Thousands of Toronto hospital staff haven't got their COVID-19 shots, memo reveals

Thousands of staff at a Toronto hospital network have still not been vaccinated against COVID-19, prompting an internal email from its president, which has been obtained by CBC News, urging them to get immunized.

Roughly 4,000 employees of University Health Network (UHN) had not registered for their shots by Monday, according to the email sent that day by UHN president and CEO Dr. Kevin Smith.

"While our overall rate of uptake is very good, there are areas and programs where vaccination remains below 50 per cent of people," Smith wrote.

"We must change this immediately."

Smith also said he's worried the hospital network's supply of vaccines will be greatly reduced in the days ahead as Ontario "expands its list of priorities."

The plea was made to staff at some of the highest risk for encountering the SARS-CoV-2 virus in the workplace, according to UHN spokesperson Gillian Howard, including those working in the emergency department, intensive care units, inpatient units and COVID-19 units.

Since the email was sent out, Howard said, around 1,000 more UHN workers had registered for their vaccinations, bringing the total to just over 18,000 people who will be vaccinated.

The network has set up a phone line and "vaccine ambassadors" to answer questions from staff, she said.

It was not immediately clear why some employees were slow to register.  

UHN includes multiple hospitals, including Toronto General Hospital, Toronto Western Hospital and Princess Margaret Cancer Hospital.

'Strong uptake' at certain hospitals

It's not clear how many staff at other health-care networks and hospitals in the Toronto area have been vaccinated or signed up for their shots, though several did provide data in response to a CBC News request.

Women's College Hospital, a separate facility from UHN, has vaccinated around 664 of some 929 eligible staff members, or about 71 per cent.

"However, this number is constantly changing as staff numbers fluctuate and we have many who are awaiting appointments in the coming weeks," said spokesperson Jen Brailsford in an email. 

"This is also likely an underestimate as these numbers are based on self-reporting to occupational health."

Toronto's Sinai Health System is also seeing "strong uptake" among its staff and physician teams, according to spokesperson Jennifer Specht, with roughly 5,000 people, or about 78 per cent of the total pool, registered for a vaccine appointment.

"This number is based off the number of vaccination appointments booked by Sinai Health people in combination with data provided by our partner hospitals who are administering the vaccine to our staff," she told CBC News. 

Toronto-area hospital sites had early access to the province's vaccination rollout, with thousands of doses given to front-line workers and other staff in recent months.

Despite that, hospital outbreaks have continued. UHN alone is currently reporting three, affecting a handful of staff and patients. 

CBC News has also previously reported on how an estimated one-third of long-term care workers — who have been eligible since December — have not yet gotten their shots. 

A memo from the Ontario Ministry of Long Term Care dated March 8 revealed an estimated 67 per cent of staff in nursing homes across the province have received at least one dose of a COVID-19 vaccine, compared to over 95 per cent of residents.

According to public health ethics researcher Alison Thompson, an associate professor at the University of Toronto, hesitancy among health-care workers can lead to "tricky" ethical issues in the workplace, particularly in a hospital setting.

"It basically boils down to a matter of protecting patients and their right to having a safe space for care, and their colleagues being protected … versus their individual charter right to not have to be subjected to some kind of medical intervention against their will and consent," she said.

'Not a good track record' 

Dr. Susy Hota, medical director of infection prevention and control at UHN, said the lack of vaccine uptake during the pandemic's third wave is disappointing.

But she stressed that while these are medical professionals, they're also dealing with the vaccine hesitancy that's increasingly common among the general population.

"My hospital is huge. We're like a community in ourselves, like a little village or town," she said. 

"And there's a diversity of different roles that people play here. And people come from different backgrounds, and different cultures and have had different past experiences."

Hota says, from an infection control perspective, figuring out how to combat this hesitancy among health-care workers can be difficult.

"We haven't been successful in mandating vaccinations in the past; there's not a good track record," she continued.

Could mandatory masks or other personal protective gear for unvaccinated workers be an option? It's not that simple, Hota says.

For one thing, most infections in hospitals are thought to occur when workers aren't conducting patient care and no longer wearing masks; like chatting in a break room. 

"Masking versus vaccination was tried for influenza, and that didn't succeed," Hota added.

Thompson agrees. If each individual employer tries to implement that kind of policy, it's much less likely to be successful, she said.

"It's much more effective, probably, if the provincial government were to mandate that vaccines have to be administered for health-care workers, with legitimate exemptions," she said.