Politics of vaccination creating chaos in Ontario

Ontario’s vaccination system is in chaos. It’s not clear who should be getting shots first. Appointments for inoculation against COVID-19 are not being honoured.

What is the rationale for who gets the jab? Sometimes the authorities cite age. They say that anyone over 70 is eligible for vaccination.

At other times, they point to location. Priority, they say, should go to those who live in so-called hot spots, places where the pandemic is particularly virulent.

What constitutes a hot spot? Officials don’t always agree. The province says downtown Niagara Falls is the hot spot of that region. Local health officials say the real hot spots are agricultural communities outside the city proper.

Meanwhile, vaccinations languish. Some 10,000 appointments in Scarborough had to be cancelled this week, as the authorities had run out of vaccine.

This, after the province has announced it will vaccinate all adults over 18 whose postal codes indicates they live in hot zones. Which postal codes are deemed hot? It’s not that easy to find out.

Pop-up clinics are being set up to offer vaccinations. But as the Star’s Rob Ferguson has reported, these clinics are often deliberately not advertised for fear they will be overwhelmed.

As well, their location is sometimes curious. One pop-up was established in Thorncliffe Park around the corner from an existing city-run mass vaccination clinic. The mass clinic then ran out of vaccines, and is now closed until further notice.

Throughout all of this, appeals are being made to fairness. Is it fair that a senior living in Toronto’s middle-class Moore Park be vaccinated before a 35-year-old who hails from a poorer area such as Jane and Finch?

The answers are not always simple. In this example, for instance, a 35-year-old resident of Jane and Finch may be more likely to be infected with COVID-19 than the senior from Moore Park, but the latter — once having caught the bug — is more likely to die.

Nor are postal codes always indicative of income. In some cases they are: Rosedale is unambiguously richer than Regent Park. But in others, they are not. In many Toronto areas (Cabbagetown is one), the well-to-do live cheek by jowl with the less fortunate.

All of this plays into the politics of vaccination. What began as a matter of public health — where the aim was to control the pandemic wherever it showed itself — is fast becoming a morality play based on the question of who deserves to be saved.

This is unfortunate. The emphasis on fairness neglects the real point of vaccination — which is to control the disease. In that sense, it shouldn’t matter if the recipient of the vaccine is deserving. It should matter only that the vaccination is useful in, for example, reducing deaths and hospitalization.

Indeed, we may end up deciding that the now discredited criterion of age is the best measure for rolling out vaccines. It is simple, meaningful and easy to calculate.

Best of all, it takes the question of eligibility out of the political arena. People are vaccinated not because they are virtuous, but because it’s their turn.

But the real problem with focusing on inoculation to the exclusion of all else is that vaccines alone will not save us. We can control the virus only if we stop its spread.

In other words, the central failing in Ontario is not the province’s botched vaccination program. It is our boneheaded reluctance to take the obvious steps — like shutting down child care operations — needed to defeat the coronavirus.