Pop-ups are good, experts say, but can be improved
Clinics have vaccinated thousands, but concerns over accessibility linger
It was pandemonium at the St. John the Evangelist Catholic School pop-up vaccination clinic in Weston last Friday.
A reporter on the scene said traffic around the school was backed up completely. People took off sprinting from the backs of Ubers and taxis, stalled blocks away, to join a massive line on the sidewalk. The school wasn’t even visible from the back of the queue.
Scenes like this have become common in this stage of the vaccine rollout. Quiet places in the margins of the city now attract more people than some downtown concert venues prepandemic.
Although the efforts of pop-up clinics to vaccinate people have been successful, leading to tens of thousands of inoculations, experts say some concerns over communication and accessibility linger.
Quynh Pham, a scientist at Toronto’s University Health Network (UHN) and professor at the Dalla Lana School of Health, said people who show up to large vaccination opportunities where eligibility is expanded to anyone over 18, like at St. John, may not be the ones who need the shots most, because of how these vaccine drives are advertised.
“People who are online, waiting around all day to see something pop up in their area, those are the people who are going to show up and use up all the surplus (vaccines),” said Pham. “The information isn’t being broadcast in a useful way to communities that actually need to get vaccinated — people working in factories, healthcare providers with day jobs — people who can’t just get up and go.”
Waiting outside the St. John pop-up, which was run by Women’s College Hospital, for more than an hour was a mass of young, ostensibly tech-savvy people from anywhere within driving distance. People who could see and act on this lastminute Twitter update with the school’s address:
“OPEN FOR EVERYONE IN TORONTO 18+! THIS IS NOT A DRILL. IT IS YOUR CHANCE EVERYONE GOOOOOOOOOOOOOO!!!” tweeted Vaccine Hunters Canada, a group of volunteers who post vaccine opportunities around the country online. “WE DON’T KNOW HOW MANY DOSES ARE LEFT. WE DO KNOW THEY PROBABLY HAVE A LOT AND DEFINITELY NEED PEOPLE SO GOOOOOOOOOOOOOO.”
About an hour and a half after that tweet went out, supply at the school had run dry.
A voice from the front shouted that the clinic was out of doses, according to a reporter who was there. A sea of people then streamed back down the street toward the TTC — minus a few stragglers in denial.
Infectious disease physician Dr. Isaac Bogoch said better communication around popup capacity is needed.
“These clinics are fantastic and they’re certainly doing their job — but there’s always room for improvement,” said Bogoch. “If they’re taking walkins, it would be good to say to people waiting, ‘We have 1,000 vaccines to give today. After this individual here, we’re done — you’re the last person getting vaccinated, everyone else can go home.’”
Aside from that, Bogoch said the efforts of pop-ups and the ways in which they function and are advertised are effective.
“Programs like the Vaccine Hunters are certainly helpful,” he said. “They help connect people to vaccine sites. But there’s also very local advertising for pop-ups. There are programs that go into high-density urban housing and slip papers under the door letting people know they’ll be around vaccinating.”
Although physical distancing in lines outside pop-ups isn’t always followed, Bogoch said there’s little to worry about in terms of people becoming infected while waiting for a dose.
“These lines are outdoors, so the risk of transmission is negligible at best,” said Bogoch. “And lineups are big when the vaccine clinics open, but in many instances they dissipate after about an hour.”
Despite generating mad rushes and frustration for those turned away after hours in line, pop-up clinics are among the most important and successful parts of the roll out, experts told the Star.
Dr. Andrew Boozary, a physician and executive director of population health and social medicine at UHN, said there’s no ideal, one-size-fits-all rollout approach. Pop-ups, hospitals, mass clinics and pharmacies need to work in concert.
“You need a myriad of options to come together to address health equity challenges,” he said. “Certain options are going to work better for certain communities.”
Boozary doesn’t like the term pop-up, preferring instead to call them “low-barrier clinics.” He said “pop-up” conjures images of tents that get taken down after a day. Instead, many pop-ups are rooted in community fixtures, like health centres, and were established by local leaders who advocated for vaccine supply and hospital partnerships.
“We need to ensure that funding, focus and resources for them are sustained over the next few months. The vaccine effort is only going to move at the speed of trust.”
After Ontario expands vaccine eligibility to all adults (18-plus) at the end of May, pop-ups will continue to operate, according to the hospitals that run them.
“We don’t see it as an ‘either or’ scenario; pop-up clinics and registered appointments at mass immunization clinics both play a role,” said Jordan Benadiba, a spokesperson for Women’s College.
Benadiba said for people lacking internet access, transportation options, schedule predictability and consistent child care, city-run mass immunization clinics often are not a good fit.