Some hospitals offer doses to non- front- line staff,
Where front- line workers have been vaccinated, doses go to low- risk staff
Some Toronto hospitals have started vaccinating staff who don’t deal directly with patients — and, at Michael Garron Hospital, offering doses to executives — raising questions over the ethics of immunizing these employees ahead of community health workers and the thousands of long- term- care residents and staff still waiting for shots.
As Ontario’s case counts continue to explode, and fears mount over more easily transmissible new variants of the coronavirus, there is growing urgency to vaccinate as quickly as possible, especially in longtermcare facilities, where mortality rates have been highest.
Hospitals are distributing scarce vaccine doses according to provincial guidelines that prioritize people at highest risk and face pressure to vaccinate as fast as possible. But in some cases where front- line staff have already been vaccinated, or surplus doses are at risk of being thrown away, some hospitals have started offering vaccines to executives or low- risk employees who don’t interact with patients — even as other hospitals, community health workers or long- term- care homes await first doses.
On Sunday night, a leaked email from University Health Network revealed the hospital system had secured a “limited” number of vaccines from Newmarket’s Southlake Regional Health Centre and was offering them to all staff, including researchers. Health workers on social media reacted with outrage, questioning why Southlake’s extra doses were being redirected to low- risk employees downtown when so many highrisk health workers — including in Newmarket — were still waiting to get vaccinated.
UHN spokesperson Gillian
Howard said Southlake’s offer was made to five hospitals: UHN, Sick Kids, Mount Sinai, Women’s College and Toronto Grace. The Star, which obtained the UHN email, also surveyed 19 other hospitals that have received vaccines about whether they were offering doses to executives or staff with no patient contact.
Most who responded said they have so far been only vaccinating front- line staff. Only Michael Garron Hospital said it is now offering doses to all employees, which includes its executives.
Dr. Isaac Bogoch, an infectious disease physician with UHN and member of the province’s vaccine task force, said Ontario’s clear priority right
now is long- term- care residents, staff and front- line workers who come into contact with COVID- 19 patients. “We shouldn’t veer from that.”
Kerry Bowman, a bioethicist at the University of Toronto, believes offering the vaccine to non- front- line staff is “fundamentally wrong” and a “clear ethical violation” that should be investigated. “It erodes trust in the system.”
Officials at Southlake Regional Health Centre realized Sunday morning it had excess appointment slots, spokesperson Kathryn Perrier said in an email. She did not explain what caused the surplus, but said Southlake offered its extra doses to UHN because “we were aware that they had run out of vaccine.”
“Our objective, while keeping with the provincial prioritization framework, was to ensure that no vaccine supply was wasted,” Perrier said. “The Pfizer doses planned for Sunday’s clinic were already onsite yesterday morning and could not be transported, which is why staff from UHN came to Southlake.”
Once vials of Pfizer and Moderna
vaccine are thawed they can’t be refrozen, according to Health Canada.
Perrier did not respond to questions about whether the hospital first tried offering its additional doses to long- termcare workers or community doctors, and directed the Star to York Regional Public Health.
The agency redirected the Star back to Southlake to answer questions about “specific decisions made” by the hospital. But spokesperson Patrick Casey said all staff and residents at long- term- care homes in York were expected to receive their first dose by end of Monday.
As for redirecting hospital doses to community doctors, at Michael Garron, spokesperson Shelley Darling explained hospitals are “not permitted” under the provincial distribution plan “to administer the COVID19 vaccine outside of health- care workers and physicians working in long- termcare homes ( LTC), priority retirement homes and hospitals.”
Howard said that when UHN received Southlake’s offer Sunday, UHN had already vaccinated all of the long- term- care and retirement homes it’s responsible for.
She said no UHN executives have been vaccinated and the hospital’s process is to first offer vaccines to those directly caring for COVID patients. She added that UHN also has 300 researchers working directly on COVID “and therefore at risk for both disease and transmission.”
She said it was up to individual employees “not to step forward if they are not patient- facing.”
“We have to rely on the honour principle of staff and others as we roll out a mass vaccine campaign,” she said. “We certainly are discussing what disciplinary actions should be considered for those who are jumping the queue.”
She said a complication was that the Pfizer vaccine originally couldn’t be moved from the site ( as it requires super- deepfreeze temperatures). “Later, UHN demonstrated how Pfizer could safely be moved so we now have the capacity to use Pfizer and Moderna in longterm care, which we are doing,” Howard said, adding the task force is not recommending moving vaccines out of red zones to areas with less COVID.
At east Toronto’s Michael Garron, all employees are now being offered the vaccine, including communications staff, employees who work from home, and executives, though president and CEO Sarah Downey has not received it, Darling said.
This is “to ensure there are large volumes of eligible people in our clinic each day to meet the 500 doses a day goal,” Darling said. She added provincial guidelines are being followed for prioritizing among its employees, and the hospital has already vaccinated all LTC residents in homes it supports.
Dr. Samir Sinha, director of geriatrics at Mount Sinai Hospital and UHN, said UHN was clear in previous emails, one of which was seen by the Star, that the vaccines should only be for researchers who interact with patients. But what troubles him is so many long- term- care staff and residents are still waiting.
“Our objective, while keeping with the provincial prioritization framework, was to ensure that no vaccine supply was wasted.”
KATHRYN PERRIER SOUTHLAKE REGIONAL HEALTH CENTRE SPOKESPERSON