Dear Colleagues,

 Over the weekend, we received updates from the Ministry of Health about the vaccination rollout and are sharing a summary of these updates with you.

 Thankfully, more doses of the Pfizer-BioNTech vaccine are on the way!

Led by the 34 Public Health Units, the vaccination rollout will eventually require “all hands on deck” once supply increases. While the detailed PHU plans have not been officially released by the government, we understand these include a role for family physicians – in mass vaccination or mobile clinics and eventually in our offices. We know family doctors have already been instrumental in vaccinating priority populations (example here), working with public health and other local partners.

New MOH information on the rollout and related forms

• Updated MOH priority sequence for Phase 1 was just released and next priority for vaccination includes: adults over age 80 now added to previous groups, though specifics of how they will be notified is TBD in the PHU plans; staff and caregivers in congregate living; healthcare workers in the high priority level; all Indigenous adults and adult recipients of chronic home care. 

• Updated healthcare worker prioritization confirms those treating COVID-19 patients, on immunization teams, or working in assessment and testing centres are among the “highest priority”. Next are those in “very high priority” which includes community-based family physicians and staff (see page 10, references to “primary care” and “walk-in clinics”). PHUs are tasked to manage HCW prioritization and use regional data to assist.  

• The MOH plans to launch a call centre and online reservation system “in the next few weeks” This is part of the provincial COVax system (the separate but required system for administering COVID-19 vaccinations) that will also include record keeping, site inventory management and adverse event reporting. Training on the system will be offered by the MOH, so stay tuned. 

• Download this list of local PHU contacts should you wish more information on what’s happening in your region.  

Consent for allergies and special populations

• Allergies: NEW – Written documentation of counselling from an allergist/immunologist is now required for any patient who has had an allergic reaction to a previous dose or any components of the vaccine. The allergist must also provide a vaccination care plan for the administration of the vaccine. As needed for your patients, use the allergy eConsult or refer to these allergists. 

• Updated consent process now requires verbal attestations by the patient of counselling by a primary provider on vaccine risk/benefits in these two scenarios:  
  • immunosuppressed, if receiving: stem cell therapy, CAR-T therapy, chemotherapy, immune checkpoint inhibitors, monoclonal antibodies (e.g., rituximab) and other targeted agents (e.g., CD4/6 inhibitors, PARP inhibitors);
  • pregnant.
• The vaccinator can use this form to document the patient's verbal attestation.
•  We have updated our special populations summary to reflect these consent-related changes.
• The full list of updated MOH documents related to vaccination are found on the MOH website.
• Children and adolescents: Patients age 12-15 at high risk of exposure or serious illness from COVID-19 may be offered the Pfizer-BioNTech vaccine under certain conditions (see page 6).

 Reinforcing our vital role

• Last week, I joined a roundtable discussion of healthcare workers with Prime Minister Justin Trudeau and Minister of Health Patty Hajdu to promote our essential role as family physicians in vaccination. The PM affirmed what we know to be true: family doctors are “most knowledgeable and most trusted” and “a core part of getting everyone vaccinated.” Sincere thanks my fellow Ottawan and family physician Nili Kaplan-Myrth for her terrific advocacy and creating this opportunity. You can view my four-minute clip with the PM here, and the full session is available here.
• Here are this week’s key messages from Primary Care COVID-19 Vaccination Action Council that we shared with vaccine decision-makers. Recent meetings with General (retired) Rick Hillier and Drs. Kieran Moore and Isaac Bogoch of the COVID-19 Vaccination Distribution Taskforce affirm their commitment to the role of community-based family physicians in the vaccine rollout. It will be critical that we see this translated into action locally.

Upcoming COVID-related events and new resources

• Register for the February 19, 8-9 a.m. (ET) COVID-19 Community of Practice, featuring Oxford University’s Dr. Trish Greenhalgh on long COVID and lessons learned from the UK. Dr. Daniel Warshafsky, from Office of the Chief Medical Officer of Health, will also join.
• How can you support your COVID-19 patients at home? See the resources from Hamilton Family Medicine including the COVID Care @ Home program and register now for this special “hot topic” presentation at the OCFP's Family Medicine Summit on February 22. Space is limited for this session which is open to all.
• New updates about the COVID-19 variants, compiled by the Centre for Effective Practice.
• The Public Health Agency of Canada has developed a COVID-19 Vaccination Toolkit for Health Care Providers, sample social media messages and images you can use in your clinics, and a Toolkit for use with, and for Indigenous communities.
• Learn now or learn later – it is not too late to sign up! Terrific feedback so far for the OCFP’s Family Medicine Summit. The second livestream day is February 27. You can join live or access sessions until July 31, 2021. Up to 65 Mainpro+ credits.

In closing, let’s remember to celebrate the incredible work of family doctors across the province! At a time when things may seem bleak, it feels good to lift up and nominate a colleague for an OCFP Award! Nominations are open until February 28.

Take good care everyone,

Liz