Ontario vaccine rollout ‘uncoordinated’ and ‘wasteful’: auditor general

Ontario’s COVID-19 vaccination campaign roll-out was uncoordinated and wasteful, the province’s auditor general has found, leading to thousands of doses of the vaccine being unused.

In her annual report, Ontario auditor general Bonnie Lysyk said the province’s COVID-19 vaccination system favoured those with access to better technology, duplicated its functions across different systems, and failed to adequately prioritize areas identified as hotspots.

A central system took three months to develop, resulting in tech-savvy individuals booking multiple appointments and consequentially wasting time through no-shows.

Appointments were offered by public health units, pharmacies and hospitals. This, the report said, encouraged people to take part in “vaccine shopping,” creating around 227,000 unfulfilled appointments in 2021.

Wasted vaccines

The report sheds new light on vaccine wastage in Ontario, with the auditor’s report pointing to pharmacies and private vaccine delivery clinics as the biggest culprits behind discarded doses.

Overall, Ontario wasted around nine per cent of the vaccines it received as of June 2022.

The report, however, found that pharmacies were responsible for 70 per cent of the wastage between December 2020 and June 2022, with the average pharmacy wasting two-in-10 doses they were tasked with administering.

In contrast, the AG found, hospitals wasted just one per cent while public health units wasted four per cent of their doses.

Lysyk’s report also points the finger at two private-sector companies that were contracted by the Ford government to deliver vaccines and which ultimately wasted 20 and 57 per cent of the doses delivered to them.

“There wasn’t value-for-money,” Lysyk said. “Money was paid for services that weren’t delivered.”

FH Health, which was responsible for administering vaccines at nine locations across Toronto, wasted 3,223 doses during a two-month period, the report states.

The AG also noted that over the course of four days, FH Health wasted more vaccines than it actually administered: 488 doses wasted compared with 95 doses delivered.

“None of the contracts with these private-sector companies contained a clause requiring the company to minimize wastage or charging the company penalties for excessive wastage,” the report states.

The Ministry of Health told the auditor the province returned over 4.4 million unused doses to the federal government to donate to the international market and plans to establish appropriate wastage targets for distribution centres.

Hotspot communities

As the Ford government tried to determine which Ontario communities should be first in line to receive the COVID-19 vaccine, the province’s Vaccine Distribution Taskforce identified 114 hotspot communities as priority zones for the shot.

Between April and May of 2021, the report found that 875,000 doses of the vaccine were set aside for these high-risk regions.

The audit discovered, however, that the Ministry of Health applied the task force’s recommendations “inconsistently,” which resulted in some high-risk communities not being prioritized.

“The Ministry did not clearly communicate how scientific data was used to support their selection of hotspot postal code regions, leaving the public confused about why some communities were selected and others were excluded,” the report states.

At least eight postal codes were included despite having a lower risk for the spread of the virus at the time, while four regions were excluded even though residents had a higher risk of hospitalization or death.

Doctors paid more for vaccine administration

As the province and public health units dramatically scaled up vaccination clinics in 2021, the auditor uncovered a massive disparity in wages depending on job title.

Physicians, for example, were paid between $170 to $220 per hour for administering vaccines at private-sector organizations, a hospital or public health unit.

The compensation, the audit found, was as much as five times higher than what nurses or pharmacists were being paid for the same work.

The report found that nurses earned between $32 to $49 per hour while pharmacists received between $30 to $57 an hour to administer the COVID-19 vaccine or booster.

“It was a surprise to see a difference in the rates,” Lysyk told reporters at Queen’s Park.

The government, Lysyk said, the disparity in pay was due to the government’s decision to pay workers based on profession rather than the execution of the work.

Personal protective equipment

The auditor found that millions of dollars in personal protective equipment that was purchased during the height of the pandemic needed to be disposed of in March because the PPE either was damaged, had expired, or had become obsolete.

Lysyk noted that approximately $30 million of a $201-million stockpile had to be disposed of, while expired equipment worth millions was “written off” by the province.

The AG discovered that some masks purchased by the province required assembly and were “undesirable” while certain hand sanitizer products contained alcohol once endorsed by Health Canada but were later not recommended by some public health units.

“Once the supply chain stabilized, some products became more desirable than others by the end users, so certain products were not used prior to expiry,” The report noted.

The auditor also cautioned the province that it needs to create a plan to use 100 million units of N95 respirators — worth $81 million — by 2030 or risk having them thrown out due to expiry.

The number of masks, the AG noted, will exceed demand by the end of the decade, raising the risk of wasting personal protective equipment.