Waitlists for COVID-19 vaccinations are being used by health units in other areas why not Hamilton?

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 awaitlist that has been used to contact hundreds of residents, with two to six people on the list managing to secure a vaccine ateach of the area's clinics every day, according to Haldimand spokesperson KyraHayes.

"The vaccine waitlist has been an integral part of the HNHU's delivery of the COVID-19vaccine," she wrote in an email.

The area's health unit is "proud to have an exceptionally low level of wastage (0.1 per cent) and to have never wasted a single dose due to inability to identify eligible candidates."

Standby lists are also being usedin Kitchener-Waterloo and ahospital in Toronto to fill missed appointments and use up doses, but not at clinics run by Hamilton Public Health Services. 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 health-care 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'tbeing used here.

The plans for leftover doses differ based on the clinic but include vaccinations for staff and first responders and vaccines for patients orcaregiverswho are eligible and staying at a location where shots are being given, he wrote in a follow-up email Monday.

A standby list is used, but only for healthcare workers who have registered for a vaccine, said Berry.

Dr. Elizabeth Richardson, the city's medical officer of health, also appears tohave 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 reportsvery little vaccine waste

Public health estimated221 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 whenfive 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 isnow eligible for a shot underPhase 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.

"I think it's brilliant," she said of waitlists, explaining that addingher 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?"

"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 60Kjoinwait list within hours

Other areas have used waitlists, including Kitchener-Waterloo, where it'shelped fill gaps caused bycancellations or missed appointments.

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

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 updatefrom 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 to 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, havinga 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 thatplan 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."