Bowman, and if it shows that infection rates are increasing among essential workers they should be bumped up the list.

“If the essential worker data is strong and compelling. Absolutely. What I would say is, at the beginning of phase two, that they be much more integrated, not left until the end, if the data supports that,” he told CTVNews.ca in a phone interview.

Looking at Ontario’s COVID-19 infection rates and the number of cases in schools, Sharkawy said that it will be difficult to keep them from skyrocketing without teachers getting vaccinated.

People who haven’t been vaccinated yet are the ones ending up critically ill, and a lot of them are young workers with public facing jobs, said Sharkawy.

“Those are a lot of the same patients that are ending up in hospital right now, whole families of them. And some of them are ending up in the ICU,” he added.

Other hospitals are also seeing younger patients end up hospitalized with COVID-19.

“If you can imagine on Monday, six patients with COVID-19, just my shift alone, two went to the ICU and two were hospitalized and they were pretty young,” emergency room physician Dr. Lisa Salamon told CTV News Channel on Wednesday.

The way to best protect the people working public-facing, essential jobs is to ensure they are vaccinated quickly.

“We've got to be pragmatic and practical, and we've got to attend to the people that are clearly at higher risk right now, and that may not be just related to an underlying medical issue or age.”