'This isn't over': COVID-19 pandemic will continue and rules don't 'go out the window' after being fully vaccinated, expert says

While about 60 per cent of Canada’s eligible population is fully vaccinated with Health Canada authorized COVID-19 vaccines, with each local jurisdiction at their individual point of relaxed public health measures, Canadians should still proceed with some caution as they increase their social contacts.

“Getting the vaccine doesn't mean everything else goes out the window,” Dr. Andrew Boozary, executive director of health and social policy with University Health Network (UHN) in Toronto told Yahoo Canada.

Boozary said communication around the risks and benefits of vaccination needs to continue, in addition to messages of solidarity, stressing that just because some communities and neighbourhoods have had extensive access to vaccines doesn’t mean it’s “over” for everyone else.

“I think that element of solidarity cannot be lost, that we saw early in the pandemic, and we're going to need to tap into that same solidarity around the vaccines and in science to get through this pandemic,” he said.

'A pandemic for the unvaccinated'

Boozary added that we are approaching a point where this is “a pandemic for the unvaccinated” and while there are some who are choosing not to get vaccinated, it’s also important to remember that in this global pandemic, there are people around the world who do not have access to vaccines.

“It’s easy, I think, for some people to want to believe ‘hey this is over, we can move on, people have paid their dues,’ but this isn't over and it will not be over for many people in different parts of the world. The seriousness of COVID is continuing to impose suffering.”

He added that the best thing people can do is to get vaccinated to ensure we can get to the level of immunity we need, to ensure that we can then shift vaccines to where they are needed most in the world.

“If people want to be talking about things like travel then we have to be well acquainted with terms like global vaccine equity because if we don't... nail those parts down, discussions around travel and ‘going back to normal,’ that's not going to be a reality,” Boozary said.

“That's the sort of piece where we need to continue to see that messaging take place and action take place which is getting more vaccines out to where people need it, both here at home and globally.”

‘Barriers are definitely still there’

When we look at domestic vaccine administration, Boozary stressed that “the barriers are definitely still there” in terms of people being able to actually go out and get vaccinated.

He highlighted that there has been a shift from mass vaccination clinics to pop-up clinics and low barrier clinics, as well as mobile efforts, including going to apartment buildings, churches, mosques and temples.

“We've seen incredible community leadership in partnership with the hospital and healthcare system to see some really remarkable results,” he said.

“But what we're also seeing is that there continue to be internal inequalities when it comes to accessing the vaccine and when you look at even some of the first dose data...is that there's still about 20 to 22 per cent of people who are over 70 that do not have their first dose in the highest risk neighbourhoods, and we continue to see that kind of inequity playing out for the second dose.”

In a press conference on Tuesday, Dr. Kieran Moore, Ontario's chief medical officer of health, highlighted that about two in 10 eligible Ontarians have not received a single dose of a COVID-19 vaccine.

"This is despite having great capacity across Ontario, a steady supply of all mRNA vaccines," he said.

Clear messaging still needed

Boozary explained that there also continue to be challenges for people trying to navigate where and how to get a vaccine, particularly when most of the information is online and primary care providers haven’t had the opportunity to play a large role in vaccine administration.

“We've not seen the primary care engagement from the outset that we really needed,” he said.

"The highest rate we have will allow our society to return to a more normal state, a post-pandemic era, with less fear because there will be less risk of the virus spreading in our communities, spreading to vulnerable populations, spreading in long-term care facilities or overwhelming our health system."

“There's been some efforts over the last few weeks to see primary care play more of a role, but we also know that there are a sizeable number of Ontarians that do not have a family doctor, are not part of a primary care team, and so I think we still see these barriers taking shape.”

Boozary added that this is in conjunction with a lack of consistency on protected time from employers for employees to get vaccinated.

“We still need to see, I think, a real shift in reaching out to people who've not been vaccinated, whether it's through email or text or calls, or going door-to-door with people they trust,... to really ensure that the vaccine effort is coming out to them because that's how we're going to have to get through this last mile,” he said.

“We know that the structural determinants of health continue to impose barriers and we've had long standing inequities that were really shaping what we saw in the beginning of the rollout, a mismatch into where the vaccine access was and where we saw the highest COVID rates, and we've seen some more parity or some more fairness take place...but there's still many, many people at risk who still have barriers in access.”

He added that lack of clarity on aspects of vaccine administration, like mixing doses from different manufacturers, in addition to outstanding questions around travel and workplace requirements, lends itself to the misinformation that can spread on social media, in particular.

"We've talked about this from the beginning of the pandemic, just how crucial communications is and how important public health messaging is, in terms of the need for clarity and for it to be effective in addressing people's concerns," Boozary said.

"It's still as crucial and when there are communication blunders...they have ramifications, there is a real downside to when there isn't clarity, or there's an answer that's convoluted and opens itself up to hundreds of different interpretations. That is problematic."