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Province faces charter challenge over equity in vaccine rollout,
A GRIM ANNIVERSARY On Sunday night, the one-year anniversary of the first COVID-19-related death reported in Toronto, the city held a ceremony of commemoration at Nathan Phillips Square, featuring 2,753 candles, one for each life lost due to the pandemic.
The provincial government is facing a new legal challenge under the Charter of Rights that claims the vaccine rollout is resulting in many vulnerable people falling through the cracks.
Those missing out include people with disabilities, seniors who are homebound, and those who live in harder-hit neighbourhoods.
It was filed March 15, by David Daneshvar, a Toronto man who lives with a number of disabilities, represented by David Baker, a senior partner at the human rights firm Baker law.
Daneshvar cannot make it to mass vaccination sites, Baker said, and will need accommodation to get the shot.
“He’s not trying to jump in line ahead of anyone else,” said Baker, who added the case is scheduled to be heard April 15. “The mass immunization program excludes him and many other people.”
The filing calls for the Ministry of Health to direct public health units to make equity central to their vaccination plans, and provide the resources to do it.
It notes the province’s online vaccine booking system is not accessible for people who are blind, and those who are not digitally literate or lack computer access. People need phones and to be able to be on hold for a long time if they want to use the call centre.
The website is available only in English and French, and while some public health units also include mobile or neighbourhood clinics, “these clinics are not functioning at a level which provide equal access, if they exist at all.”
Ministry of Health spokesperson Alexandra Hilkene said in an email that “the province is committed to achieving a balanced and equitable distribution of vaccines.” She added it would be “inappropriate” to “comment further” as the matter is “before the courts.”
But Baker believes the province should have been planning how to accommodate his client and others like him six months ago. “And instead of doing it they dropped it on the public health units with no resources,” he said.
Door-to-door vaccine clinics are happening in some seniors buildings in Toronto, but not in every building and not everywhere.
“People who require support are not receiving it except on an ad-hoc or pilot project kind of basis,” Baker said.
Dr. Michael Rachlis, an adjunct professor at the University of Toronto Dalla Lana School of Public Health, submitted an affidavit in support of the case.
“I can see that equity has not been part of the planning for vaccination,” he said in an interview. “There’s just suggestions for what might be done, there is no mandate.”
Some health units, like Toronto, have some programs to address equity, while others don’t even mention it in their vaccination plans.
The province has a “constitutional responsibility” that within the groups you have prioritized “you accommodate people to ensure that they get the service,” Rachlis said.
Seniors 60 and up who are mobile and tech-savvy are able to secure appointments for the AstraZeneca vaccine at their neighbourhood pharmacies, for example, in Kingston, Windsor and Toronto. But, according to a recent CBC story, there’s a gap in pharmacies offering the vaccine in the hardhit northwest corner of city.
“If you live in Rexdale you shouldn’t have to get on a crowded bus to get it,” he said. “You can’t leave out 94-yearolds at home because they can’t get to a mass vaccination clinic.”
Ann Fitzpatrick’s 97-year-old father, Tom, lives in Scarborough and receives home care. That makes him part of two of the highest priority groups on the province’s website to get the vaccine, and he’s at risk because of caregivers coming in.
But he uses a wheelchair and is essentially homebound, unable to get to a mass vaccination centre.
Fitzpatrick has been advocating on his behalf, “shuttled from bureaucracy to bureaucracy.” She’s frustrated that 60somethings, including herself, in Toronto are now able to get vaccines, while her father is still very much at risk.
“Why is the province allowing such an ad hoc approach?” she asks. “Why wasn’t this planned better?”
The province sets the prioritization for vaccine groups but it’s up to public health units to make and implement their own plans, following this guidance. This has resulted in some variation based on where people live.
Some public health units are using the provincial booking portal, while others are using their own sites.
Wellington-Dufferin-Guelph Public Health is preregistering those age 60 and up, essential workers such as teachers, and people with serious medical issues, even though they are part of Phase 2 of the province’s rollout, which is supposed to start in April.
And in Toronto some hospitals are doing their own registration. University Health Network, for example, is now offering the vaccine to faith leaders who live in its hospital catchment areas, as many other essential workers continue to wait.
Asked about this, Ministry of Health spokesperson Lindsay Davidson said the government “understands the important role faith leaders play in the lives of many Ontarians.”
He added that vaccination of this group “should be considered” for “individuals who, as part of their regular role, are at increased risk of exposure to COVID through close contact with persons and families” in circumstances such as end-of-life care at hospitals and long-term-care homes, and visits to people in those settings.
“If you live in Rexdale you shouldn’t have to get on a crowded bus to get (the vaccine). You can’t leave out 94-year-olds at home because they can’t get to a mass vaccination clinic.” DR. MICHAEL RACHLIS UNIVERSITY OF TORONTO DALLA LANA SCHOOL OF PUBLIC HEALTH