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‘Not vaccine hesitancy but inequity.’ Organizers take us inside Toronto’s northwest pop-ups where lines form everyday at 5 a.m.

‘Not vaccine hesitancy but inequity.’ Organizers take us inside Toronto’s northwest pop-ups where lines form everyday at 5 a.m.
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As the organizers of pop-up clinics in Toronto’s hard-hit northwest neighbourhoods, we’ve seen how much the community wants to do their part to get their shot. The scenes of thousands lined up in rain and snow make it clear that low vaccination rates in these communities aren’t products of vaccine hesitancy. Rather, the situation unfolding has everything to do with structural inequities that starve communities of key resources, and in this case, life saving vaccines in the midst of a deadly pandemic.

But there is an important early lesson here: If vaccines are made accessible in trusted spaces, through trusted relationships, people will come.

Despite comprehensive data showing COVID-19 disproportionately affecting racialized and low-income neighbourhoods in Toronto, high risk communities were not immediately prioritized for access to vaccines. We know structural inequities have long produced health outcomes. This has been a defining feature of Ontario’s COVID-19 response. It has played out repeatedly over the course of the pandemic, and we’re seeing first hand with the vaccine rollout.

At every pop-up clinic in Toronto’s northwest community, members begin lining up as early as 5 a.m. in anticipation. Often, they remain in line through rain and snow , desperate to receive vaccines made inaccessible to them by other routes in a fragmented vaccine infrastructure. These clinics are unlike any other running in the city. They run late and on weekends to accommodate work schedules of essential workers. Specially commissioned local DJs contribute to the welcoming atmosphere, along with trusted community ambassadors who are on hand to provide services and build trust in multiple languages. Community organizations are doing everything possible to create a welcoming environment for their neighbours to access care.

The majority of the people receiving doses at these clinics are racialized and low income — the very communities carrying a disproportionate burden of illness in Ontario’s pandemic with the most recent data showing . These communities showing up in the thousands at every pop up clinic dispel the myth that racialized communities do not want the vaccine. Rather, the issue at stake is access and systemic neglect that has produced low vaccination rates in the hardest hit neighbourhoods in our city.

Many of the people we see and meet are essential workers who live in provincially designated hot spots. Northwest Toronto is home to thousands of labourers who work in sectors that have been deeply impacted, such as factories, food processing and retail. Many of these essential workers cannot afford to stay home when they are sick and do not get paid if they take time off to find and get vaccinated. They do not have the ability to register online to get a vaccine. Despite this, vaccine roll out models that factor in these community specific complexities have not been consistently prioritized.

Ensuring accessible and equitable access to vaccines for these essential workers must be a priority in flattening Ontario’s pandemic curve. Community led pop up clinics can address these barriers and bring vaccines directly to these communities using low barrier access strategies. On the ground organizations, such as BlackCreek CHC, Unison, TAIBU and Rexdale CHC are making these services accessible in partnerships with various hospitals. The recent reallocation of vaccine supply in line with the COVID-19 Ontario Science Table’s recommendations also provides a prioritization that is so crucial right now.

Increased efforts must be made to mitigate barriers to accessing vaccines for communities inequitably impacted by COVID-19. There is overwhelming desire for vaccines and there needs to be protected time for workers and other social supports to finally make access a reality. More local pharmacies and primary care teams in hot spots need to be stocked with vaccines. And as we know the vaccine effort will move at the speed of trust, we need to ensure community leadership is central to the momentum taking hold. The daily calculus remains one of life and death for too many in our communities.
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