Ontario’s Covid-19 Vaccine Immunization Program: Highlighting disparities and accessibility concerns

By: Ruth Rosalle and Megan Annable

Amidst climbing rates of virus transmission and the government working to implement “Phase 2” of the COVID-19 Vaccine Immunization Program, Ontario faces a pressing challenge of working against the clock to implement policy to help curb the spread of COVID-19 effectively. As the new variant strains of COVID-19 continue to place pressure on local health care units, the province needs a flexible yet robust approach to mitigating the rapidly evolving situation. While the Ford government recently announced a declaration of emergency and a province-wide stay-at-home order, their response structure and restriction guidelines have come under scrutiny as being inconsistent and difficult to follow. Accessibility throughout the vaccination process has especially been left unclear for specific populations, such as those who require language services, individuals with mental health conditions, and racialized communities. 

The linguistic diversity of Ontario highlights the importance of providing timely, accessible, and reliable information during times of crisis. The Ontario government has launched a Provincial Vaccine Information Line in tandem with the Provincial Online Vaccine Booking System to offer information in more than 300 languages over the phone. However, only Canada’s two official languages remain available on the Government of Ontario website for COVID-19 related information. This limited online offering can be problematic as it may lead to significant miscommunication between healthcare professionals and their patients. Major hospitals within Toronto also offer extensive services; the University Health Network, for example, offers access to language services in over 180 languages in-person and over the phone for short appointments. A gap still exists between the dissemination and portrayal of COVID-19 information about both the virus and the growing vaccination rollout. Ontarians who speak non-official languages may be reliant on resources from their home country, which may be at different stages within their vaccination rollout or could be distributing different vaccinations than in Ontario. Thus, these individuals will have incomplete information if unable to access Ontario or Canada based COVID-19 information in their preferred language. 

Ontarians could benefit from the provincial website using a model similar to that of the City of Toronto, which currently offers online translation in 51 languages using Google Translate. Providing technology-assisted interpretation services for patients online and in-person would also benefit immigrant and refugee populations whose limited familiarity with Canada’s official languages may prevent them from receiving adequate healthcare services. An accessible website allowing people to select their preferred language would provide vital information that may otherwise be unavailable. 

Although the current vaccination plan allows individuals with a diagnosed mental health condition to receive vaccination as a member of an at-risk population, the requirements around booking based on these grounds is still unclear. This is problematic as it creates an added level of difficulty for those attempting to access vaccinations. The language used for this at-risk group is the only one to specify requiring a medical diagnosis, which allows for the exclusion of those that may have recently developed a mental health condition in the wake of the pandemic but remain undiagnosed. 

An intersectional study on the Mental Health Impacts of COVID-19 during the second wave of the pandemic, conducted by the Canadian Mental Health Association, found that only 2% of respondents accessed mental health resources online despite 65% self-reporting experiences of adverse mental health as a result of the pandemic. Although 44% of all respondents from Ontario noted a deterioration in their mental health, those with a disability, who identify as members of the LGBTQ2+ community, and who identify as Indigenousreported declining mental health at considerably higher rates. 

Multiple reports produced by Statistics Canada on topics including Canadian immigrantsvisible minorities, and gender identities found various correlations between the respective groups’ lived experiences and higher reports of adverse mental health symptomatology during the pandemic. It is important to note that while these are separate studies, Canadians can have intersectional identities that may reach across and extend beyond these groups, potentially intensifying their mental health outcomes. Those belonging to intersectional groups and communities may also have their experiences compounded by factors such as food insecurity and housing vulnerabilities, further exacerbating both existing social determinants of health and mental health disabilities.

The collection of COVID-19 related race-based and demographic data is not frequently available in municipalities across Ontario, despite the Ontario Human Rights Commission recommending race-based data collection to allow for equal access to public health resources and protections for all Ontarians. In a recent update, Canada’s Chief Public Health Officer noted that racialized communities are disproportionately impacted by COVID-19, with data from Toronto and Ottawa demonstrating that cases are one and a half to five times higher for racialized communities. In light of this, the City of Toronto plans to operate five mobile vaccination clinics to target neighbourhoods with a high number of COVID-19 cases in response to trends observed in their race-based data. However, it is unsure if these supports are enough to help communities already deeply impacted by virus transmission. 

The province should deploy additional vaccination measures if it is interested in curbing the spread of COVID-19 and to address inequities in communities through transparent data collection. The province has begun to prioritize vaccinations by targeting hot spots and high-risk groups to reduce hospitalizations, ICU admissions and COVID-19 related deaths. 

While this article identifies three areas of concern related to Ontario’s COVID-19 response, the discussion does not end here. The pandemic has revealed numerous health equity and service availability issues that will need to be tackled with sensitivity and an intersectional focus.

Megan Annable is a Master of Public Policy candidate at the University of Toronto’s Munk School of Global Affairs and Public Policy. She is interested in public health, environmental, criminal justice, and social policy. Megan holds an Honours Bachelor of Arts in Political Science and Criminology & Sociolegal Studies from the University of Toronto. She currently serves as a Policy Analyst with the Policy Innovation Initiative researching the disproportionate representation of racialized communities in COVID-19 cases. She is also a Policy Analyst with the Indigenous Policy Initiative.

Ruth Rosalle is a Master of Public Policy candidate at the University of Toronto’s Munk School of Global Affairs and Public Policy. She has interests in social policy, environmental policy, public health, education, and econometrics. Ruth holds an Honours Bachelors of Arts from the University of Toronto in Political Science and Criminology & Sociolegal Studies. She currently serves as a Policy Analyst with the Policy Innovation Initiative at the Munk School researching effective health services for immigrant, refugee and racialized populations in Canada. 

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