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#BehindTheVaccine – Meet the mobile team at Michael Garron Hospital and East Toronto Health Partners
#BehindTheVaccine tells the stories of Michael Garron Hospital’s (MGH) and East Toronto Health Partners’ (ETHP) COVID-19 vaccine team, a group of dedicated staff, physicians and healthcare leaders who have administered more than 600,000 doses of the COVID-19 vaccine to East Toronto residents since December 2020. Meet the mobile team.
Since Michael Garron Hospital (MGH) was selected to be a site for COVID-19 administration in Ontario in December 2020, the hospital has worked closely with community partners to ensure its vaccine rollout is driven by equity. An essential part of this strategy has been bringing vaccines to where local residents live, work and go to school.
This has meant taking the COVID-19 vaccine on the road to set up mobile or “pop-up” vaccine clinics in apartment building lobbies, community centres, mosques, schools, grocery stores, parks, plazas, subway stations and other places where people in East Toronto naturally gather and that are easy to get to. These mobile clinics offer first, second and third doses to eligible groups by walk-in.
The clinics help break down barriers to the COVID-19 vaccine, including barriers related to a lack of time or access to transportation, because they make vaccination as easy and convenient as possible. They also help build vaccine confidence in local residents: when people see their friends, family and neighbours getting vaccinated in a place that’s close to home, they may be more motivated to get vaccinated themselves.
“Not everyone is able to go to a mass immunization clinic,” says Phillip Anthony, Manager of the Mobile Vaccination Strategy for East Toronto at MGH. “If someone can’t get to a clinic for whatever reason, we want to be able to go to them with the vaccine. This is the equity piece that has driven – and continues to drive – our vaccine campaign.”
However, taking COVID-19 vaccines on the road is no easy feat. It involves immense planning and coordination; liaising with health system partners; and collaborating with dozens of healthcare, social services, community and grassroots organizations in East Toronto to ensure the locations and hours of mobile clinics make sense for the local community.
Many of these partner organizations are members of East Toronto Health Partners (ETHP), the Ontario Health Team (OHT) that MGH is part of. They have been instrumental in local outreach and promotion, often mobilizing teams of volunteers known as community ambassadors who go door to door, flyer buildings and common areas, and answer questions to make sure people have accurate information about the COVID-19 vaccine and where to get it.
Below, meet some members of MGH and ETHP’s mobile team who, since December 2020, have helped operate hundreds of mobile clinics in East Toronto and beyond in collaboration with the clinic team, pharmacy team, strategy and operations team and others. This includes a record-breaking pop-up vaccine clinic at Scotiabank Arena in June 2021, when 26,771 doses of the COVID-19 vaccine were administered within 24 hours.
Manager, Mobile Vaccination Strategy for East Toronto, Michael Garron Hospital
Thanks to his previous role at MGH of helping to manage outbreaks at and deliver vaccines to long-term care homes in East Toronto, Anthony understands well the nuances of taking COVID-19 vaccines outside hospital walls. But he’s quick to credit collaboration with partners as the key to the success of MGH and ETHP’s mobile clinics. “I usually tell people, yes, I know how to run a vaccine clinic. But our partners know our community best,” he says.
To this end, Anthony is in regular contact with representatives from organizations like TNO – The Neighbourhood Organization, Flemingdon Health Centre, Access Alliance Multicultural Health and Community Services and WoodGreen Community Services. They share feedback on ideal locations and hours for mobile clinics in neighbourhoods like Thorncliffe Park, Oakridge and Taylor-Massey, which have been disproportionally impacted by the COVID-19 pandemic. Together, they also capture and analyze data to find specific buildings or blocks with low vaccination rates so they can plan mobile clinics for those areas.
In addition, these partners provide Anthony with feedback on the challenges local residents are facing to vaccination, so together, they can find solutions that help address vaccine hesitancy and other obstacles. At the peak of the mobile vaccine rollout in spring 2021, when MGH and ETHP were running multiple mobile clinics in East Toronto every day, Anthony, a Registered Practical Nurse (RPN), was often on-site at clinics to help with setup and coordination. He has also co-chaired the City of Toronto’s Vaccine Equity Strategy, Joint Vaccine Operations and 5-11 Vaccination Planning Table.
“I remember there was one day where myself and another nurse visited an apartment building in Thorncliffe Park to deliver vaccines,” Anthony says. “We went door to door and not a single person said they wanted to be vaccinated. The next day, we returned with community ambassadors from TNO – volunteers who live in the neighbourhood and who local residents know and trust – and we were able to administer more than 200 doses. It just goes to show how important it is to work with those people and agencies who know their communities best. There’s a level a trust and familiarity that we’re able to build on.
“I’m proud of how well our teams have come together,” Anthony adds. “When everyone is working toward a common goal, you can really move mountains.”
Vaccine Clinic and Scheduling Coordinator, Michael Garron Hospital
As the Vaccine Clinic and Scheduling Coordinator from March 2021 to January 2022, Chow liaised with suppliers, couriers and stakeholders like the City of Toronto and TTC to ensure MGH and ETHP’s mobile clinics had everything they needed to run. This includes permits, tents, tables, chairs, signage, and IT and medical equipment, as well as staff like nurses, physicians, screeners, clerks, security personnel and others.
