With third doses in Hamilton, ‘gating’ may equal ‘frustrating’ for older adults

A new term for the COVID-19 lexicon was borne Monday, the sometimes-chaotic first day where everyone over age 18 could get a third dose.

Generally, older adults are more at risk to complications and severe outcomes from COVID-19. But the City of Hamilton faced questions on Monday about why its appointment booking site allowed younger people to book their third doses before becoming eligible, and ahead of many seniors. There were also long lines in Freelton, in rural Hamilton, where many people queued in the cold in hope of getting vaccinated at the GO-VAXX bus vaccine clinic.

Dr. Elizabeth Richardson, Hamilton’s chief medical officer of health, did not exactly answer why that was the case. But there was a term she used for it.

“We call that ‘gating’ on the systems and the gating isn’t perfect in some of the systems that we have for booking vaccine across the province,” Richardson said. “We’ve very much been relying on people to follow the guidance of when they are eligible to book their appointments.

“At this stage, the provincial government has made the decision to open up to to the broader group of (age) 18-plus. We very much encourage people age 50 and up to look at all sources of where they can find vaccinations.”

The province has a searchable database at covid-19.ontario.ca/vaccine-locations that residents can use to find pharmacies that are taking appointments. Last week, those bookings were also opened to people aged 18 to 49, ahead of eligibility being opened. An appointment at a pharmacy is subject to vaccine availability.

‘End of January’

With community spread in the low end of the “uncontrolled” level, Hamilton has created a target of giving 8,000 doses per day. That is more than three times the rate from just prior to the advent the Omicron variant. Richardson has been careful to note Hamilton Public Health Services and the city’s healthcare partners are stretched thin.

“We expect it’s going to take through to the end of January to provide third doses to all those eligible,” Richardson said. “We know it’s frustrating at this time to book appointments as we deal with strained human resources. We want to make sure, as we did previously, that every appointment can be filled without cancellations.”

There were delays at the city’s clinic at the Centre on Barton on Monday due to staffing issues. That might be a harbinger of what’s to come as Hamilton tries to ramp up efforts even though healthcare workers are under mental strain, and many will have to isolate if they contract Omicron or have a close contact.

“That (8,000 target) is (dependent on) if we are able to secure the human resources, particularly the health human resources that we need to have in order to deliver these doses,” she said. “As we go forward and people become ill or are required to be isolated, that will put further pressure on our ability to deliver the vaccines. As well, we know we’re going to have, increasing pressure on our acute care system, so we’ll be prioritizing that going forward.”

The city is looking to hire new people for clinical and non-clinical vaccines as part of the ramp-up. While Richardson said she was “pleased” to see Premier Doug Ford call for volunteers last week, the city is not using them at this stage.

Last week, Hamilton expanded capacity of its clinic at St. Joseph’s Healthcare Hamilton West 5th Campus, and is also adding capacity at several other clinics.

Following the media briefing, the city announced people under 30 will start getting the Pfizer BioNTech vaccine. The 30-and-over population will receive Moderna.

The current emphasis, Richardson said, is to “slow down that wave” of Omicron. Hamilton’s seven-day average of 113 cases is double what it was just a week ago. But the reproductive number (Rt) of 1.32 is lower than the province’s 1.89 for all variants. (The provincewide Rt for Omicron is 3.38, according to the Ontario Science Table.)

“The best community service you can do for yourself, for your family, your neighbour is to get vaccinated, be it that first dose, second dose, third dose,” Hamilton Mayor Fred Eisenberger said.

“We have many, many people to vaccinate, so patience is the order of the day.”