Most provinces and territories will be using online portals to sign Canadians up for COVID-19 vaccinations as they become more widely available next month, according to a survey by CBC News.
Every province that has shared their plans will use some online sign-up, as will Yukon and the Northwest Territories. The option to book by phone will be available across Canada, and Nunavut is scheduling vaccination appointments strictly by phone.
While vaccinations started back in December 2020, what’s soon changing is the pace and distribution list — from targetted high-risk groups like seniors in long-term care, to the general population, starting with the oldest first in many jurisdictions.
“That is absolutely what we need to be doing,” said epidemiologist Kirsten Fiest, the Director of Research & Innovation in Critical Care Medicine and an assistant professor at the University of Calgary.
“I think the efficiency piece is really the most critical.”
But, while health officials and independent experts agree online appointment booking sites will be essential to managing a mass vaccination campaign, they’ve also raised problematic questions of equity in parts of the U.S.
WATCH | Some say online vaccine portals could shut out most vulnerable:
As vaccinations ramp up in Canada, many provinces are talking about using online portals to help organize and register people for their shots. But some people worry that the Canadians who are most vulnerable and have the greatest need for the vaccine could end up getting lower priority. 2:01
Stories in the Los Angeles Times, New York Times and Washington Post have documented how online booking has prevented senior citizens, racialized individuals and poor people from getting fair access to vaccination. In some cases activists have stepped in to book shots for those who lack tech savviness, struggle with communication or cannot afford the devices, data plans or internet service.
The problems seen south of the border concern Fiest.
“You have to worry that something similar could happen here.”
Kirsten Fiest, an epidemiologist and assistant professor at the University of Calgary beliieves online portals to sign up for COVID-19 vaccination will be an essential part of the mass immunization effort, because they’re efficient — but not without problems. (Cumming School of Medicine, University of Calgary)
Manitoba, Saskatchewan and Alberta told CBC News they intend to offer web-based sign ups, without providing a timeline.
Quebec, Ontario, and B.C all say they’ll launch online sites for booking vaccination relatively soon.
Quebec said its site could be online before the end of the month.
Ontario said it has successfully tested a scheduling site it developed with three American companies in January, but the province’s Ministry of Health would only say it expected to launch it “in the coming weeks.”
B.C. said its booking site will be launched to the public in March, and has released sample images of the COVID-19 immunization record card citizens will receive.
British Columbia says it will have an online portal open in March for COVID-19 vaccinations for the general population. People will have the option to receive a paper record of their vaccination, like the one above, and a digital record. (Government of B.C.)
Online booking portals currently running in Yukon and Nova Scotia were built by CANImmunize, the Ottawa based tech firm co-founded by Dr. Kumanan Wilson, an internal medicine physician and senior scientist at Ottawa Hospital.
CANImmunize started out as an app for tracking vaccine records a decade ago, and was supported by the Public Health Agency of Canada.
The company has expanded its scope offering more services to help fight the pandemic because “this will be the largest mass healthcare intervention in our lifetime,” said Wilson, “and probably the most important.”
Wilson says CANImmunize is in talks with other provinces interested in its tech, but declined to name them.
Dr. Kumanan Wilson, an internal medicine physician at Ottawa Hospital is also co-Founder of CANImmunize, the company that created online vaccine sign-up portals for Nova Scotia and Yukon. Wilson says vaccinating people for COVID-19 ‘will be the largest mass healthcare intervention in our lifetime.’ (Kim Barnhadt/CANImmunize)
Perpetuating the ‘digital divide’
With millions of Canadians clamouring for COVID-19 vaccines, using technology to help facilitate booking shots will make the process more convenient for many Canadians and more efficient for health departments.
“I think that we have a mass vaccination strategy that will work for a lot of people,” said Dr. Kwame McKenzie, a physician and the CEO of the Wellesley Institute, a non-profit group in Toronto that works in research and policy issues to improve health equity.
“The problem is that there are some people who are at highest risk that it won’t work for at all.”
Dr. Kwame McKenzie, a psychiatrist and CEO of the Wellesley Institute, a Toronto-based think-tank that advises on policy for more equitable health care in urban communities. He’s concerned the process to sign-up for vaccines might make existing inequities worse. (Richard Agecoutay/CBC)
McKenzie is concerned the mass vaccination campaigns across Canada built on the power of online booking portals will perpetuate the country’s “digital divide.”
He says the seniors, racialized groups, low income groups, and people with disabilities who have been at higher risk of getting COVID-19, are exactly the same groups who are less likely to have computers, broadband, and be “digitally savvy.”
Having call centres for phone bookings isn’t a fix-all, he said, if people using pay-as-you-go credits end up on hold for hours.
“That could be all your credits for a week,” he said, “and the most likely scenario is that you’d use your credits before you got through. And that’s your opportunity gone.”
He also points to Statistics Canada data that shows about 20 per cent of Canadians have a mother tongue other than English or French.
Bookings in Canada’s official languages, said McKenzie, could present challenges not just for younger people new to Canada from places like South Asia or Africa, but also for some older Canadians from places like Italy, Portugal or Ukraine, who still function primarily in their first languages.
Alternatives for access
McKenzie wants to see vaccination slots proactively held back for those who will struggle to book online or by phone.
He believes community outreach for at-risk groups should be coupled with no-appointment-necessary walk-up vaccination sites in targeted areas.
In Canada, we say diversity is our strength … that means that we need a diverse vaccine roll out strategy to meet the needs of that diverse population.– Dr. Kwame McKenzie, CEO The Wellesley Institute
He also said on-the-job immunization clinics for essential workers should be part of vaccine access.
“In Canada, we say diversity is our strength. And that’s something I believe, but that means that we need a diverse vaccine roll out strategy to meet the needs of that diverse population.”
Several provinces have announced plans for mobile vaccination clinics, “focused immunizations teams” and community clinics set up by local public health units to reach vulnerable groups.
Fiest believes provinces will have to be careful that “whatever system is going to be rolled out is not making health inequities worse.”
A long process and public patience running low
A number of questions have poured into the CBC News COVID@cbc.ca email address in recent days from Canadians anxious for specifics about when and how they can sign up for vaccination.
Linda O’Neil of Barrie, Ont., is one of them.
Linda O’Neil of Barrie, Ont., is concerned about when and how she’ll be able to get a COVID-19 vaccination booking for her mother, who is in her late 80s. (Submitted by Linda O’Neil)
She’s worried about getting a booking for her mother, who’s in her late 80s.
“It’s just really frustrating, because my feeling is they’ve had quite a few weeks to be able to prepare this plan,” said O’Neil.
“So I’m just looking to have it publicized now that the vaccine is starting to come in.”
While O’Neil and millions more wait for details from their provinces, Wilson sees a silver lining in COVID-19 accelerating what he sees as overdue technological change in Canada’s medical system. He acknowledges that older Canadians and others may need help figuring out how online registration works.
“In my mind for immunization, an individual, the health care provider, and the government would have the same immunization information in real time,” he said “that’s probably true for immunization, but also for all of our health care.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
