Frustration evident over lack of booster appointments

While Niagara has been focusing on getting children aged five to 11 vaccinated against COVID-19, adults eligible for third doses are becoming increasingly frustrated over the difficulty of getting their booster shot.

Each day, national news outlets are featuring health experts urging people to get that third dose, to protect against the rapidly-spreading Omicron variant, but not warning of the difficulty of getting appointments, resulting in angry people taking their annoyance out on pharmacists and doctors who are struggling to do the best they can in a difficult situation.

Bruno Laliberte is among those in the 70-plus age group who was frustrated at not being able to find an appointment for a booster shot, but he was persistent.

The St. Davids resident had his two COVID-19 shots more than six months ago, and once he became eligible for his third dose, he began trying to find out where he could get it.

“All day long, all we hear on TV, news, social media, and other places is for people who are eligible to get their booster shot,” he said. “I even received a phone call telling me that I’m eligible for the booster shot and to get it as soon as possible.

“This must be the biggest farce, or sick joke, as far as I am concerned,” he continued.

Laliberte said he tried “over and over to book an appointment for the booster shot,” but there were no locations or clinics in the area offering appointments.

He called local pharmacies and his doctor’s office, and was given varying reasons why there was no availability.

Many of his neighbours are in the same boat, “and some are very upset and angry about this.”

 Laliberte understands that “eligible children should be vaccinated as soon as possible, and that is a must at this stage of the game,” but with all the seniors in the region, and the province “pounding on us” to get a booster that is nowhere to be found, the experience has been “somehow contradictory, misleading, and very disappointing.”

After going on several pharmacy websites to try to find an appointment, with no luck, Laliberte was finally successful late Monday in booking his booster shot at the Pen Centre for Monday, Dec. 20 through the provincial booking site — at a clinic with some appointments recently opened up by public health.

As happy as he is to be getting the shot, he’s still frustrated by what he had to go through. The province should be “more transparent and honest, and tell people the truth that they don’t have the resources, and perhaps wait until all this mess is sorted out before telling us about the increasing importance of receiving boosters.”

Pharmacist Sean Simpson is hearing daily from people who don’t understand why they can’t get the booster they’re being told is so important. He has a waiting list that could take him weeks to get through, he said.

He just doesn’t have the capacity to meet the demand for third doses, but people are having a hard time understanding that.

“It’s almost like the good old days,” he says, referring to the time last winter when the province was opening up eligibility to certain ages and groups of people, but there was no vaccine available.

The demand is increasing as the third dose is becoming more important because of Omicron, the new variant, he says, but there was a time in late September and through October when the demand waned, and clinics were scaled back.

Now, with Niagara Health having completely removed itself from vaccinations, and public health focusing on children, “the availability is limited.” But the “talking heads” we see on TV don’t seem to realize that, as they urge people to get their third dose, increasing the anger and confusion of those who want that shot, said Simpson.

“People are getting quite demanding,” wanting their vaccination immediately, either because they want to travel, or get together with family over Christmas. He gets frequent calls and emails from people who are angry about the delay.

He is estimating it will take until mid to late January to get through his list of those in the first round of eligibility, with the staff he has available.

“Going back to the early days, we would have put in all the time in the world to get people their first vaccinations, but we’re exhausted. The demand is more than we can handle.”

Simpson, who sits on the region’s vaccination task force, says while the region’s initial focus on the five to 11 age group was the right decision, once the number of appointments diminished, the clinics could have been used to accommodate those adults who wanted and were eligible for their third dose. “We can’t prioritize people who are hesitant,” he says, “while keeping people who want to be vaccinated on the sidelines.”

The excess demand, while waiting for the public health clinics to ramp up for boosters, is creating a drain on resources for pharmacists with the number of phone calls and emails from people anxious for those boosters, said Simpson.

“We are seeing people with the expectation they will walk in the door and get it. We just ask them to be patient and get on the waiting list.”

He also suggests that if appointments become available elsewhere, they should take the first opportunity to get their booster.

He said he’s hearing the same level of frustration from pharmacists across the province — the problem isn’t unique to Niagara.

