Vaccine Q and A: What happens when York Region hits a vaccination ceiling?

What happens when we hit a vaccination ceiling, like in the U.S? 

Demand for vaccines in York Region has been high, which may have been fuelled initially by the limited supplies, medical officer of health Dr. Karim Kurji says. 

When the pace of appointments has slowed, the public health unit has quickly expanded eligibility to other groups — as it did when appointments remained available following the opening of second dose bookings to ages 80 and older on May 31.

About a quarter of residents may have obtained their vaccines elsewhere, he added.

Also, individuals who live outside of the region have been vaccinated here — about 131,237 of 903,508 doses administered as of June 8.

Since June 3, the majority of daily doses administered have been second doses, according to the region’s public dashboard.

The number of individuals in younger age groups has been encouraging, Kurji said.

According the region’s dashboard as of June 8, the number of residents vaccinated by age group is:

Strategies for increasing vaccination rates include mobile clinics in areas where the rate of vaccination has been lower and opening up workplace clinics to employees’ extended family members, Kurji said.

More than 64 per cent of York Region’s population has currently received at least one dose. About 76 per cent of adults aged 18 and older have had at least one dose, and close to 74 per cent of residents aged 12 and older.

How is it being ensured that residents who wish to get the same second dose vaccine as the first will get it?

The provincial COVAX system tracks which type of vaccine was administered to each client, when and where. However, you are encouraged to confirm which vaccine types are available at your clinic of choice on york.ca/COVID19Vaccine when making your appointment, according to York Region spokesperson Patrick Casey. The region’s website identifies which clinic supplies which vaccine. 

Most vaccination clinics in York Region have both the Pfizer and Moderna vaccines onsite, Casey said. SoccerCity in Whitchurch-Stouffville currently has Moderna only, and the hospital-led clinics (Ray Twinney and Cortellucci-Vaughan) have Pfizer only.

Will second dose appointments automatically be cancelled if earlier appointments are booked? Or are the individuals responsible for making the cancellation?

When you change your appointment as a result of the shortened time interval between the first and second dose of the COVID-19 vaccine, your original second dose appointment will be cancelled by York Region Public Health, spokesperson Patrick Casey said. 

For residents who booked their appointments at Cornell Community Centre in Markham, the provincial booking system will automatically cancel the original second dose appointment.

What’s with the inconsistency regarding vaccine eligibility for 12-year-olds? Some GTA public health units are allowing the vaccine by year of birth, but York Region Public Health says the child must be 12 or older at the time of the vaccine.

Under licensing agreements with Pfizer in Ontario, the child must be 12 at the time of the vaccine, according to medical officer of health Dr. Karim Kurji.

“By accepting anybody who hasn’t turned 12, (it’s) an off-label use, which then means should something untoward happen, an adverse reaction, the individual who then administered the vaccine takes on a disproportionate amount of liability,” Kurji says.

The Ministry of Health policy for use of the vaccines is “very clear,” he said.

“We in Ontario have generally followed the practice of using the product for the age groups that it is licensed.” 

I'm curious how eligibility is being controlled for second doses. Has anything changed? I'm hearing of people who do not yet qualify for second doses under current age or any other categories, who are getting them. I know one couple, 68 and 76, who received their second dose appointments at the Vaughan drive-thru when only 80 and older were eligible.

York Region Public Health is aware some individuals may have received their second doses despite not qualifying under the current eligibility, according to spokesperson Patrick Casey.

Staff at vaccination clinics are asked to adhere to York Region’s current eligibility criteria, he said.

“Residents should not book an appointment for early second doses if they are not currently eligible; please wait your turn, but when it’s your turn – don’t wait,” he said. “As per provincial guidance, York Region follows an honour system for many of the eligibility groups and we ask residents to please respect this.”

Now that the province is requiring health-care workers at long-term care homes to be vaccinated, will they do the same for children attending school in person when a COVID-19 vaccine is approved for children under 12?

Ontario’s chief medical officer of health is considering mandatory immunization for COVID-19 for children attending schools, medical officer of health Dr. Karim Kurji says.

It is a provincial decision, he added, not a regional one.

“I think you will see increasing discussions about the mandatoriness of the COVID-19 vaccine as we get into the area of vaccine hesitancy,” he added.

My daughters, who are of child-bearing age, are being told by their physicians not to get the COVID-19 vaccine. Is there a valid reason to be concerned about the vaccine and infertility?

No, according to WHO physician Dr Soumya Swaminathan, however, it’s a common myth. There is no scientific evidence or truth behind this concern that vaccines somehow interfere with fertility, either in men or in women, because what vaccines do is stimulate an immune response against that particular protein or antigen of that virus or bacteria, she says.

The COVID-19 vaccine stimulates both antibody response and a cell mediated immune response against the spike protein of the SARS-CoV-2 virus. 

“So, there is no way in which they could interfere with the functioning of the reproductive organs in either men or women. So, I think people can rest assured that these vaccines in no way interfere with fertility,” Swaminathan states.

What about women who are pregnant or are planning to get pregnant?

That's really important because pregnancy, of course, is a very special situation because we are concerned about the health of the mother, but also about the health of the fetus, the unborn child, WHO physician Dr Soumya Swaminathan says.

Special care needs to be taken regarding any drug or vaccine administered during pregnancy. In the case of COVID, we know that pregnant women are at higher risk of getting severe COVID and also at higher risk of delivering a baby prematurely. 

In situations where there is a lot of COVID transmission in the country and a woman is exposed to it, or if she's in a profession like a health-care worker or a frontline worker, the benefits of getting the vaccine definitely outweigh the risks, particularly since the platforms used currently for vaccines are the mRNA platform, inactivated viruses or the viral vectored platforms or subunit proteins, she says. It's best to consult with your physician.

None of the vaccines have a live virus that can multiply within the body and that could potentially create a problem, Swaminathan says.