Ontario hopes family doctors can reach those unvaccinated against COVID-19

With Ontario's COVID-19 vaccination coverage showing signs of levelling off, the province is enlisting help from family doctors. 

About 78 per cent of Ontario adults have received at least one dose of a COVID-19 vaccine, but that figure has increased by just three percentage points in the past three weeks.   

To vaccinate as much of the rest of the population as possible, the health-care community widely considers the participation of family doctors critical. 

That's because many unvaccinated people have questions they need answered by a trusted medical source, or don't want to go to a mass vaccination site or pharmacy to get a shot, says Dr. Liz Muggah, president of the Ontario College of Family Physicians. 

"That combination that family doctors offer: the trusted person who knows their history, and a place that they feel comfortable in receiving vaccine, those two things together really mean that we have a really important role to play to help move the dial toward getting to herd immunity," said Muggah in an interview Wednesday. 

While the provincial Health Ministry was unable to provide any specific figures, it is clear family doctors' practices account for only a fraction of the 16.1 million doses administered in Ontario so far.

"From the very beginning, family doctors across the province have been saying, 'Please give us vaccines. We're expert at this. We want to do this. Our patients are telling us that they want to be vaccinated in office,'" Muggah said. 

"To this point, we have not had the supply of vaccines in our offices to address the need that we're seeing from our patients. So I definitely hope as we head into this last stretch of the vaccination that more vaccines come to us." 

Ontario is not alone in having given family doctors little in the way of vaccine supply.

Manitoba has made vaccines available at more than 50 family doctor clinics. In Alberta, despite promises that family physicians could be administering thousands of shots every day from their offices, the province's pilot project expanded to just 60 practices.

Other provinces have almost entirely stayed away from providing vaccine doses to family doctors, a situation that was prompted in part by initial concern about meeting the cold-storage requirements for the Pfizer-BioNTech vaccine that accounts for the bulk of Canada's shots.

Ontario's family physicians and other primary-care providers have been administering COVID-19 vaccines in about 700 primary care and community settings, said Alexandra Hilkene, spokesperson for Health Minister Christine Elliott. (There are more than 15,000 family doctors in Ontario, some of whom have participated in giving shots at mass vaccination clinics.) 

"The onboarding of additional primary care settings to administer vaccines continues and is ongoing by public health units," said Hilkene in a statement provided to CBC News. "Primary-care providers will play an even larger role in vaccinating Ontarians as we continue to vaccinate harder to reach patients and combat vaccine hesitancy."

The bulk of family doctors in Ontario are to receive later this month a list of all their patients who have been vaccinated against COVID-19, whether with one or two doses. The provincial agency Ontario Health is asking physicians to reach out to their patients whose names are not on the list.

The idea is that the family doctor can help overcome hesitancy by answering questions that unvaccinated patients still have about the COVID vaccines, said Dr. David Kaplan, chief of clinical quality at Ontario Health. 

"Who better than primary care providers that have had lifelong relationships with these patients to build that confidence?" he said in an interview. 

Kaplan, who also practices as a family physician in North York, says talking to patients about their immunizations concerns — from childhood diseases such as measles to diseases that affect seniors such as shingles — is something family doctors do every day. 

"We're used to having these conversations with some of our patients that are a little more hesitant and really build their confidence in knowing why it's important to be vaccinated, what to expect," he said. "I think that's really important for many patients. They're just worried about what's going to happen."

In Ontario, the lowest COVID-19 vaccination rates are among the youngest eligible age groups. About 67 per cent of those aged 18 to 29 have had at least one dose, along with 59 per cent of youth aged 12 to 17, according to Health Ministry figures published Wednesday. 

Family doctors say a common fear raised by younger patients is that the vaccines could affect their fertility, although there's no evidence that's the case. 

Muggah, who practices at the Bruyère Family Health Team in Ottawa, says she tries to ask every patient she encounters — regardless of the nature of the appointment — whether they've had a shot. 

"If they haven't been vaccinated, to me, it really is a conversation that has to be approached with great empathy and some curiosity, " she said, "You can't assume why somebody may not be ready to get vaccinated." 

Muggah says that combating vaccine hesitancy "isn't just about giving somebody a whole bunch of information. It really requires meeting that person where they're at, digging into what their reasons might be, and addressing them." 

Family doctors will be particularly important in ensuring vaccination coverage among the 12 to 17 age group, said Dr. Adam Kassam, president of the Ontario Medical Association.      

"We encourage anyone who is still on the fence or still having questions to reach out to their family doctors, reach out to their pediatricians to get the best information to make an informed decision," he said.