When a new COVID-19 vaccination clinic opens in her region, Brenda Vandal goes into action, pulling out her call list and picking up the phone. “I just wanted to make [patients] aware every time there was a new clinic,” says Vandal, the secretary for the Foleyet Nursing Station, in northeastern Ontario.
Born and raised in Foleyet, she’s been at the nursing station for 25 years and operated as the community’s unofficial vaccine hunter since the first clinic nearby opened on March 11 — posting on the nursing station’s Facebook page and hanging signs around town advertising the station’s social-media channels. Normally at this time of year, the nursing station (housed in a small building and staffed by Vandal and a single nurse practitioner) deals with campers and outfitters, treating such issues as poison-ivy rashes and fish-hook removals. This year, her focus is on her growing call list and helping residents book their appointments. “I made a lot of appointments for the older seniors who are not tech savvy.”
Older residents, Vandal says, can’t always keep up with online news, and television coverage focuses on southern Ontario, meaning that people in Foleyet are often left confused as to where and when to get a shot. Vandal says it can take upwards of an hour to book over the phone and estimates she’s set up appointments for at least 50 people.
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The task is a familiar one: she uses similar skills during the annual flu-shot rollout. “When [the pandemic] came by, I said, ‘Let’s do the same thing.’” The response has been overwhelmingly positive. “Most people were happy to have it available — and they couldn’t wait for their appointment,” she says. “I’ve got one or two calls back where someone says, ‘[COVID-19 is] a hoax.’ But I say, ‘Well, that’s your preference. I’m just passing you the information, and if you’re interested, I can make the appointment for you.’”
Vandal is one part of a coordinated effort by northern public-health units, local health-care providers, and residents to immunize Ontarians living in rural and remote regions. In Foleyet, the problem isn’t long lineups — it’s long commutes. Its 200 residents have to drive either 100 kilometres west to Chapleau or 100 kilometres east to Timmins for their chance at a jab. Remote and sparsely populated communities — such as Foleyet; Gogama, located on Highway 144 between Sudbury and Timmins; and Shining Tree, with its many outfitting lodges and hunting camps — are often far from health-care providers. The Public Health Sudbury and Districts health unit (PHSD) serves roughly 160,000 adult residents, but its catchment area is more than 46,500 square kilometres — larger than the entirety of southwestern Ontario and the Greater Toronto Area combined.
Residents of these communities rely on municipalities that are larger, but still comparatively small. Chapleau Health Services, for example, has distributed a first dose to nearly 1,100 people at an immunization clinic at the local recreation centre, which serves the nearly 2,500 adults who live in the area. For residents who need a ride to the clinic, free transportation is available upon request, and people who are homebound can get their shot delivered to their doorstep by emergency services.
These clinics, though, come with logistical hurdles. “Only public health is authorized to transport the vaccines, so we rely on their staff for bringing the vaccines to the community,” a CHS spokesperson tells TVO.org via email. “We have to take weather and road conditions into consideration because of the time of year. Also, we can’t go to public health and pick up extra vaccines if needed.”
Nastassia McNair, PHSD’s program manager for vaccine, preventable diseases, and COVID-19 prevention, notes that the region’s size can make transporting the doses difficult. “[PHSD] spans from Manitoulin Island to the Sudbury-East municipalities of Markstay-Warren and French River area. We also include Espanola and Massey, and then we go all the way up north to Chapleau — which is about five hours away from our main office,” she says. “There are limitations on how [the vaccine] can be moved, which means that there are limitations on where we can move it to.”
To coordinate the vaccination effort, PHSD instituted five implementation committees across its catchment area, each with local representatives that might come from municipal government, primary-care centres, social-service agencies, and First Nations. Through the committees, McNair says, “we can look at planning vaccine rollout in a way that is specific and relatable for the area.” The committee submits recommended clinic locations — selected on the basis of vaccine supply, transportation requirements, staffing, WiFi availability, and population size and density — that are then brought to the health unit’s command table for approval.
Despite the geographic and logistical challenges, the immunization rate across the health unit’s regions has remained on par with that of Greater Sudbury, where 45 per cent of the adult population has received a single dose. The rates in areas outside Greater Sudbury range from 35 per cent in Espanola and the LaCloche Foothills to 67 per cent on Manitoulin Island — overall, roughly 47 per cent of adults have received a first dose. As eligibility for vaccines has opened up, so too have opportunities for pop-up clinics. Gogama hosted one last Tuesday, and extra clinics have opened along Manitoulin Island.
McNair, reflecting on Vandal’s efforts and the work of the implementation committees, says “a lot of our northern Ontario partners get very creative and really think outside the box in order to have their clients vaccinated.”
Back in Foleyet, residents are left to choose between Chapleau or Timmins. Vandal says she reached out to the Ministry of Health to make sure vaccination appointments were eligible for the Northern Ontario Health Travel Grant, which helps with health-care-related transportation costs. “There was only one person out of the whole town that we were kind of wondering how he was going to get there,” she says, adding that the person’s son drove in from Sudbury to help.
For Vandal, the personal approach was a natural fit for Foleyet. “Me and my nurse practitioner, we decided this is probably a good way to go about it, because it’s a small community.”
This is one in a series of stories about issues affecting northeastern Ontario. It's brought to you with the assistance of Laurentian University.
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