Alberta's immunization plan needs to bring vaccines to communities facing barriers, doctors say

Doctors and nurses in Alberta say the provincial government needs to change its vaccine approach and start bringing vaccines to communities with high infection rates by using pop-up or mobile clinics to help break down any barriers. 

"Our vaccine distribution is not targeting the people that it should be," said Dr. Chuck Wurster, an emergency physician at Sherwood Park's Strathcona Community Hospital.

"We're not going to get rid of COVID if we're not targeting the hotspots."

'I think that we are failing' 

Bringing vaccines to communities with a higher risk of contracting the virus is an approach other places, like Ontario, have adopted during the third wave of the pandemic. Alberta also committed to sending extra vaccines and increasing eligibility in Fort McMurray and Banff when infection rates were spiking in those communities last month. 

In a report published last Thursday, Alberta Health Services' Scientific Advisory Group cited modelling data from Ontario (not peer-reviewed) that showed that "an additional 10 to 15 per cent of hospitalizations, ICU admissions, and deaths could be prevented by directing vaccines to areas with a high rate of COVID-19 transmission."

The report's authors noted that areas in Alberta that have a high number of COVID-19 cases often have lower vaccination rates "that are insufficient to mitigate viral transmission."

The AHS group recommended directing more vaccines to those areas and making sure it's easy as possible for people to get their shot.

"We know that ... these are newcomer communities, low-income, frontline, essential workers that have to go to work," said Dr. Gabriel Fabreau, an internal medicine specialist at Calgary's Peter Lougheed Centre and assistant professor at the University of Calgary's O'Brien Institute for Public Health. 

"They don't work from home and there's a very high concentration of ethnic minorities and multiple barriers to vaccination."

Barriers like not knowing how to navigate the booking system or not being able to get online have stopped some of his patients from booking their shots. 

One week ago, Fabreau and colleagues proposed pop-up clinics for communities with a higher risk of transmitting and contracting COVID-19 and working with community leaders to find solutions after learning from the pop-up vaccination clinics at the meat-packing plants he co-led last month. 

They never got a response back from the government, he said. 

"As a health-care professional, physician, that sees patients and talks to families, it's very frustrating to know that we could be doing a much more equitable, much more science-based, much more efficient vaccination rollout that would help put this pandemic to bed and would actually be protecting those that are most vulnerable," Fabreau said.

"I think that we are failing."

Looking at options

Alberta Health spokesperson Tom McMillan said in an email that Alberta Health is looking at options to target what he called low-uptake communities. 

He said in an email that it could potentially include pop-up clinics or other activities.

McMillan noted the province started releasing vaccine percentages by local geographic areas online on Monday.

"This will help us and local partners identify areas where additional work is needed to get people vaccinated," he wrote. 

Jennifer Jackson, a registered nurse and assistant professor at the University of Calgary's nursing faculty, said consulting with community leaders is key.

"It's important to look at where we are not getting the uptake and not to make assumptions about why that community might not be engaging, because as soon as we start doing that, our services are going to fall apart."