Each day, as appointments at COVID-19 vaccinations clinics wind down across Haldimand-Norfolk, people waiting for their shot received a call offering them a chance to roll up their sleeve and save a dose from being wasted.

The residents are drawn from a waitlist that has been used to contact hundreds of residents, with two to six people on the list managing to secure a vaccine at each of the area’s clinics every day, according to Haldimand spokesperson Kyra Hayes.

“The Vaccine Waitlist has been an integral part of the HNHU’s delivery of the COVID-19 vaccine,” she wrote in an email.

The area’s health unit is “proud to have an exceptionally low level of wastage (0.1%) and to have never wasted a single dose due to inability to identify eligible candidates,” Hayes added.

Standby lists are also being used in Kitchener-Waterloo and a hospital in Toronto to fill missed appointments and use up doses, but not at clinics run by Hamilton public health. Instead, a spokesperson for public health said local clinics only thaw out enough vaccines needed for the number of appointments that are booked each day.

“It is very carefully managed to minimize wastage, as City of Hamilton Public Health Services and its healthcare partners understand how vital each and every dose is for our community,” wrote James Berry in response to questions from CBC on why a waitlist isn’t being used here.

Hamilton’s clinics have “residual dose plans” to use up any leftovers, Berry added. However, public health did not immediately respond to follow up questions, first asked on Thursday, about what those plans involve. The health unit said it intends to reply on Monday.

An immunization station is shown at Hamilton’s first COVID-19 vaccine clinic. (Submitted by Hamilton Health Sciences)

Dr. Elizabeth Richardson, the city’s medical officer of health, appears to have provided some insight on Hamilton’s approach to ensuring shots aren’t wasted during a media update on Tuesday.

“They know this is the gold, essentially, that they’re handling, so they’re very, very careful about it,” she said of staff at the city’s clinics.

“They thaw as much as they need and then utilize those doses as they go to … minimize wastage. So, that vaccine would be held for the next day’s appointments and continue to go forward and be utilized.”

Public health reports very little vaccine waste

Public health estimated 221 doses of the vaccine have been wasted since the rollout began locally, compared to a total of 120,573 that had been administered as of Thursday. That works out to 0.18 per cent.

Examples of where waste occurs are when five doses, rather than the expected six, are pulled from a vial, or vials and syringes are dropped, according to Berry.

Still, some are questioning why a waitlist isn’t being used locally.

Kelly Nott has multiple sclerosis. The 50-year-old is now eligible for a shot under Phase 2 of the province’s rollout, but her past attempts to get the vaccine were unsuccessful. She wonders if a standby list would have helped her get it sooner.

Kelly Nott, 50, said she supports setting up a COVID-19 vaccination waitlist in Hamilton. (Submitted by Kelly Nott)

“I think it’s brilliant,” she said of waitlists, explaining that adding her name to a list in Hamilton would help address some of the anxiety, frustration and sadness she’s faced while waiting.

“Why on earth are they not doing that everywhere to try to get the vaccines out there?” asked Nott.

“It’d be nice to at least even be able to be put on a waitlist for that opportunity, if there is leftovers and someone’s not going to use it.”

Hospital saw 60K join wait list within hours

Other areas have used waitlists, including Kitchener-Waterloo, where it’s helped fill gaps caused by cancellations or missed appointments.

Michael Garron Hospital in Toronto started a list of its own after finding that despite “rigorous inventory management” five or more doses were often left over at the end of the day.

A staff member from Michael Garron Hospital administers a Moderna vaccine at a mobile vaccination site outside the Masjid Mosque in Toronto on Saturday April 10, 2021. (Chris Young/The Canadian Press)

COVID-19 vaccines come with strict storage requirements and must be used within a few hours, so the hospital said it created an online form where people could sign up for a standby wait list. It was filled almost overnight.

“We received over 60,000 submissions in approximately 30 hours,” read an update from vice president Wolf Klassen.

“We are grateful to those eligible individuals who signed up as this will help ensure we get COVID-19 vaccines into as many arms as possible and that no dose will be wasted.”

Plan must be transparent: Bioethicist

The waitlist in Haldimand-Norfolk is currently only open to people 60-64, with health officials saying new lists will be generated by five-year increments when eligibility widens.

When there are outstanding doses, staff begin calling, but if someone does not pick up right away, they move to the next number, said Hayes. People who are on the list must be able to get to the clinic withing 30 minutes of the call, she added.

Regardless of the specifics of a certain area’s strategy, having a plan for any extra vaccines is vital, according to University of Toronto bioethicist Kerry Bowman.

“What should never happen is that you have even a handful of vaccines left at the end of the day and you have no real plan for what you’re going to do,” he said, adding people also have a right to know what that plan involves and who is eligible.

“In a democratic society such as ours … in a long-term emergency, they really do have an obligation not just to have a plan, but to make it transparent.”

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