Ontario has vaccine supply. How do we get more jabs in arms?

OPINION: A few months ago, we were all scrambling to get our shots. Now we have more than we can use — it’s time to increase capacity
By Matt Gurney - Published on Jun 10, 2021
Ontarians from certain regions who got their first shots before May 9 will now qualify for second doses starting June 14. (Lars Hagberg/CP)

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Life comes at you fast. I woke up this morning planning to write one column but then saw a Brian Lilley story in the Toronto Sun and knew I needed to change my plan. Lilley wrote that several large public-health units, including Toronto, have been unable to keep up with the supply of vaccines they’ve been receiving. Doses are piling up in an unused reserve. In Toronto, Lilley wrote, it’s as much as 10,000 unused shots a day.

Well, I thought, I shall write about this! But after lunch. And by the time I’d had lunch — and it was just reheated leftovers! — the news had changed again. The government is accelerating second doses in priority health areas, including Toronto. If you got your first jab before May 9 and live in the Toronto, Peel Region, Porcupine (the Timmins area, where there has been a large outbreak), York Region, Halton Region, Waterloo and Wellington-Dufferin-Guelph public-health units, you’ll now qualify for your second dose starting June 14. That’s a big step up from the earlier estimates.

I had three immediate reactions to this. The first was entirely personal — woo hoo! I got my first shot of Pfizer on May 6 and figured I wouldn’t be qualified for my second shot until July. June 14 is a big jump forward, which is, from my entirely selfish perspective, amazing.

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The second was more big-picture: as much as daily charts showing rapidly climbing Canadian vaccination rates tell the tale of our turnaround of what at first looked like a troubled effort, I actually think this is the more telling symbol. (Whether it was a troubled effort or just looked that way is something I still wonder about, but that’s another column.) In any case, a few months ago, we were all scrambling to get our shots — an effort sarcastically but aptly described by many as an Ontario version of The Hunger Games. Now here we are in early to mid-June, and we have more than we can use as our first-dose campaign overtakes those of our quicker-starting allies. Imagine telling yourself 90 days ago, in March, as the third wave surged, that by June, we’d have more Pfizer and Moderna than we apparently knew what to do with. It would have blown whatever was left of your mind a year into this long grinding horror.

But the third reaction is the more pragmatic one: Okay, so. Great. We’ve accelerated the timeline for a bunch of people. Are we going to be able to keep up, or are we just trading one problem for another?

Even if we were just trading problems, it’s probably better to have the problem be one of too much demand rather than too much supply. So fair enough. But based on Lilley’s report, the problem has been one of demand … specifically, not enough of it. Lilley says that Toronto could vaccinate 31,000 people a day but has more typically been vaccinating 20,000. That’s still a lot! Toronto’s numbers are strong, and there’s certainly no sign that we’re bombing out, relative to the rest of the province (and indeed, the country). But if there’s slack in the system, moving up the eligibility of a whack of people — your columnist here included — would certainly help. Give me that damn mRNA juice! Stick it right into my arm! I’ll happily do my part to reduce Toronto Public Health’s stockpile of unused vaccine.

And I doubt I’m alone in my total commitment to this civic duty. So, yes, adding more eligible people will probably eat up some — maybe all! — of the slack. Good. But as I digested Lilley’s article, before lunch and the government’s announcement, I pondered the issue of vaccine delivery — not the part where planes fly it in from abroad, but the part when a health-care worker inside a hockey rink stabs your arm and pushes the plunger. If supply keeps ramping up as it has (a huge delivery of Moderna was announced this week, and Pfizer routinely exceeds its targets), can we ramp up our ability to deliver much more? If Toronto can do 31,0000 a day, could we do 40,000? Or 50,000? What’s the ceiling here?

I don’t know. I’m not sure anyone does. I’ve talked quietly with some people inside the system, and they agree that they could increase capacity. It would be hard in some places, and opening new facilities isn’t as easy as you might think. (Staffing is a major constraint — though more personnel will become available as the hospitals continue to decompress.) The short answer is, while we could increase our capacity, I’m not sure we’d know how far we could increase it until we tried. 

So … let’s try. 

Again, as the situation in the hospitals improves, we will be able to cautiously deploy some personnel away from the front lines and into vaccination clinics. Bring in family doctors. Expand pharmacy programs. We could continue reactivating recently retired medical personnel. We could dragoon dental techs and veterinarians. We could request more help from the military — let’s train every rifleman in the army to jab arms. Train me! I’ll do it.

Maybe some of these steps are impractical or unnecessary, but let’s at least consider them and ask ourselves how perfectly we can match supply and demand. As vaccine supplies ramp up, we should do our best to scale up our deliveries. There’s a hard limit to our capacity, sure, but no one knows what it is yet. Let’s find out.

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