After a few months, Chow had the process down to a science. But he remembers the early days of the vaccine rollout when the mobile team transported many supplies to the clinics themselves. This often required wake-up calls as early as 5 a.m. and multiple trips between the hospital and various clinic sites. The unpredictability of running what is essentially a pop-up mass immunization clinic in a parking lot, plaza or other site continues to keep Chow on his toes.
“There’s something new every single day. As soon as you think you’ve nailed everything down, something unexpected pops up,” he says. “It’s our job to respond to that and make sure the clinics are running smoothly and our clients are happy.”
Chow has since transitioned to the role of Project Manager, COVID-19 Vaccination Program at MGH. He continues to work with community partners to scout potential locations for mobile clinics that will help bring vaccines to hard-to-reach and at-risk groups. He says knowing that the team is making a difference is what drives him.
“There are a lot of people out there who have limited access to healthcare or who don’t have a family doctor. And then there are others who lack access to transportation or have mobility issues or other challenges. So it means a lot to know that we are helping people get their first and second dose. That’s one less person who is going to be seriously ill because of COVID-19.”
Manager, Community Development and Special Projects, TNO – The Neighbourhood Organization
Throughout the pandemic, Thorncliffe Park and Flemingdon Park residents have been at increased risk of COVID-19 because of the neighbourhood’s large population of essential workers and families living in multi-generational households in high-density buildings. So when TNO had the opportunity to collaborate with MGH, ETHP and other partners to help deliver vaccines to the community, it represented a “turning point” after what had been a challenging year.
“Thorncliffe Park and Flemingdon Park had some of the highest COVID-19 positivity rates earlier in the pandemic, which led the neighbourhoods to be unfairly stigmatized,” Lhamo says. “There are people who live here who can’t afford to take time off work to get the vaccine or don’t have anyone to look after their kids so they can go get vaccinated. So it was important we were able to bring the vaccine to them.”
As part of this work, Lhamo works closely with community ambassadors at TNO and Flemingdon Health Centre, who she says have been crucial to vaccine outreach in the area. In the days before a mobile vaccine clinic, these volunteers go door to door in apartment buildings to inform residents of the clinics and ask if they’d like to be vaccinated. If a resident says no, the ambassadors ask if they would like a healthcare provider to follow up with them to answer their questions and concerns.
The team conducts most of their outreach in the evenings, when they find most residents are home. “We want people to know that we’re here to listen and that we’re ready to support them with whatever information they need,” Lhamo says. “We’ve been able to use this approach to motivate a lot of people who were on the fence to get vaccinated. That is the best feeling.”
Community Health Worker, Access Alliance Multicultural Health Services
Vaccine Engagement Team Lead, East End of City of Toronto and United Way’s East York-Don Valley Cluster
Maria Dasoo works closely with MGH, ETHP and other partners to help increase vaccine uptake in Taylor-Massey, Oakridge and Victoria Village. These are areas in Toronto that have been disproportionately impacted by the COVID-19 pandemic and, due to their unique demographics and geographies, require tailored approaches to sharing vaccine information.
For example, Dasoo says going door to door is an effective strategy in Taylor-Massey, where many residents – particularly those in Crescent Town – live in high-rise apartment buildings. However, in Victoria Village, where residents are more spread out in comparison and there is a large senior population, visiting places where people tend to spend their time, like local businesses or sites of seniors programs, may prove more effective in vaccine outreach.
These are just some of the things Dasoo considers when developing and facilitating hyperlocal strategies that help get vaccines into arms. “At Access Alliance, we facilitate access to a wide variety of programs, including primary healthcare for immigrants, refugees and the communities they live in. We work to improve health outcomes and help clients access programs, such as food security and housing that impact their social determinants of health,” she says. “So when the pandemic hit, it made sense for us to help increase access to COVID-19 vaccines. This is especially important for people who are uninsured or unsure of how to navigate the healthcare system. We want to engage people in a way that works for them and makes sense for them.”
Dasoo says the vaccine engagement work has been especially meaningful because it’s allowed her and other community health workers to connect with local residents during a time that has been isolating for many. “After not being able to interact with our community in-person for so long, it’s been really nice to have these conversations where we can share health information and help people make the decision that’s best for them about vaccination,” she says.
Manager, Newcomer Wellness, WoodGreen Community Services
One of the many areas that WoodGreen Community Services serves is Taylor-Massey, a neighbourhood with a high proportion of newcomers and immigrants. Many of these individuals are uninsured, unattached to primary care and/or don’t speak English as a first language. For these reasons, developing a multilingual strategy that helps build trust has been key to local vaccine outreach.
“We’ve done lots of work in the community in terms of connecting newcomers and others with the health and social services they need, and addressing the social determinants of health, like income and housing, that impact someone’s well-being,” Alamyar says. “So when COVID-19 vaccines became available, we were able to build on these established relationships to share vaccine information, help people book appointments and get them to the closest clinic.”
