Province announces mandatory vaccination policies, third doses for vulnerable populations

High-risk settings will need to enforce mandatory vaccination policies, and third doses of COVID-19 vaccines will be made available for those at the highest risk due to the virus, according to the Province of Ontario.

The announcement, made by Kingston’s own Dr. Kieran Moore, Chief Medical Officer of Health for Ontario (and former Medical Officer of Health for KFL&A Public Health), took place on Tuesday, Aug. 17, 2021.

“For the last several weeks, I have been unwavering in my pleas for all eligible Ontarians to step up, roll up their sleeves, and get vaccinated. I said time was of the essence, but now that time is here. We must take assertive action to protect the health and safety of all Ontarians, especially as we move closer to a return to school, and the cooler weather drives us indoors,” Moore said calmly and steadily as he looked into a camera.

“The policies I’m announcing today are an important link in the chain of protection that will help keep Ontario strong in the face of the fourth wave.”

Mandatory vaccination policies in healthcare settings

The first part of the announcement focused on Moore’s directive mandating that hospitals and home and community care service providers have a “COVID-19 vaccination policy for employees, staff, contractors, students, and volunteers, and for ambulance services to have a COVID-19 vaccination policy for paramedics.” The policy, which must be effective by Tuesday, Sept. 7, 2021, is strikingly similar to that currently being employed by Kingston Health Sciences Centre (KHSC). According to the provincial government, the police must, at minimum, require the above individuals to provide proof of one of three things:

• Full vaccination against COVID-19
• A medical reason for not being vaccinated against COVID-19; or
• Completion of a COVID-19 vaccination educational session

As reported earlier the same day, results from KHSC implementing such a policy found that 74 per cent of those healthcare workers required to respond by the end of July had actually done so.

According to the province, those who do not provide proof of full vaccination will be required to undertake regular antigen testing, and the above settings will be required to track and report on the implementation of their policies to the provincial government, similar to the vaccination policy requirements currently in place for long-term care homes.

“While Ontario remains a leading jurisdiction for first and second doses administered, and we have the infrastructure in place to manage outbreaks, the Delta variant is highly transmissible and the experience of other jurisdictions shows we must remain vigilant as we head into the fall,” Christine Elliott, Deputy Premier and Minister of Health, said in a statement.

“By taking additional measures in high-risk settings we will further protect our most vulnerable, safeguard hospital capacity, ensure a safe return to school and keep Ontario running.”

Mandatory vaccination disclosures and policies in schools and licensed childcare settings

While still focused on vaccination policies, the announcement moved on to looking at the approaching return to school. According to the province, the Ministry of Education will introduce a vaccination disclosure policy for all publicly-funded school board employees and staff in private schools. Additionally, all staff in licensed child care settings for the 2021-2022 school year will have to adhere to the vaccination disclosure policy. All staff in those settings will require rapid antigen testing if not immunized.

“The Ontario government is also working with public health units and publicly funded school boards to run voluntary vaccination clinics in or nearby schools to make vaccines even more convenient and accessible for eligible students, their families, educators and school staff returning to school this fall,” the government said in a press release.

The government also said that vaccination policies will also be implemented at other high-risk settings, such as:

• Post-seconary institutions
• Licensed retirement homes
• Women’s shelters
• Congregate group homes and day programs for adults with developmental disabilities
• Children’s treatment centres and other services for children with special needs
• Licensed children’s residential settings

“With the support of Ontario’s Chief Medical Officer of Health, our government is taking action to make schools as safe as possible. Our plan will protect our schools, ensure rapid speed with contact tracing, all with the intention of keeping them open for the benefit of Ontario students,” Stephen Lecce, Minister of Education, said in a statement.

The province did not release any further information on what those latter vaccination policies include, nor when or how they will be implemented and/or enforced.

Third doses for those most vulnerable

“The Delta variant is more transmissible, and has resulted in a re-introduction of COVID-19 in some high-risk settings, such as hospitals, home and community care, and congregate settings. These are settings where individuals are at a higher risk due to age or their health conditions, or comorbidities. And we need to better protect them,” Dr. Moore said of the fourth wave of the COVID-19 pandemic currently facing Ontario.

For this reason and based on a recommendation from Moore, the province plans to begin offering a third dose of COVID-19 vaccines for those most vulnerable to the virus in order to provide those people “with an extra layer of protection against the Delta variant.”

Those who will be eligible for the third shot include:

• Transplant recipients (including solid organ transplant and hematopoietic stem cell transplants);
• Patients with hematological cancers (examples include lymphoma, myeloma, leukemia) on active treatment (chemotherapy, targeted therapies, immunotherapy);
• Recipients of an anti-CD20 agent (e.g. rituximab, ocrelizumab, ofatumumab); and
• Residents of high-risk congregate settings including long-term care homes, higher-risk licensed retirement homes and First Nations elder care lodges.

The province stated that the locations and timing for third doses will vary by Public Health unit and high-risk population “based on local planning and considerations, with some beginning as early as this week where opportunities exist.” Kingstonist has reached out to KFL&A Public Health for details on how this will roll out locally, but had not received a response by time of publication.

On Wednesday, Aug. 18, 2021, KFL&A Public Health announced an expansion of COVID-19 vaccine clinic hours clinic locations for area residents. Full details can be found in our coverage here.

Kingstonist will update this article as more information becomes available.

Vaccinations opening to all those born in 2009

To “further support a safer return to school by ensuring more children and youth can benefit from the protection offered by the vaccine,” eligibility to the Pfizer vaccine will be extended to children born in 2009.

“Ontario has closely monitored data from Alberta and British Columbia in making this decision, and these provinces have offered the Pfizer vaccine to youth born in 2009 for several months with no risks identified,” the government said in a press release.

All children turning 12 years old before the end of 2021 will be eligible to receive their first dose of the COVID-19 vaccine beginning on Wednesday, Aug. 18, 2021, according to the province. Appointments can be made through the provincial booking system, through local public health units or pharmacies, or those eligible can attend vaccination clinics.

“Keeping a low rate of infection in our communities and protecting our most vulnerable is how we can keep our schools, our businesses and our social settings as safe as possible while minimizing disruption,” said Moore. “To provide the best protection to each individual while learning to live with the virus, we are taking action by requiring individuals who work in higher-risk settings to be fully vaccinated, by providing a third dose of a COVID-19 vaccine to certain groups who have a decreased immune response and by expanding the eligibility to the children born in 2009 or earlier.”

Exit from the Roadmap to Reopen paused

According to the government, “out of an abundance of caution,” and in consultation with Moore, the province is pausing the planned exit from the Roadmap to Reopen.

“The Chief Medical Officer of Health and other health experts will continue to monitor the data to determine when it is safe to exit the Roadmap and lift the majority of public health and workplace safety measures currently in place,” the province said.