Vaccination gap
Toronto areas with highest numbers of racialized people have lowest vaccination rates, analysis finds.
With hospitals at breaking point, the gap between who needs COVID vaccines and who’s getting them is particularly bad in Toronto, new research shows. The neighbourhoods with the highest populations of racialized people have the lowest vaccination rates, despite the disproportionate impact of the disease on these communities.
The findings, shared exclusively with the Star, come from the Wellesley Institute, and the research takes into account factors such as age.
The analysis, published Friday, draws on data broken down by the first three letters of a postal code on COVID-19 risk and the percentage of the population that have had at least one shot. It was first released last week by the Toronto-based non-profit ICES, formerly the Institute for Clinical Evaluative Sciences.
Looking at the M postal codes in the city, the higher the COVID-19 rate, the lower the vaccination level, said report author James Iveniuk, a researcher for the Wellesley Institute, a non-profit think tank.
“If you wanted to say where are these inequities the strongest, you’d zero in on the city of Toronto.”
“You have to get the vaccine to where it’s most needed, it’s as simple as that,” added CEO Dr. Kwame McKenzie.
“Our biggest defence is equity; if we can make sure we have fewer weak spots, we will be able to make us all safer.”
Iveniuk found that the Toronto neighbourhoods with the highest populations of South Asian, Black, South East Asian and Latin American people, have the lowest vaccination rates, as he matched census postal code data with ICES’s vaccine rates.
For example, in areas that have a very low percentage of South Asians in the population, around 30 per cent of people are vaccinated. In ones that have the highest percentage of South Asian people, it’s less than 15 per cent.
Communities with the most racialized people, who are, generally speaking, more likely to work in jobs that put them at risk, live in crowded housing with older family members and suffer from other medical conditions such as diabetes, are the hardest hit by COVID-19, according to an October 2020 brief from Statistics Canada.
While Toronto has done a
“huge amount to try to reduce inequities,” there was already a big gap between rich and poor before the pandemic, with high rates of poverty, poor housing and lots of essential workers, McKenzie said.
The city has hired almost 300 neighbourhood ambassadors, to offer support and answer questions about vaccines in communities. And in February, Mayor John Tory announced a $6.8-million plan to support community health agencies in predominantly Black communities, in an effort to address the disproportionate impact the disease has had on Black Torontonians.
But, McKenzie noted, “there have been decades of poor investment in particular populations and particular areas and that can’t be undone overnight.”
Last week, the province announced a strategy to target high-risk postal codes, making the vaccine available to people 50 and up there, and 18 and older through pop-up clinics, although there has been some confusion around the younger group not being able to book on the provincial portal.
Dr. Dirk Huyer, Ontario’s chief coroner, in charge of the province’s COVID testing, told reporters at a Thursday press conference that the hot spots were developed based on data that showed “ongoing historic increased rates” and “increased burden of hospitalizations, illness and death within those locations.”
He acknowledged that, given their size, some postal codes will have areas where people are more affected than others.
But Sabina Vohra-Miller, cofounder of the South Asian Health Network, noted that the Ontario Science Table brief that found a vaccine strategy aimed not just at age, but also at high risk postal codes, could save lives, was published months ago, in February.
“We missed the boat on that,” she said. “We have to be nimble; it’s a pandemic.”
Vohra-Miller does not see vaccine hesitancy as the problem. There are “so many barriers” right now, from an early lack of vaccines in pharmacies in the hard-hit northwest corner of the city, to language issues, to essential workers not having time to travel to mass sites or stand in line for shots.
“This is what structural racism looks like,” she said.
It’s not like anyone’s trying to give these communities the least amount of shots, “it’s just that equity is not baked into the actual foundation,” VohraMiller remarked.
Even within the new postal code strategy, the most privileged people within these areas will continue to win the race for vaccines, she fears.
Toronto’s rollout, with several different hospital sites to wade through, each with slightly different criteria, makes finding a spot a competitive sport.
“Who are the people who are sitting in front of the computer refreshing their screens constantly to see if appointments are popping up?
“They’re people who work from home, not people who work in a warehouse, not people who are working in a processing plant.”