Nearly six weeks after Toronto was greenlit to start vaccinating its homeless population, less than a quarter of shelter residents have received their first-dose jabs — a pace that has alarmed outreach workers and advocates, and prompted health-care workers to rethink their strategies.
As of Friday morning, roughly 1,400 shelter residents had received their first dose, said Andrew Bond, medical director of Toronto’s Inner City Health Associates. Occupancy in Toronto’s homeless shelter system sat this week at around 5,800 people.
Meanwhile, the system is bearing the weight of the pandemic’s third wave and new, more contagious variants, with 342 infections across 18 outbreaks.
“Vaccines are absolutely a linchpin piece of our ability to get on top of it … right now, I think it feels like we’re behind,” said Bond.
Street nurse Cathy Crowe was alarmed by Friday’s numbers, noting that the pace of the rollout seemed to be decelerating. “It’s horribly slow, especially given the huge escalation in shelter outbreak numbers. They should be double where they’re at,” Crowe said.
In the two weeks after vaccinations were allowed start in shelters, Bond estimates 900 residents got their shots. They haven’t kept up that pace, with 500 vaccinated in the four weeks since.
Part of the problem was hesitancy, with about 15 per cent refusing the shot, said Bond.
But they were also struggling with the population’s transience, he said. Their vaccine clinics were one-day operations — and if someone left the shelter during the day, they’d miss their chance.
Outreach worker Greg Cook believes the rollout should have been designed from the start to account for more transient people. “If you ask a shelter manager when the most people are around, it’s not at 12 noon,” he said.
At this point, Bond said health teams were looking at ways to make vaccine doses more continuously accessible — like having a vial or two available at every shelter, at all times.
“Trying to figure that out, while maintaining the requirements of the vaccines, is a challenge,” he said.
He believes one-day clinics were the best approach in the early weeks, to lay a foundation, but that doing “more of the same” wouldn’t necessarily help.
To effectively guard against outbreaks, he has previously said that each site needs 70 to 80 per cent uptake.
For now, the race between vaccine and virus can be seen at a downtown Homes First shelter. In early March, the Star spent the day on-site as vaccines were delivered to 51 residents. Now, they’re in the throes of an outbreak that’s seen 36 infections.
Homes First CEO Patricia Mueller said she learned someone had symptoms around the same time as the vaccine clinic. “I was very frustrated, I was angry,” she said.
With the variants, she said it’s been harder to tell exactly how people were getting sick — leaving her questioning whether they were making mistakes, or if it was just more aggressive.
"That's what's so, for me anyways, baffling and terrifying about the third wave," she said. "This variant is just like a computer hacker. You close that door, you figure out that fix, and the variant is a new little wrinkle that's there to thwart us."
She believes vaccinating more residents, but also essential workers they interact with, is the key to tamping down infections.
"Vaccinations are going to help us wade our way through this."
Victoria Gibson, Local Journalism Initiative Reporter, Toronto Star