Down the road, at The Garrison Village Shoppers Drug Mart, technician Brenda Matthews is experiencing similar problems. She says staff have people yelling at them regularly, angry that they can’t make appointments. The local pharmacy doesn’t keep a waiting list — the issue is the amount of vaccine  and not knowing how much they will receive. They’ve been getting a shipment of 120 doses once a week, on Thursday afternoons and that’s when they take appointments for the following week, for Mondays and Wednesday. But on Thursdays, people start calling or coming into the store, lining up to make appointments. And as hard as they try to treat everyone fairly, people are really angry at the delay, she says.

“We had one customer standing at the counter crying. She was going to be travelling, and she said she needed it to feel safe. We’re trying to do our best, trying to accommodate everyone, but it’s very stressful on the staff. If we could get more doses we could accommodate more people. We keep asking for more.”

Dr. Karen Berti of the Niagara North Family Health team is also feeling the frustration of patients wanting booster shots. The health team has a small number of appointments available for the elderly and shut-ins, and those who are having trouble manipulating the COVID booking system. But they don’t have the capacity to offer booster shots to all their patients.

It’s a combination of factors, lack of vaccine and lack of resources, she says. They are seeing many patients who because of COVID haven’t been getting the care they need, and getting caught up is taking a lot of manpower.

She reminds people that we still need to abide by all the public health rules. “Vaccinations are good, but we have to try to keep our numbers down at gatherings, stick to small groups, and keep following all the other protocols, especially over Christmas.”

The responsibility for adult vaccinations that has fallen on pharmacies and family physicians, while public health departments prioritized vaccinations for children, comes at a time when 175,000 adults in the Niagara Region have become eligible for booster shots, says acting chief medical officer of health Dr. Mustafa Hirji. As the requests for appointments for kids’ vaccinations have declined, public health clinics began offering some of those appointments to adults, beginning last weekend, but it will take some time before there is enough capacity in the system to accommodate all those who want their third dose.

In January, the system will be further taxed when those 18 and over become eligible for boosters.

In September, many of the large areas used for clinics, such as arenas and gyms, became unavailable, and the demand for adult vaccinations started to slow down. “We just don’t have those larger sites now,” said Hirji.

Staffing is also a problem, with nurses leaving, retiring or taking medical leave due to burnout. Also staff is needed for contact tracing — with the increasing number of people infected and their level of activity, “people have a lot of contacts.”

Public health is looking at other options to ramp up for additional appointments, he said, “but with 175,000 people 50 and up now eligible, it’s not something we can do in a few weeks. It’s likely to take five to seven weeks to vaccinate that many people.”

The clinics that are taking appointments for adults are now open for first, second and third doses, but it’s the group that has their first two that are “really enthusiastic” about being vaccinated, and who are now looking for boosters, he said.

“I still say the first and second doses are more important to get that base level of immunity, but with Omicron, the value of boosters is become higher than it used to be. The booster makes a bigger difference against Omicron.”

With the number of new cases in Niagara the highest in the last “several months,” those in the hospital with COVID-19 are “overwhelmingly” those who are not vaccinated. “There is close to a 20-times higher risk” for the unvaccinated.

Hirji said he was expecting a better uptake for children, and has been “a little bit disappointed” in the numbers. He was hoping about 50 to 60 per cent of parents would want their kids vaccinated, but only about 26 per cent in Niagara have had their first shot, falling well short of what he was expecting.

He is hearing that some parents are waiting until after the holidays, he said, whereas as cases go higher, it’s important to have more children vaccinated before the holidays. 

There is no shortage of vaccine, he says, for kids or adults, although the province hasn’t been shipping to pharmacies in the numbers they’ve been asking for.

His advice is for people to be patient and keep trying to book appointments — as more become available they will be listed on the Niagara Region Facebook page and through the provincial portal, and in the meantime, to be cautious over the holidays, don’t go to crowded places, limit the number of people in social gatherings to no more than 10, and make sure those attending family gatherings are vaccinated.

Although that can’t be enforced, Hirji added, “we’re really relying on people wanting to keep their parents and grandparents safe, wanting to keep everybody safe.”

He is anticipating there could be more restrictions or recommendations announced by the province  this week, and although
he doesn’t know what they will be, he suggested maybe new vaccination requirements in places such as malls and retail stores might be coming.