They’re on the front-line of the COVID-19 pandemic, among the most at risk, and one of the first priorities for the rollout of the vaccine.
But vaccine uptake among employees of city-run long-term-care homes in Toronto has been spotty, and a lack of hard numbers in other regions is making it difficult to know exactly how many are on their way to being protected.
On Friday, the city announced a milestone, that vaccines have been administered at all long-term-care homes, ahead of next week’s goal. But according to Toronto Public Health, less than half, or 43 per cent, of the roughly 3,000 workers in city-owned homes have received the first dose of the vaccine or given consent to be vaccinated at an upcoming clinic. That’s compared to 91 per cent of residents within the city homes who opted to get the voluntary jab.
Sabina Vohra-Miller, the co-founder of the Toronto-based Vohra Miller Foundation, and a member of the South Asian Health Network, who has written about vaccine hesitancy, also believes some long-standing issues are at play.
“If you want a good vaccine uptake you need to make it accessible, because putting any barrier to it is just going to work against you,” she said.
A lack of paid sick days for possible minor vaccine side effects (such as temporary headache), as well as the fact that clinics are only during the daytime, can make it tough for the mostly female, racialized, low-paid and precarious workforce to access the shots, added Vohra-Miller.
Vaccines were first available only at hospital sites, and even now that teams are going into homes to administer them, part-time and shift workers are not always there when they arrive, she added. That means they may be left having to go to a vaccine clinic on their day off, or after a long shift, which can be difficult without child care.
The Toronto figures do not include privately owned nursing homes. At Copernicus Lodge, which has now been taken over by Unity Health Toronto to help with an outbreak, only 22 per cent of staff have been vaccinated, said Unity Health spokesperson Jennifer Stranges in an email. The hospital network is running an additional vaccine clinic this weekend with the hope more staff will roll up their sleeves.
The province’s goal was to vaccinate all residents and staff in Peel, York, Windsor-Essex and Toronto by Jan. 21. A spokesperson for the ministry said the vaccinations are now also “complete” in Windsor, in addition to Toronto.
Over 53,000 vaccinations have been administered to health-care workers in long-term-care homes and retirement homes, and more than 21,000 vaccinations administered to residents, the spokesperson added. He added that “to date, the uptake has been very positive.”
A letter from Ontario’s chief medical officer of health Dr. David Williams and the deputy minister of long-term care to LTC homes, dated Thursday, acknowledged that “vaccine hesitancy may be a concern in some settings.” It offered some tips to dealing with this, such as identifying “peer champions” who can help build trust, holding town halls for questions, and paying staff for time if they need to be vaccinated outside of their working hours.
Peel Public Health did not have an official tally for how many LTC employees had gotten the shots, but, according to its COVID dashboard, 5,494 doses have been administered in the region’s long-term-care and retirement homes.
Salil Arya, president of CUPE Local 966, which represents almost 1,000 workers at four municipal long-term-care homes in Peel, said for his members,“it’s not the mistrust of a vaccine, it’s the mistrust with the employer and with the government.”
Many part-timers are “struggling” to “make ends meet” now that they can’t move between homes (an emergency order was put in place to prevent the spread of COVID between facilities in the spring). And many feel the province and the city haven’t had their backs, he said.
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Vohra-Miller, who runs a science and health blog and spends hours combating vaccine misinformation on social media, also thinks tailored messages in different languages answering specific questions and concerns about the vaccine would go a long way, including in Peel’s large South Asian community.
For example, given the largely female workforce, she said she’s spoken to many personal support workers who are pregnant or trying to get pregnant and have questions about the vaccine. Pregnant and breastfeeding women can choose to get it, but should discuss this with their doctors as these groups weren’t included in the vaccine safety trials.
In many racialized communities, including her own Punjabi one, “there is distrust with health care,” Vohra-Miller said.
And it’s an uphill battle to fight COVID misinformation that is rampant on both WhatsApp groups and some Punjabi, Hindi, and Urdu TV and radio shows.
But it’s hard to tell how big an issue it is, because the data is not being collected properly, in a way that shows exactly how many long-term-care workers in each region are taking a pass on the vaccine.
“If you don’t see the problem you can’t fix the problem,” she said.
In York, public health spokesperson, Teresa Vader, said in an email, as of Tuesday 841 doses had been given to staff and essential caregivers in long-term-care homes in the region. But this does not include the doses administered at the hospital sites. There are approximately 4,660 long-term-care staff in York Region.
According to a survey from the Canadian PSW Network, about 65 per cent of respondents said they would get the vaccine, but 16 per cent said no (others were unsure).
Ian Da Silva, director of operations at the Canadian Support Worker Association and Ontario Personal Support Workers Association, said there’s hesitancy about the vaccine “across the board,” regardless of language or cultural background.
As the industry is unregulated, it’s harder to get consistent messaging out and track who’s got the vaccine where, he added.
Dr. Amit Arya, a palliative-care physician who works in LTC homes in the GTA, said he’s been hearing a huge range of uptake, as low as 20 per cent in some homes and as high as 70 per cent in others. Where it’s been higher, it tends to be because leadership have taken it on themselves to hold meetings with staff and answer questions.
He believes the rollout needs to be “refined” so that more local doctors and nurses are engaged. An ideal model would see them going from home to home with refrigerated trucks, and, if workers are initially hesitant or unsure, answering their questions and even giving them time to think about it.
“They’re feeling sacrificed and they’re feeling very vulnerable,” Arya said of long-term-care workers, noting recent deaths among them in the province.
“The rollout, the shipments, that’s one thing, but we need to have uptake, on the other end, for this to work.”
May Warren is a Toronto-based breaking news reporter for the Star. Follow her on Twitter: @maywarren11
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