For Alamyar, the mobile vaccine clinics in Taylor-Massey operated by ETHP, which have taken place in school playgrounds, parks, grocery stores and other sites, have been a game-changer. They’ve allowed local residents to get vaccinated in their own backyards without any barriers. Even the lineups seen at earlier mobile clinics had a silver lining, Alamyar says. “It was like this snowball effect. When people saw their neighbours lining up to get vaccinated, some of them felt more comfortable. They said, ‘You know what? I can get vaccinated too.’
“I’m proud of our partnership and how so many different agencies and organizations have been able to collaborate since day one,” Alamyar adds. “We’ve been able to share our resources and expertise to focus on the community. When everyone has a seat at the table, we’re able to accomplish greater results.”
School Outreach Lead, Michael Garron Hospital
As “hubs” in their communities that many families live close to and are familiar with, schools make sense as sites for mobile vaccine clinics, especially for children. That’s why, in May 2021, when children aged 12 to 17 became eligible for the COVID-19 vaccine, MGH and ETHP started partnering with local schools to host vaccine clinics.
As School Outreach Lead at MGH, Lucifora connects with principals, school boards and other stakeholders to set up these clinics in the schools’ gymnasiums and cafeterias. He also works closely with the schools to understand that community’s needs.
At times, this has meant setting up specialty clinics for students with developmental disabilities, where healthcare staff are able to spend more time with each child to ensure they feel safe and comfortable before vaccination. “At all of our school clinics, we have mats on the floor where kids can sit and relax, and children are able to get vaccinated with their families by their side,” Lucifora says.
Through this work, Lucifora and other members of MGH’s school outreach team have built on the hospital’s existing relationships with local schools. As a Registered Nurse (RN), Lucifora has also been able to administer vaccines to children and families at a number of these clinics. He says he’s grateful for the opportunity to help protect local residents, particularly kids, against COVID-19. “It feels really good to know that we’re helping people move toward some semblance of normal again,” he says.
Communications Specialist, East Toronto Health Partners
During a rapidly evolving pandemic, clear communication is key. It’s Lucy Lau’s job to ensure the information being shared about MGH and ETHP’s vaccine work is as accurate and timely as possible. This includes updating the MGH and ETHP websites and social media with the most current information, developing flyers with details about local pop-up clinics, organizing a series of vaccine confidence-building town halls, liaising with media, and working with the vaccine team and partners to ensure local residents can easily find and understand details like vaccine eligibility and what documentation to bring to a clinic.
“Whether it’s interpreting changes in vaccine eligibility from the provincial government or navigating emerging data about vaccine safety and effectiveness – things have changed almost every day during the pandemic,” Lau says. “We appreciate that these changes can be difficult to follow, so we want to ensure information is as accessible as possible to the people we serve. This has meant ensuring information is conveyed in plain, easy-to-understand terms in the places people get their information, from WhatsApp and community Facebook groups to apartment building lobbies and local businesses.”
Part of this work has also involved ensuring individuals understand the rationale behind some of the MGH and ETHP vaccine team’s decisions, including restricting first, second and third doses to individuals in specific priority postal codes at some clinics during certain periods. “Our immunization strategy is driven by data and equity – we want to ensure that those people who have been most affected by COVID-19 have access to life-saving vaccines,” Lau says. “Being transparent about this helps build trust and understanding in the community and prioritizes groups that may need the vaccine most.
“It’s been incredible to see how many different people have come together across sectors to help get vaccines into arms,” she adds. “I’m happy to be able to play a small part in this meaningful work.”
Community Engagement Coordinator, Michael Garron Hospital
As a trained social worker and former Case Counsellor Specialist at WoodGreen Community Services, Tharnya Sivanithy has seen and heard firsthand some of the challenges that local residents face in getting vaccinated. It’s what motivated her to join the MGH team as a Community Engagement Coordinator this past summer, where she facilitates relationships between the vaccine team, community agencies, local elected officials, residents and other stakeholders to ensure all voices are included in MGH and ETHP’s vaccine planning, particularly with mobile clinics.
“Our teams strive to ensure that community partners and members feel heard and are included in the planning process. We also work to consider and implement their ongoing feedback,” Sivanithy says. “We want the community to feel empowered in making informed decisions during these tough times.”
With Sivanithy’s support and feedback from community partners, MGH and ETHP have been able to consider social, spiritual and cultural aspects in their delivery of COVID-19 vaccines. This involves operating pop-up clinics at local mosques following prayer times and ensuring all individuals feel safe and welcome at clinics, even if they do not have a health card or formal identification.
Sivanithy has also helped facilitate a number of proactive community engagement strategies. These include coordinating a youth-led vaccine clinic; developing a system that allows residents in priority neighbourhoods to easily access vaccines at local clinics by walk-in; and building vaccine confidence by sharing multilingual resources, collaborating with community agencies to plan hyperlocal virtual town halls and organizing automated calls from local family physicians in different languages.
“Every day I see the importance of building strong partnerships and relationships that are representative of the community through transparency and collaboration,” Sivanithy says. “When all of us come together to learn and exchange information, it creates a bigger impact in the community. I’m proud to be a part of this team and collaborative effort.”