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The Review

Proposal for Pfizer Mass-Immunization Hub Ready to Execute in Rural Ontario

Posted On: Monday, January 4, 2021

The Grey Bruce Health Unit has a proposal before the provincial government, addressed to General Hillier that would provide the Provincial Government with a successful pilot of a Pfizer logistic hub for vaccine delivery in small-urban and rural communities, which is representative of the majority of communities in Ontario.

Proposal for Pfizer Mass-Immunization Hub Ready to Execute in Rural Ontario

The pilot is a design of an effective hub that can overcome the logistical challenges related the population-level mass immunization with the Pfizer vaccine. Such an effective model, specifically validated in small-urban and rural communities, will increase the utility of the Pfizer vaccine and save lives throughout Ontario. 

The proposal capitalizes on the optimal readiness and collaboration among Grey Bruce Health Unit, Grey and Bruce municipalities, three hospital systems and health care partners, and community partners including Bruce Power and Chapman's Ice Cream (cold chain experts in Canada).

For logistics, the proposal outlines the unique resources available in Grey-Bruce. For example, the Security Risk Assessment of all vaccine hubs is conducted and coordinated by the state-of-the-art security services for Bruce Power (the largest nuclear generation facility in Canada). Bruce Power has also provided resources for two Recovery Centres (field hospitals) in two arenas currently being converted to Mass Immunization Hubs by adding an ultra-low temperature vaccine freezer and accessories. The resources for a third hub is on standby for deployment if needed. Lower tier municipalities have provided the arenas, and the two Counties have funded part of the project. Chapman’s has committed to deliver two ultra-low temperature vaccine freezers this week, and the necessary human resources with expertise in dealing with storage and management of ultra-low temperature vaccine inventory.

Grey Bruce Health Unit’s expertise encompasses the management of mass immunization clinics in schools, field hospitals, arenas, on buses and other community settings. Our staff are not only medically trained and approved to administer the vaccine, they are also experienced in operating during Public Health emergencies - Walkerton water crises is one example. We are also experienced in working with the diverse populations within Grey-Bruce, such as First Nations, Low German-speaking communities, and others.

Public Trust and an acceptance of vaccination are critical to the success of the pilot – both of which are optimal in Grey-Bruce. Our population has a higher than provincial average vaccine coverage rate for the in-school program (a proxy of vaccine acceptance rate in the area). Data from the vaccine readiness survey conducted by our Epidemiology Team in December 2020 show that nearly 70% of Grey Bruce healthcare workers surveyed will definitely or probably get the COVID-19 vaccine once available.

The proposal includes two population-level immunization plans designed to utilize mass immunization hubs to distribute and administer the vaccine based on the product handling requirements and stability guidelines.

The first plan, for Pfizer vaccine distribution, recognizes rigorous handling requirements and ultra-low temperature storage guidelines. In this plan, the vaccine is delivered to and administered at central locations (Mass Immunization Hubs). A central site necessitates the more vulnerable populations' safe transportation, particularly the high-risk groups, to these locations. A partnership with the Counties of Bruce and Grey and the local school transportation consortium provides access to both large and small vehicle fleets with the capacity to achieve the desired immunization target. A unique asset for this plan is the SMART (Multi-jurisdictional Disability Transportation System), which is funded and operated by a partnership of lower-tier municipalities in Grey and Bruce Counties.

The second plan, for all other types of COVID-19 vaccines, is based on less rigorous cold storage and vaccine stability demands, which allows secondary transportation to identified delivery points. Led by the Grey Bruce Health Unit, clinics would include community partners such as hospitals, family health teams, EMS, pharmacies and others. Mass Immunization Hubs, arenas, schools, mobile clinics, and other community settings are potential sites for these immunization clinics.

Regardless whether one of the two plans or both plans are utilized, the pilot is designed to achieve the objective of preventing the danger of the pandemic (the hospital system’s ability to care for COVID and non-COVID patients being challenged leading to death and suffering) by eliminating the following two scenarios:

1. Increased demand:  Hospital system overwhelmed by increased number of hospital admission of infected high-risk individuals (>65 year old, heart and lung disease)

2. Decreased supply: Reduced hospital human resources by being in isolation (infected) or quarantined (exposed)

“Population-level mass immunization is the bread and butter for public health; on an annual basis public health effortlessly vaccinates millions of school students throughout Ontario.” Said Grey-Bruce’s Top Doctor, Dr. Ian Arra “With sufficient supply of the vaccine by our Government, and through collaboration with local partners in Grey and Bruce, I have the utmost confidence we will put the last nail in the coffin of this pandemic.”

Dr. Arra added “Most importantly, we will provide our Government with a robust and effective tool to save lives and livelihoods. A tool that is validated for small urban and rural communities, which is representative of the majority of communities in Ontario. Moreover, the pilot will also best position us for success to deploy our resources to support hot spots in Ontario”.

“By leveraging our logistics, recovery centers and purchased medical freezer now in hand we are supporting the leadership position taken by Grey-Bruce Public Health to have the infrastructure in place to be a rural hub for the Pfizer Vaccine.” said James Scongack, Bruce Power’s Executive Vice-President of Corporate Affairs & Operational Services. “All of these elements under the leadership of Grey-Bruce Public Health are being mobilized with urgency so we will be ready to be the first rural region in Ontario to put into use the Pfizer Vaccine which is a model and capability that can support neighboring Health Units in Western Ontario” added Scongack.

For More Information:

Dr. Ian Arra, MD MSc FRCPC ACPM ABPM

Medical Officer of Health and Chief Executive Officer

To arrange to speak with Dr. Arra, please contact Drew Ferguson at:

519-376-9420 or 1-800-263-3456 ext. 1269 or d.ferguson@publichealthgreybruce.on.ca

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