As It Happens·Q&A

Government needs to step up and vaccinate people faster, says doctor

Canada's falling behind some other countries when it comes to getting vaccines into arms, and a Toronto infectious disease doctor says there's no need for it. 

Dr. Allison McGeer says provinces should tap public health units, pharmacies and family physicians for rollout

Dr. Allison McGeer is an infectious disease specialist at Toronto's Mount Sinai Hospital. (Craig Chivers/CBC)

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Canada is falling behind some other countries when it comes to getting vaccines into arms, and a Toronto infectious disease doctor says there's no need for it. 

Israel is currently rolling out COVID-19 vaccines 24 hours a day. As of Tuesday, it has given vaccines to 7.4 per cent of its population, according to Oxford researchers tracking the distribution. Canada, where the rollout is being headed up by the provinces, has so far hit 0.19 per cent.

Dr. Allison McGeer, an infectious disease specialist at Toronto's Mount Sinai Hospital, says we can do better — especially in Ontario.  Here is part of her conversation with As It Happens guest host Helen Mann. 

It seems like the COVID-19 vaccine rollout is going too slowly. Is it?

Yes, it is. You know, [there's] no question that we're not doing as well, particularly as the U.K. and the United States, in terms of delivering vaccine. And vaccine is incredibly useful when it's in people's arms, but it's no good to us at all in the freezer.

What is causing these delays?

As always, it's a bunch of factors.

I think it starts with we weren't really expecting to get vaccines in December at all, and so we were caught unprepared.

It's complex because the vaccines we've got have to be kept in the freezer.

It's been difficult because we've been uncertain about how much vaccine [we're] going to get in the next period of time.

But all of those things, honestly, are things that we should have thought about and we should have been able to get past. And we're still using way fewer doses than we ought to be using every day.

[Gen.] Rick Hillier, who is heading up the Ontario vaccine rollout, said that he's working on a plan to be ready when the larger shipments of vaccines start to arrive. I mean, was it your understanding that they were planning for this earlier? Again, why hasn't this happened by now?

You know, I think in truth, the people have been so focused on getting through today and tomorrow that we've not done as much advance planning for anything in the pandemic as we technically ought to have done.

At the rate we're going, it's going to take us probably three weeks to get through the doses that we have in freezers today. And we have more coming tomorrow, and a lot more coming next week. And we really badly need to up our game.

When you look at a place like the U.K. or Israel, which has, I think got 7.5 per cent of its population vaccinated already, what does that tell you about what they're doing right and where the lessons are for us?

I think, first of all, they planned ahead. I think, secondly … they've taken advantage of existing structures, which we have not done for our vaccine programme. They've been more willing to make good decisions for public health rather than than hewing to exactly what the manufacturer says about what the manufacturer would like done.

But mostly, I think it's just been about about preparedness and about using existing structures. And we have done neither of those things.

And when you mentioned the manufacturers, the vaccine producers and their recommendations, we were seeing today the U.K. saying that it is going to go to a single-dose regimen to begin with and not withhold the second vaccines, at least in the short term. Is that something that we should be considering? Rick Hillier did mentioned that as a possibility yesterday.

That's something we've decided to do in Ontario, which is good news. But the truth is at the moment, it doesn't matter because we're not getting through enough doses to actually care about that. 

The U.K. has primary practices giving out the vaccine. The U.K. is taking the Pfizer vaccine to nursing homes. The U.S. is taking the Pfizer vaccines to nursing homes. We have so far resolutely refused to do so.

And I get the fact that, you know, the manufacturer has said you're not supposed to transport it. But it did come from Germany to here, you know? And transporting frozen is something that many other countries are willing to do that we have not been willing to do. If we're willing to do that, we could roll it out to nursing homes today or tomorrow.

Merdina Nangle-Palmer was identified as the first person to receive the COVID-19 vaccine in Hamilton, Ont. She is a personal support worker and chief steward at Parkview Nursing Centre. (Submitted by Hamilton Health Sciences)

You mentioned front-line practices. On Monday, we spoke Dr. Nili Kaplan-Myrth. She's an Ottawa family doctor. And she says she and her colleagues are not only ready and willing to jump in and do what's needed, they signed up to do so months ago and have never been contacted. Why aren't these kinds of resources being maximized?

I don't know. You know, the correct answer is I think people have been worried about the logistics of frozen vaccine. People have been worried about control over vaccine supply. People have been worried about getting good data about vaccination, about people coming back for their second dose. Those are all reasonable concerns.

But, you know, the U.K. has demonstrated you can make it work. And I honestly don't understand why we can't in Canada.

I'm hearing today some doctors saying that they've learnt they're not to be engaged until Stage 3 of the vaccine process. So it sounds like you think that should be rethought.

I think we have a number of choices.

Our public health units are used to doing this. We could ask them to do it.

Our family physicians are used to delivering vaccines. We could ask them to do it.

We could sign people up to support public health with mass vaccination clinics.

There's a long list. And we're talking about doing all of that. And it's not that we're not going to do it. It's not that we can't rise to this. It's just that, at the moment, we're not successfully using the doses we have. And so that immediate problem needs to be fixed.

And at the same time as we're fixing that problem, we need to be working on how are we going to grow that, so that when we have many more doses available next week, the week after, the month after, that we can successfully vaccinate people.

Edna Halup, a staff member at a private nursing home receives a Pfizer COVID-19 vaccine, in Ganei Tikva, Israel, on Dec. 22. (Ariel Schalit/The Associated Press)

Right now there's a lot of finger pointing going on. But if we get beyond that, whose job is it to be looking at this bigger picture? How can we improve the logistics quickly?

To my mind, what we need to be doing to improve logistics quickly is to be using existing structures that we have to deliver vaccines. And a piece of that is about being willing to transport the Pfizer vaccine frozen, which we have so far not been willing to do. A piece of it is getting more people working together. A piece of it is just catching up with some things we haven't done. You know, we've told nursing homes that we want them to vaccinate everybody, but we've not provided them with information for their staff or residents they can use. They've all had to invent it.

So, you know, somebody who knows how to run vaccination programs needs to be in charge of the process, in my view.

So does that mean that you think Rick Hillier isn't that person?

I think Rick Hillier is clearly very, very good about logistics. But as as [former head of the U.S. Centres for Disease Control] Tom Frieden said about vaccination programs for COVID: it's not a logistics problem. It's a vaccination program with logistical issues. And we're having trouble, I think, putting those two things together.

We have been told in recent weeks that, you know, September is this target to get the majority of the population vaccinated. But how confident are you that that that is going to happen?

I think we probably can make the September target … once we have enough vaccine flowing and we're willing to move it to pharmacies or family physician offices on a regular basis.

You know, it's not like we don't do this. Every October, we vaccinate 5.5 million people in Ontario and we do it quietly and without fuss and without complication.


Written by Sheena Goodyear. Interview produced by Kevin Robertson. Q&A has been edited for length and clarity. 

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