At least 50 Ontario long-term-care homes have a COVID-19 outbreak. How many staff in the homes are vaccinated? The province has no reliable idea

Ontarians with loved ones in nursing and retirement homes have no idea how many of the homes’ staff have COVID-19 vaccinations. That’s because the government database supposed to track this information, public health officials say, isn’t doing it in a reliable way.
A few weeks ago, a public health official said, the government added a feature to its COVax database that appears to allow monitoring of vaccination uptake rates by institution, which includes retirement and nursing homes.
But since it’s not a “required field,” it’s up to the person inputting the patient data at a hospital or vaccination clinic to choose to fill it in.
And that’s not happening regularly.
In Peel, workplace information for vaccinated healthcare staff is missing roughly 60 per cent of the time, according to the region’s public health unit.
It means “critically important” information is going unrecorded, said Dr. Nathan Stall, a geriatrician at Mount Sinai Hospital in Toronto.
“It’s very much in the interests of families and residents to know whether the staff providing direct and hands-on care in indoor settings are vaccinated,” said Stall, who also sits on the province’s COVID-19 Science Table.
The province tracks the overall vaccination rate of staff in nursing and retirement homes — it just cannot reliably break down these numbers at an individual home level.
Across the province, 75 per cent of long-term-care home staff and 64 per cent of retirement home workers are vaccinated, according to the health ministry. (This data is available because the fact of an individual’s employment with a nursing or retirement home is required to be recorded in the COVax database as a “reason for immunization.”)
The Ministry of Health did not respond to repeated requests for comment on whether its COVax database tracks vaccination uptake by LTC and retirement home staff at a facility level.
“We strongly encourage all staff to roll up their sleeves to get the COVID-19 vaccine. This is the surest way we can protect those living and working in congregate care settings,” a ministry spokesperson said in a statement.
When the Star asked the province for a home-by-home breakdown of vaccine uptake data, it said contact individual public health units. Those units told the Star this information should be in the provincial COVax database.
But it is not. Not in any consistent way.
“I guess they were building the plane in the air,” Jastej Dhaliwal, a manager for vaccine preventable diseases at Peel Public Health, said in describing the government’s COVID-19 vaccination database.
A recent survey of homes by Hamilton Public Health shows significant variation between facilities. Of 39 sites canvassed on March 8, more than a dozen homes had staff vaccination rates below 60 per cent. At one home, the rate was 1.1 per cent.
Public health units in Toronto and Peel said they could not provide home-level breakdowns. Durham did not address the question about home-level data, noting instead it will add “additional information about priority groups … as soon as we are able.” York’s public health unit did not respond.
At least 50 Ontario long-term-care homes are managing outbreaks. The number of confirmed staff infections increased by 14 cases Friday to 115 compared with nine new resident cases.
“A quarter of the staff are actually causing the majority of outbreaks now,” Stall said.
Families of seniors in these homes are fed up with being under lockdown, especially as many residents assumed being fully vaccinated would be the ticket to their freedom.
One man whose parents live in Port Credit Residences, a Mississauga retirement home that bills itself as “resort inspired,” said his “jaw dropped like Oprah’s” when the general manager confirmed to him that an outbreak in early March was connected to an unvaccinated staff member who tested positive.
“He said, ‘I don’t know if they refused it or just didn’t have an opportunity. It’s like the flu shot, we can’t force them to take it.’ ”
The family member asked the Star to protect his identity out of fear that publicly airing his concerns might impact his parents’ care.
“When vaccines came in January, February, we saw the light at the end of the tunnel” after a year of confinement to their suite, he said.
The outbreak on March 12 closed the dining room, which had reopened only weeks earlier.
Since then, a second staff member and one resident have also tested positive for COVID-19. One staff member, the home’s chef — identified by his family and residents as Christopher Wilson, 29 — died. On March 25, the home announced the death of a COVID-positive resident.
The Star reached out to the home’s general manager Duarte De Oliveira several times by phone and email to ask about vaccine uptake among staff.
While province-wide vaccine uptake among long-term care staff improved slightly in March from 68 per cent to 75 per cent, that figure has plateaued, Stall said.
“We’re at the same uptake level as the flu vaccination but we need to drive higher than our usual rate,” he said.
Infections among staff trigger staffing shortages because it’s not only the infected person who has to stay away but other workers they’ve been in contact with.
“And then residents have to go back into isolation, which is very hard,” said Stall.
Low numbers of vaccinated staff, Stall said, will impact the ability of homes to loosen restrictions as British Columbia plans to do starting April 1 — allowing indoor visitors, including children; letting residents hug their loved ones; and allowing trips outside the home without needing to self-isolate upon return.
New Democrat MPP Jennifer French said she was reaching out to nursing homes within her Oshawa riding to ask about their staff and resident vaccination uptake rates. She has called for an independent public inquiry into deaths at two Durham Region nursing homes, including ThorntonView, which remains in outbreak.
“It’s quite distressing that we have an opportunity to collect purposeful data to stop this cycle of lockdowns and maybe get ahead of this thing but we’re not using it,” she said. “If the government isn’t keeping track of what they’re trying to do, how can Ontarians have faith that their loved ones are going to be protected?”
Amir Attaran, a professor of medicine and law at University of Ottawa says it’s time to broach the subject of mandatory vaccinations for the benefit of residents and workers alike.
“An employer has the duty to take steps to create a safe workplace,” he said. “If you have an unvaccinated person in a care home, it’s not just the patients who are at risk. It’s the other workers who are at risk.
“The tentativeness that has sometimes come about when employers have sought to mandate vaccination for flu is not going to be regarded in the same light when you’ve got a pandemic that’s killed 22,000 Canadians.”
Ontario’s Human Rights Commission agrees.
“Requiring proof of vaccination to ensure fitness to safely perform work, or protect people receiving services or living in congregate housing, may be permissible under the Code if the requirement is made in good faith and is reasonably necessary for reasons related to safety,” Chief Commissioner Ena Chadha wrote in a statement to the Star.
The son whose parents live at Port Credit Residences wants managers to close what he perceives to be a vaccination gap among staff.
“I think the public should decide if this is something they want to live with,” he said. “I’m prepared to move my family to another home.”
When the Port Credit Residences’ chef, Christopher Wilson, told his sister Natalie he was starting to feel sick with a migraine, “We never talked about vaccination,” she said. “He never voiced any concerns. He loved his job. He loved the people. He was always washing his hands, wearing his mask.”
When she spoke with him on Wednesday, March 17, his own positive test had been confirmed. He told her he was feeling weak but better. That he just needed some rest.
“We felt more relaxed, that he was on the other side of this.”
Wilson died at home on Saturday, March 20.
Data analysis by Andrew Bailey