H1N1 shots available at family clinics in Toronto
Last Updated: Tuesday, November 3, 2009 | 9:04 PM ET
By Christine Peloquin, CBC News
A registered nurse stores prepared syringes of H1N1 flu vaccine in a fridge at a Toronto medical clinic last week. (Darren Calabrese/Canadian Press)Some family doctors in Toronto have started administering the swine flu vaccine as part of the Ontario Ministry of Health's effort to reduce lengthy lineups at mass clinics.
The ministry first offered family clinics the opportunity to participate in the immunization program about three weeks ago, but some doctors declined because they felt they could not meet the requirements, said Dr. Akhlaghi Fatereh from the Willowdale Medical Clinic in North York.
Doctors were initially told they would have to fill out additional paperwork after each dose of the vaccine they administered to ensure they were serving people who were in one of the high-risk groups identified by health officials.
"We didn't participate before because the paperwork seemed very intimidating," said Fatereh, "I'm already overworked, and I didn't think I could administer it."
That requirement has since changed. Ontario's health ministry has reduced the amount of paperwork required for each dose of vaccine administered, and the forms can now be filled out electronically, making it easier for family physicians, said David Jensen, a spokesperson for the ministry.
Clinics were also told they could order the vaccine only in 500-dose increments. Such large amounts pose a problem for smaller clinics because the vaccine doses must be stored in huge, ministry-approved refrigerators to ensure they are not wasted.
"I understand why public health is applying restrictions for the vaccine, but the larger doses are placing a lot of pressure on smaller family clinics," Dr. Cathy MacLean, president of the College of Family Physicians of Canada, said Tuesday.
'We like to be able to help our patients, but the criteria before were too intimidating.' —Dr. Akhlaghi Fatereh, Willowdale Medical Clinic
The dose requirement has also since been changed, and clinics can now order the vaccine in increments of 100 doses.
Fatereh received an email last week informing her that physicians no longer had to fill out extra paperwork and that the amount of doses and the storage criteria had changed.
"We like to be able to help our patients, but the criteria before were too intimidating," said Fatereh. "I just ordered 200 doses because I don't want to waste it. Just like every flu vaccine, I order what I think we need, and if I can help more people, I'll order more."
Expand role for family physicians
A stronger relationship is needed between public health officials and family physicians to avoid the pitfalls that have plagued the rollout of the H1N1 vaccine, MacLean said.
The vaccine targets the strain of H1N1 influenza A virus responsible for the current swine flu pandemic.
Despite the setbacks, Toronto clinics have begun receiving the vaccine, some as early as Friday.
Queen Spadina Medical Centre — a walk-in clinic in Toronto's west end — had no problem meeting the initial requirements. The clinic received 500 doses on Friday and started administering the vaccine.
Albany Medical Clinic on Danforth Avenue also received 500 doses of the vaccine. It has limited vaccination to existing patients with the highest risk of developing flu-related complications.
Meanwhile, the lineups at the city's mass flu clinics are getting shorter compared to last week.
Nevertheless, MacLean said family physicians are still not being fully utilized and need to be more involved in the vaccination effort.
"I do think it's important for family physicians to play a bigger role in the immunization," said MacLean. "Family physicians are often involved in the vaccination — including seasonal flu — meaning they have a lot of experience providing vaccines.
"Family physicians also know who is at higher risk, because their patients' histories are already known."
