No vaccines for most community medical clinics, Alberta government decides

The Alberta government is permanently cutting off the flow of publicly funded vaccines to community medical clinics, save a select few, sparking yet another wave of concern from health-care providers.

As CBC News previously reported, shipments of publicly funded vaccines to community medical clinics were halted in April when a distribution contract expired. 

A replacement was never hired and, as a result, family physicians did not receive COVID-19 and flu vaccines for the fall immunization campaign.

Clinics have been unable to access a number of other publicly funded vaccines for months, including the shot that protects against pertussis (whooping cough).

After months of uncertainty punctuated by messaging that the disruption was temporary, the Alberta government now tells CBC News it is ending the wider distribution program, which was launched in 2021 in an effort to increase access.

"As we continue to move past the pandemic, we have re-evaluated and have determined that we will return to distributing provincially funded vaccines to the select community medical clinics that previously administered vaccines," a statement from the health minister's office said.

"To ensure we limit vaccine waste as much as possible while maintaining access, we will focus on serving the most vulnerable populations, those in rural [and] remote locations, and on clinics administering the highest volume of vaccines."

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Moving forward, the province plans to distribute influenza, pneumococcal and Tdap shots (which protect against pertussis, tetanus and diphtheria) to between 20 and 25 community medical clinics.

Before distribution was halted in the spring, between 500 and 600 community medical clinics were administering publicly funded vaccines, a government document shows.

'Alarming' change

"This response falls far short of what we need to see.… We need all community medical clinics to be able to administer appropriate vaccinations to their patients," said Dr. Mareli Powell, a family physician working in Fox Creek and Edmonton.

According to Powell, a variety of clinics will be affected, including family doctors' offices offering flu shots, those that perform stitches and administer tetanus shots at the same time and maternity clinics that offer vaccines as part of prenatal care.

"It's not acceptable that this service cannot be provided through medical clinics anymore," said Powell, past-president of the North Zone Medical Staff Association.

"If we take that about 300,000 patients get their vaccinations through medical clinics, it will impact our vaccination rates.This will put further strain on our acute care system once the flu season is in full swing."

 Alberta's flu vaccine uptake last year was the lowest it's been in a decade, at 24 per cent.

Dr. Christine Luelo, a Calgary family physician, is concerned about the scale back.

"When I hear the number of 20 to 25 [clinics] as a provincial number, I'm a little alarmed that that is a tiny drop in the bucket," she said.

"Best case scenario, they don't actually understand the implication of not including primary care providers as a key enabler to vaccination.… Worst case scenario is that they're actively working to be quiet about vaccines. And that's pretty alarming, to say the least."

Luelo said making vaccines as accessible as possible is key at a time when immunization rates are dropping.

And she's concerned the change will lead to fragmentation of care by forcing patients to take another step and go elsewhere for their vaccines.

"I've had many situations where a patient just needed a few extra questions answered, they're ready to go, and now I'm sending them away from my clinic in the hopes they won't change their mind en route to the pharmacy." 

The Alberta Medical Association is also speaking out.

"We are concerned that vaccines will not be available through community family or rural generalist clinics.… This removes the opportunity for Albertans to obtain advice and immunization from their most trusted source of medical information," Dr. Shelley Duggan, president of the AMA, said in a statement emailed to CBC News.

"About four per cent of immunizations were administered in this way last year and that's still significant: every person vaccinated means improved safety for everyone."

According to Duggan, the AMA is consulting with members and will continue to press government to consider other options.

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Meanwhile, the provincial government said it will continue to monitor vaccine uptake and will make changes if needed.

"We want to be clear that there continues to be good access to immunization services in Alberta," the statement said.

Influenza, COVID-19, pneumococcal and Tdap vaccines are available at approximately 1,600 community pharmacies and 150 AHS clinics. According to the province, 97 per cent of the people immunized against the flu last year received their shots at those locations.

COVID-19 will no longer be shipped to any community medical clinics to avoid waste, according to the province, because there are multiple doses in each vial.

The selection criteria for clinics is still in the works and the province expects to start shipping from its provincial vaccine depot between the end of November and mid-December.