In This Issue:
- Introduction including Ontario Science Table brief
- Responding to Patient Concerns About the AstraZeneca Vaccine
- Message from Ontario Health (Cancer Care) - Guidance for Primary Care & General Medical Imaging for Vaccine-related Adenopathy
- COVaxON
- Primary Care Community of Practice
- New and Updated Resources
Dear Members,
We are writing to provide you with an update from our united Primary Care COVID-19 Vaccination Collaborative (PC-VAC*).
We know the last few weeks have been exceptionally challenging and you are all exhausted - we all share in your anger and frustration with how poor policy decisions have led us to this devastating third wave, but we are continually inspired with how much primary care continues to step up and support your patients, your community, your colleagues, and the health care system.
Whether it’s pivoting to supporting vaccination or continuing with in-person care to prevent people going to hospitals, working in the assessment centres or, more recently, managing COVID@Home, primary care has been at the cornerstone of this pandemic.
This brief from Ontario’s Science Table lays out very clearly the six things that will reduce transmission, protect our health care system, and allow us to re-open safely as soon as possible. As the Primary Care Collaborative we support these principles – specifically for fair, evidence-based measures that will limit the risk of illness for workers and their families, and to provide tools to help overcome other barriers to vaccination, such as hesitancy.
While we also welcome the government walk back on the potential of introducing paid sick days, we still do not know any details on this. So, as we wait on details we are also requesting still further clarity on some of the additional measures that have been introduced. We will share more information as it becomes available.
On April 23rd, the Ministry added Pregnant Individuals under the highest risk conditions in the Phase 2 prioritization guidance. While we wait for the updated Prioritization Guidance Document to reflect this change, you can read the memo that was sent to the PHUs from Dr. Dirk Huyer, Lead, Clinical Guidance and Surveillance Workstream. Additional updated information can be found below.
Responding to Patient Concerns About the AstraZeneca Vaccine
The OMA has developed key messages to help physicians address patient concerns about the AstraZeneca vaccine, including the rare occurrence of vaccine-induced prothrombotic immune thrombocytopenia (VIPIT).
The Ontario COVID-19 Science Advisory Table has developed guidance for VIPIT for both Emergency Medicine/In-Patient Settings and Outpatient Settings, including a triage flowchart for diagnosis and recommendations for management. A lay summary is also available for physicians to refer to when speaking with their patients.
Thrombosis Canada has put together this FAQ on COVID-19 vaccines and blood clots.
OCFP has developed a message that can be used/adapted by your practice to update patients on use of the AZ vaccine, including questions about safety. The CEP also has tips for conversations with your patients.
NACI updated its recommendations on the use of authorized COVID-19 vaccines to incorporate its analysis of a rare but serious safety signal of vaccine-induced immune thrombotic thrombocytopenia (VITT), following vaccination with the AstraZeneca vaccine. Also released was a summary of the vaccine statement and the CCMOH also followed-up with a statement.
Message from Ontario Health (Cancer Care) - Guidance for Primary Care & General Medical Imaging for Vaccine-related Adenopathy
Axillary adenopathy has been reported as a common side effect of the COVID-19 vaccine. Due to the mass vaccination underway, it is expected to be increasingly found in breast and other imaging. Ontario Health (Cancer Care Ontario) has developed guidance for primary care on COVID-19 vaccine-related adenopathy. The guidance provides recommendations on management of adenopathy detected during breast screening, general medical imaging, and patient detected adenopathy.
COVaxON
If you will be vaccinating in your clinic or would like to in the next phases of the rollout, we encourage you to sign up for COVaxON training on the OntarioMD website. Training will be scheduled on an ongoing basis. OntarioMD is suggesting that each practice have one or more (depending on the size of practice) member of their staff trained on the ‘End to End Training’ module.
Primary Care Community of Practice
Ontario Health (OH) and your primary care associations have collected resources and lessons learned through a series of Community of Practice meetings with the primary care pilot participants.
Please join the Primary Care Vaccination CoP online forum for resources. If you have trouble signing up for Quorum, please message janine.theben@ontarioehealth.ca for assistance.
If you’re participating in vaccination efforts and would like to learn from other primary care sites that are currently vaccinating please register for upcoming webinars. You can view the recording from the April 22 Community of Practice here.
New and Updated Resources
- From the Ministry of Health and Ontario Health:
- Updated Directive #2 for Health Care Providers and COVID-19 Directive #2 Questions and Answers
- Ontario Health memo on the COVID-19 System Response including directives to ramp down of non-emergent and non-urgent surgeries and procedures in hospitals
- From the OCFP:
- The OCFP has compiled these guiding considerations on balancing priorities, based on Directive #2 and ramp down of non essential care. A reminder that PPE allocations are still available from the provincial pandemic stockpile – Q&A here.
- The OCFP Community of Practice - The COVID-19 Vaccine: Vaccination in primary care, evolving vaccine evidence, and more from April 23, 2021 with Dr. Rosemary Lall and Dr. Allison McGeer recording can be found here and an updated resource list can be found here.
- Resources and Tools from the Kingston-Frontenac-Lennox-Addington:
- COVID-19 Immunization Strategy: The Primary Care Partnership Arm Document and YouTube Video on the strategy
- KFLA YouTube Video on Setting up a Vaccine Clinic
- The Ontario Medical Association has developed three recent COVID-19 vaccine tools:
- COVID-19 Billing Summary – updated to reflect clarifications that address member questions and now includes two flowchart decision trees to guide members through the use of COVID-19 billing codes.
- Deciding whether to provide COVID-19 vaccines in your practice - incorporates the learnings from the primary care COVID-19 vaccination pilots.
- Guide to Providing COVID-19 Vaccines Through Your Practice - provides a high-level view of the steps to COVID-19 immunization in Ontario and includes learnings from the pilots as well as points out to resources from other organizations.
- New resources from CEP:
“Safer” vaccination site for those who are uninsured
- Uninsured Network is developing a list of “safer” vaccination sites where migrants including undocumented residents can receive access to the vaccine in a safe, dignified way. Organizations and practices standing up vaccination sites can fill out their Declaration: Access Without Fear Access to Vaccines in Ontario form online if they are interested in implementing the recommended practices (as listed on the form), and be listed/promoted as a “safer” vaccination site.
Multilingual resources
- riomix.ca is a collaborative, centralized, and accessible repository of translated materials and multilingual websites relating to health and community care and support from Access Alliance. The resource library includes but is not limited to COVID-19 materials.
Find resources from previous weeks here.
We look forward to continually updating you on the provincial vaccination strategy. Please do not hesitate to contact us if you have any questions or ideas.
Yours in good health,
The AFHTO Team
*Ontario Primary Care COVID-19 Vaccination Collaborative Partners
- Alliance for Healthier Communities
- Association of Family Health Teams of Ontario
- Indigenous Primary Health Care Council
- Nurse Practitioner-Led Clinic Association
- Ontario College of Family Physicians
- Ontario Medical Association Section on General and Family Practice
- Ontario’s Academic Chairs of Family Medicine