Health-care workers lining up for COVID-19 vaccine, but some warn of 'real troubles' with hesitancy

Melissa Vitug had mixed feelings about getting a vaccine for COVID-19 — a choice which would make her part of the first wave of health-care workers in Ontario to do so.

On one hand, she was nervous. On the other, she felt hopeful that getting the long-awaited shot would help bring the pandemic to an end.

With those thoughts whirling through her mind, the resident assistant from Houses of Providence long-term care home in Scarborough signed up to be the first front-line worker vaccinated when the hospital network Unity Health Toronto launched its COVID-19 immunization program this week.

On Tuesday, while clad in red scrubs during a break at St. Michael's Hospital before heading back to work, Vitug got her shot, with roughly 140 other health-care workers following her lead the same day.

"I'm feeling much more courageous in going to work every day," she said.

Hospital staff in Ontario's hardest-hit areas are now rolling out COVID-19 vaccination programs, with the first round of tens of thousands of Pfizer-BioNTech doses slated for health-care workers in hospitals, long-term care homes, retirement homes and other congregate settings caring for seniors.

The province anticipates that, by the end of January, more than 20 hospitals across Ontario will be administering the vaccine.

The immunization campaign marks a "turning point" in the pandemic, said Tim Rutledge, president and CEO of Unity Health Toronto, because it's targeting people at a high risk of being exposed to the virus.

"It's really important that we have front-line health-care workers immunized early on," he said.

But the challenge will be keeping this momentum going among front-line staff in the months ahead, others warn, given low uptake for annual flu vaccinations and some hesitancy over the new COVID-19 vaccine.

"We have assumed that if we get a vaccine distributed, that people are going to take it, and I think that's foolhardy based on previous vaccination rates in our province," said Dr. Nathan Stall, a geriatrician at Mount Sinai Hospital in Toronto.

Education a 'first step'

Stall pointed to flu vaccine uptake over the last decade in Ontario.

Close to three-quarters of long-term care workers got the shot on average over the last three years, Public Health Ontario numbers show, while the uptake among hospital staff was only around 54 per cent on average during the same time period.

"We're starting from a place of real troubles with vaccine acceptance," Stall warned.

"We've also heard the perception from some that they're the guinea pigs in this vaccination campaign."

The relatively low uptake numbers, coupled with fears and conspiracy theories over the arrival of a COVID-19 vaccine, could be hurdles to ensuring health-care workers are protected.

According to Matthew Miller, an associate professor at the Michael G. DeGroote Institute for Infectious Disease Research at McMaster University in Hamilton, there will need to be careful communication as the immunization campaign ramps up in the months ahead.

Discussions with caregivers of all stripes need to underscore the critical imperative of protecting themselves and the people in their care, Miller stressed, while policy-makers might want to consider mandatory vaccines when a person's occupation brings higher risk.

"No one wants to mandate vaccines," he added. "I think education is the first step. Just because we have a vaccine available doesn't mean the story's over."

Campaign needs to combat hesitancy

Combating hesitancy will inevitably be an ongoing part of vaccination campaigns, said Dr. Zain Chagla, an infectious diseases physician at St. Joseph's Healthcare in Hamilton.

That may wind up getting easier as the months pass and both health-care workers and the broader public see immunizations rolled out to more and more people beyond the veil of clinical trials, he said.

"As that accumulates, hopefully that does decrease that hesitancy."

So far, the "incredibly scrutinized" vaccine from Pfizer-BioNTech is causing some serious allergic reactions, he noted, but adverse reactions more broadly have been minimal.

The U.S. Food and Drug Administration previously said huge studies of both that vaccine and a similar option from Moderna, approved by Health Canada Wednesday morning, have uncovered no major safety risks.

Ontario officials have stressed the "top priority" in the province's vaccination campaign is safety; with decreased risk of contracting COVID-19 in hospitals and long-term care being a key piece of the push.

"As we continue to receive more doses, we will ensure that every person who wants a vaccine will receive one," Health Minister Christine Elliott said in a statement earlier this month.