Vaccine rollout plan is 'inequitable distribution,' says pediatrician

Some health-care workers in Newfoundland and Labrador say they want more clarity on who can get a COVID-19 vaccination, and a clearer timeline on when they can expect to be vaccinated.

Dr. Susan Russell, a pediatrician who works at a clinic in Deer Lake, says she and her husband, a family doctor, both applied for a vaccination rollout that was coming to the community earlier this month but neither of them were accepted.

However, a number of other health-care workers at the same clinic did receive the vaccine, Russell said.

"We were quite surprised by that," Russell said.

After a number of phone calls, Russell said they were told they didn't qualify because they don't work in long-term care, have patients who are in hospital, or do emergency room coverage.

Our risk is quite high and there seems to be a very inequitable distribution of these vaccines.- Dr. Susan Russell

"However, there were a number of other people vaccinated that day who work here in the Deer Lake clinic who also don't meet those criteria who were vaccinated."

Russell said the reasoning didn't make sense to her.

"We aren't suggesting that none of those people should have been vaccinated — we want everybody to be vaccinated, and the more people vaccinated the greater chance we have of immunity to the virus, but certainly nobody who was vaccinated that day has any greater risk of exposure than my husband or I," she said.

"Most of the risk would be equal, or in the case of support staff the risk would have been lower than ours. But we were left out of that vaccination."

Russell looked into it and found that the people who received the vaccine during that clinic were either on salary or contract by Western Health, while she and her husband operate private practices.

Their experience is consistent with a recent claim by the Newfoundland and Labrador Medical Association that hundreds of family physicians who do not work within regional health authorities or in hospital facilities are not being included in the priority groups during the phased vaccine rollout plan.

Through her practice, Russell said, she sees between 20 and 25 patients a day, in person. Since they are children, they are accompanied by an adult.

"So going through my clinic on any day there's 40, sometimes 50 people that I'm coming into contact with. Those are the same people who, when they get sick, end up down at the hospital," Russell told CBC Newfoundland Morning.

Recently, Russell said, she had a patient that she had to send to hospital. Once they arrived, they were given a COVID-19 swab and were treated by a vaccinated doctor.

"We're at equal risk. We attend to these patients in small rooms, in close contact and of course the very nature of our job is to become physically close with the patient, looking in their ears, down their throat, performing physical exams," she said.

"So our risk is quite high and there seems to be a very inequitable distribution of these vaccines between those who have some association with the hospital and those who work privately."

'Somewhat insulting'

On Wednesday, health officials announced they would be opening up pre-registration for the vaccine to health-care workers who have not already been inoculated: doctors and pharmacists who are interested in administering vaccines can apply to do so, and get a vaccine as well.

Russell called that "somewhat insulting."

"As if all of the work we have done so far during this pandemic … is not good enough for us to get a vaccine like our colleagues. We have to do something extra — we have to work in their clinic."

The lack of firm rollout dates for vaccinations is also vexing to Russell.

"The timelines that have been thrown around is maybe by the end of April. That gives us another month of practising medicine without protection of the vaccine when our colleagues have been vaccinated," she said.

"I have some colleagues who work in the hospital in Corner Brook who have had both of their COVID doses … and we're fighting to get the first one."

Unable to track which nurses not vaccinated

The timeline question is one the Registered Nurses' Union of Newfoundland and Labrador is also asking.

President Yvette Coffey said the union received information from Eastern Health and Central Health on Wednesday evening that outlined plans for health-care workers identified in Phase 2 to be able to make appointments for vaccines starting next week, with injections to start the week of April 5.

"Depending on supply and any other factors that might pop up, hopefully by the end of April, all health-care workers who have direct patient contact on the front line will have been vaccinated, including registered nurses and nurse practitioners," said Coffey.

"But it depends on supply of vaccine, and right now we only know of the supply to the end of March."

The union is also asking for more transparency, Coffey said, on who will be included in those plans, and where the vaccinations will happen.

Coffey also said there is a challenge in confirming exactly how many of her union members have, or have not, been vaccinated because of the way the information is being entered by the health authority.

"We have asked repeatedly to break it down by discipline so that we would know how many registered nurses or nurse practitioners have been done, but because they are registering people in the electronic medical record system, you're being registered by your MCP, just like everybody else in the public — even though you have to present your work ID to prove your eligibility to be vaccinated," she said.

This makes it difficult for them to know who is being missed in the vaccine rollout, Coffey said.

"We do know that generally, most people assume that the registered nurses have all been vaccinated. However, that's not the fact. We still have many groups out there on the surgical and medicine units that look after post-op patients, patients with medical issues that are admitted, such as having a stroke or heart attack, just for examples," she said.

"Those RNs have not been vaccinated.… The ones that have been vaccinated are those that work directly in a COVID unit, in the critical-care units, the ORs and in the emergency rooms. The rest of the nurses in the acute-care settings have not been vaccinated."

Coffey said the lack of clarity is putting added strain on nurses and the recent outbreak at St. Clare's shows just how quickly things can change.

"I think it has added another level of anxiety and frustration to our members."

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