TORONTO -- Ontario is developing a web portal for booking COVID-19 vaccine appointments when mass immunization is underway, but experts said Monday that more details of the province's plan are needed to ensure vulnerable residents don't fall through the cracks.
The Ministry of Health said Monday that Ontario is developing an online site for vaccine appointments, while a customer service desk will also eventually be available for those not comfortable using the web portal.
A spokeswoman said the scheduling software was launched "in pilot mode" in January and work is underway to have more of it in use at the end of February or in early March.
"These processes 'front-end' the scheduling system ... to provide a path to booking an appointment based on the province's eligibility framework," said Alexandra Hilkene, a spokeswoman for Health Minister Christine Elliott.
The booking system will be part of the province's vaccine rollout, which on Sunday was updated to identify adults aged 80 and older, seniors in congregate care and Indigenous adults among those next in line for a shot.
Hilkene noted that planning is underway for how adults 80 years of age and older will be vaccinated, with more details to be provided in the near future.
Dr. Samir Sinha, director of geriatrics at Mount Sinai Hospital in Toronto, said he was "elated" to see the vaccine priority list updated to include those over 80.
According to Health Canada, nearly 70 per cent of deaths from COVID-19 have been people aged 80 and older. Many of Sinha's patients are part of that age demographic, and he said he's been inundated with emails from patients and their families asking the same question: "How is this going to work?"
"That's the million dollar question," Sinha said by phone Monday.
While some younger seniors may be comfortable making appointments online, Sinha noted many in their 80s and older struggle with technology or may be physically unable to travel to mass vaccination sites now being developed by public health units.
Others do not speak English or French as a first language, which can be a barrier when booking health services, he said.
"I'm most worried about my 98-year-old or 97-year-old, homebound people who are quite isolated, and are high risk," he said. "This is the opportunity for Ontario to really get that right."
Sinha suggested utilizing the networks of primary care providers such as community paramedics, nurses and physicians, and teams that already have experience performing community vaccinations.
Dr. Jeff Kwong was part of a team that administered vaccinations in long-term care homes and said vaccinating seniors in their homes, as opposed to making them travel to clinics, should be considered.
"Sometimes it's the best way because these people may not be able to leave their home very easily," Kwong said by phone Monday.
It could be done with just one person going to a neighbourhood, Kwong said, suggesting home-care providers would be in a good position to administer the shots as they regularly visit patients already.
Some local public health units are in the process of planning neighbourhood mobile vaccination clinics, the Health Ministry said Monday, though the planning is dependent on vaccine supply.
Dr. Nathan Stall, a geriatrician also at Mount Sinai, said greater clarity is needed on the timing of the broader vaccine rollout -- especially considering the province has not yet finished fully vaccinating the highest-priority groups that include long-term care residents, nursing home staff and certain health-care workers.
Vulnerable residents with language and accessibility barriers may take longer to accommodate, Stall said, and those factors must be considered.
"My fear is that we may unintentionally de-prioritize them in our real zeal to try and accelerate our vaccine program," Stall said.
He added that greater clarity in the vaccination timeline would go a long way to lessening the anxiety among isolated people waiting for their shots.
The provincial NDP also called for more detail in the vaccination rollout plan on Monday, saying too many vulnerable people are still waiting in the dark.
"We need this government to reveal a comprehensive plan, now, and to pick up the pace," Deputy Leader Sara Singh said in a statement. She also criticized the Progressive Conservatives for lacking a plan to deal with vaccine "queue-jumping."
Sinha said patients are understanding about the need to prioritize certain groups, but Ontarians need to know where they stand in the process -- and the lack of clarity so far, coupled with news of non-medical and executive health-care staff receiving vaccines in some cases, is not good for public trust.
"That's exactly how you undermine people's confidence and undermine an effective vaccine rollout," he said.
This report by The Canadian Press was first published Feb. 15, 2021.
