Unhoused people should be priority for Johnson & Johnson COVID-19 vaccine, Toronto doctor says

A Toronto doctor is lobbying to have the one-shot Johnson & Johnson COVID-19 vaccine approved for use in shelters and encampments because he says tracking down unhoused people for a second shot is challenging.

Dr. Andrew Bond, medical director of Inner City Health Associates in Toronto and co-chair of the Canadian Network for the Health and Housing of People Experiencing Homelessness, said small mobile teams with the vaccine could go to shelters and encampments on a daily basis to ensure everybody has access.

Bond said vaccination of unhoused people in Toronto, if the supplies of one-shot vaccines were available, could be done in about six to eight weeks as long as it can be transported and stored easily.

Given that there are 16 shelters in outbreak in Toronto, with a total of 280 active cases, one recent death and two hospitalizations as of Friday, Bond said a new approach with a single-shot vaccine is in order.

The new approach would bring down the numbers of unhoused people exposed, infected and getting sick with the novel coronavirus, he said. The Johnson & Johnson vaccine is produced by J&J subsidiary Janssen Pharmaceuticals.

“We know this has just been ongoing,” he said.

“We know that every time we give an AstraZeneca vaccine right now, we’re creating still a complicated problem a couple months down the road for ourselves. We can get this done within a couple of months right now, at most, if we actually have the Janssen vaccine. If we don’t, we know we are going to end up having to still do this into the fall most likely as well,” Bond said.

“And that’s a real concern if we are ever going to put an end to these outbreaks, which we can do.”

Bond said the vaccination of unhoused people has been dependent on other vaccines, mostly Pfizer and Moderna, that involve two shots. He said slightly less than 2,000 vaccine doses among unhoused people have been administered in Toronto.

Dr. Andrew Bond, medical director at Inner City Health Associates in Toronto, says: ‘Despite the fact that we have covered a lot, almost a third of the homeless population so far, we have a long way to go, and unfortunately, we need now to layer a new strategy onto this in order to be successful.’ (Submitted by Andrew Bond)

The challenges are that unhoused people are “hyper mobile,” the population fluctuates and changes over time, and the city has more than 120 sites for people experiencing homelessness. Bond said the provincial government needs to prioritize unhoused people and the federal government needs to procure one-shot vaccines.

“Despite the fact that we have covered a lot, almost a third of the homeless population so far, we have a long way to go, and unfortunately, we need now to layer a new strategy onto this in order to be successful,” he said.

“We’re still going to have large numbers of unprotected people, so this is something that we actually can’t wait for. The only option is, get this done, or we’re going to see more of the same.”

Johnson & Johnson vaccine doses in storage

Health Canada, however, has decided to hold off on distributing the first shipment of Johnson & Johnson’s COVID-19 vaccine after it became clear the doses that arrived in Canada this week were partly manufactured at a Baltimore, Maryland facility with health and safety violations.

The doses will be released for distribution only if Health Canada decides they have met its “high standards for quality, safety and efficacy,” the federal department said in a statement on Friday evening.

A total of 300,000 doses are sitting in storage at a facility outside Toronto’s Pearson International Airport, Bond said. 

Anna Miller, a spokesperson for the Ontario health ministry, said it’s still too early to say exactly how they will be distributed. She said that guidance will come from the National Advisory Council on Immunization (NACI).  

“Ontario’s rollout of Johnson & Johnson will be informed by the guidance released by NACI. We look forward to sharing more details after NACI releases their guidance,” Miller said in an email to CBC News on Saturday.

Vaccination of unhoused people ‘too slow,’ says street nurse

Cathy Crowe, a street nurse in Toronto, said there have been 1,500 COVID-19 cases in the shelter system since the start of the pandemic, 850 of them since January alone, and vaccination rates need to be stepped up. The numbers include staff. 

“For us, the third wave was visible in the shelter system before it was even declared,” she said.

Crowe said the problem is partly the shelter system, which she described as “antiquated,” has been underfunded for years and conditions have been very crowded. She noted that unhoused people have been a priority group for the vaccine, but “it’s been a struggle” because the schedule has not been transparent.

“We are looking forward to the possibility of Johnson & Johnson, the one-shot vaccine being used in this population because I think it will make it easier. It’s too slow,” she said.

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