Bring mobile COVID-19 vaccine teams to Toronto buildings housing older residents, Ontario epidemiologists say

TORONTO -- Officials should consider implementing pilot mobile COVID-19 vaccination programs at apartments and condos in Toronto with high concentrations of elderly residents to help protect those at highest risk of severe infection, according to a new report by the province’s COVID-19 Science Advisory Table.

In the document, which was released on Wednesday, authors identify 489 residential buildings in Toronto that qualify as naturally occurring retirement communities (NORCs), which are defined as apartment buildings, condos, and co-op and social housing buildings that have at least 30 per cent of their residents above the age of 65 and at least 50 older people per building.

Of those nearly 500 buildings in Toronto, 256 are in neighbourhoods with the highest rates of COVID-19, including communities in the city’s northwest and east regions.

“Prioritizing COVID-19 vaccination by both age and neighbourhood of residence is an effective strategy to minimize deaths, morbidity, and hospitalization,” the document read.

“Targeting people living in NORCs in high-risk neighbourhoods for early vaccination is a practical application of that strategy, which will also address barriers to vaccination in this population.”

In the NORCs in areas with higher levels of transmission, there are approximately 40,955 adults above the age of 65, including 18,144 who are 80 and older.

Select local public health units, which will be given an influx of vaccine doses to inoculate Ontarians in neighbourhoods with high rates of infection during Phase 2 of the province’s vaccination program, could consider this strategy, the report notes.

“Such an approach is also age-friendly, as it is less complicated and physically taxing for frail or homebound older adults who might otherwise face challenges with booking appointments, travelling to and from mass vaccination clinics, and have difficulty waiting in lines,” the authors wrote.

While successful mobile vaccination pilot programs have been undertaken at NORCs in the city for influenza, the Science Advisory Table points out that these mobile clinics do pose some challenges.

Mobile teams will need a supply of COVID-19 vaccines that have less strict cold storage and handling requirements. Outreach will also be an important component, as these buildings typically don’t have existing relationships with the health-care system, the authors said.

“Mobile on-site vaccination teams should be aware of potential barriers to vaccine uptake. This includes minimizing language barriers, by ensuring that mobile teams are equipped to communicate in the dominant languages of the residents,” the report read.

The authors also recommend vaccinating an entire building, not just older adults, as interactions between people within the buildings are generally high.

The report notes that this approach could be applied to other high-density living environments in high-risk neighbourhoods, a move which would “further advance uptake of COVID-19 vaccines in Ontario’s hot spots.”