Dr. Wajid Ahmed says health care systems need to be meticulous in how they prioritize vaccine rollouts to save as many lives as possible and not allow jumping of the queue

Health-care workers wait in line at a University Health Network COVID-19 vaccine clinic in Toronto on Jan. 7, 2021.
Nathan Denette/The Canadian Press
Some hospitals and health systems are offering COVID-19 vaccines to staff who dont interact with patients, including administrators and researchers, as thousands of front-line workers and long-term care residents wait for their turn to be inoculated.
Erie Shores HealthCare in Leamington, Ont., and Torontos Michael Garron Hospital each began vaccinating non-front-line staff in recent days, whilethe University Health Network in Toronto invited a wide range of staff to a last-minute vaccine clinic on Sunday. Health officials in both British Columbia and Alberta say that vaccines have on occasion been given to lower priority individuals when approved recipients fail to show up for their appointments, in order not to waste doses.
With a limited supply ofvaccines expected for the months to come, each province in the country has established ethical guidelines to ensure available doses are directed toward those most at risk. In Ontario, for example, the first phase of the vaccine rollout is meant to target health care workers and essential caregivers in hospitals, long-term care homes and other settings where seniors gather followed by other essential caregivers, long-term care and retirement home residents, and First Nations.
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Some hospitals say theyve been forced to look outside these groups in order not to waste doses. Storage challenges have also limited distribution as the provinces ramp up their inoculation programs. Some regions have yet to see a single dose administered to high-risk populations, while several Toronto hospitals are planning to open up vaccination clinics to more staff this week.
Wajid Ahmed, Windsor-Essexs Medical Officer of Health, spoke out about non-priority hospital workers jumping the queue after several area hospitals such as Erie Shores HealthCare confirmed they had offered vaccines to non-front-line workers, including top administrators. Dr. Ahmed said that its critical not to waste vaccines, particularly from open vials, but that health care systems need to be meticulous in how they prioritize vaccine rollouts to save as many lives as possible.
We need to have better discussions so we have a good process in place to make sure were doing everything to capture the right people, rather than going through a list of whos available, or who put up their hands first, Dr. Ahmed said in an interview.
Giving doses to lower-priority groups such as administrative and out-patient staff could constitute a very serious ethical violation that merits an investigation, said Kerry Bowman, a bioethicist at the University of Toronto.
We with great work developed national consensus as to phase one of the ethical distribution of COVID-19 vaccines, Dr. Bowman said. That was pretty clear: The vulnerability was long-term care, senior citizens, Indigenous communities, etcetera.
The hospitals have decided to use their own version of this, and what is happening within hospital settings is that many of the people receiving the vaccine are in fact not people who are in phase one as identified in the ethical criteria.
As of Jan. 7, Canada has received 548,950 doses of the Pfizer/BioNTech and Moderna vaccines.
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Vaccine availability is one struggle the University Health Network (UHN) expected to receive 3,000 doses to administer this weekend, which didnt show up but their short shelf life is also putting health care systems in tough positions.
Pfizer-BioNTechs vaccine must be used within six hours of being thawed and prepared, sometimes leaving hospitals to scramble to find arms to jab when there are extra doses in thawed vials or if preregistered staff dont show up.
One such surplus scramble happened on the weekend, as Newmarkets Southlake Regional Health Centre offered UHN additional Pfizer-BioNTech vaccines doses for staff.
A copy of UHNs invitation to the Sunday clinic, viewed by The Globe and Mail, indicated that all staff, including researchers, were invited. But spokesperson Gillian Howard said the hospital amended the message to focus on patient-facing staff, with a goal of ensuring no doses were wasted.
The goal is to vaccinate people who care for patients in acute care as soon as possible, given vaccine supply, Ms. Howard said Sunday. The goal is also to use all vaccine were offered if reasonable to do so.
The hospitals chief medical officer, Brian Hodges, also tweeted earlier on Sunday that he hoped all Toronto long-term care residents would receive doses by next Friday. As of Sunday, 12,210 Ontarians in long-term care have been infected with COVID-19 since the pandemic began, and 2,967 have died.
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Torontos Michael Garron Hospital said Sunday it can now vaccinate more than 500 people a day. To ensure there are large volumes of eligible people in our clinic each day to meet the 500 doses-a-day goal, we have now been offering vaccines to all MGH employees, spokesperson Shelley Darling said in an e-mailed statement. The hospital said in doing so, it follows Ontarios guidelines, and has offered vaccination appointments to health care staff from other hospitals, including UHN.
Asked if it was aware that some hospitals were giving vaccine doses to non-front-line staff, Ontarios Ministry of Health told The Globe to speak with individual hospitals and reiterated its COVID-19 Vaccine Distribution Task Forces recommendations.
Albertas Chief Medical Officer of Health, Deena Hinshaw, and Health Minister Tyler Shandro said in a statement last week that if a scenario arises where staff have no booked appointments left but there are thawed doses available, those administering the vaccines are able to vaccinate each other.
But Dr. Bowman, the bioethicist, said this speaks to a significant planning failure. There absolutely needed to be a backup plan, he said. This didnt hit us overnight.
Christine Sorensen, president of the BC Nurses Union, said it is extremely disappointing and concerning to hear from members across the province about people who do not meet the priority criteria being vaccinated.
Ms. Sorensen, who has run mass immunization clinics for more than 30 years as a public-health nurse, also believes poor planning is to blame: You always have more people ready to have the vaccine that are in the priority group, in case you have cancellations. And then you prioritize those people for the next clinic, so you always have a rolling group of people ready.
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In a statement Sunday, B.C.s Ministry of Health said that in the event vaccine doses are left over, there are processes in place for bringing in health care workers or other priority people to be vaccinated.
Montreals McGill University Health Centre said Sunday that while it was broadly vaccinating workers who provide direct care to COVID-19 patients, it had also targeted specific groups, including staff who work with patients on ventilators and people in units dealing with outbreaks.
As parts of Canada struggle to give the vaccine to the right people, others havent gotten it at all. A spokesperson for Niagara Region Public Health said Sunday that it hadnt gotten any doses at all, though Ontarios Ministry of Health said it should receive shipments early next week.
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