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York Region residents wait in line for a COVID-19 vaccination at a mass vaccination site for residents 80 years and older, in Richmond Hill, Ont. on March 1, 2021.

Cole Burston/The Canadian Press

Several Ontario regions are forging ahead with plans to vaccinate those 80 and older against COVID-19 faster than the province’s timeline, but Toronto says it has to use more of its supply for health care workers and other priority groups and doesn’t have enough to start in the general population yet.

Ontario’s vaccine booking system won’t be up and running until March 15, weeks after Alberta and Quebec started immunizing older seniors. But at least nine of Ontario’s 34 public-health units are launching their own systems, including the Toronto-area regions of York, Peel and Halton, to start vaccinating those 80 and over. York, for instance, began bookings on Monday, making 20,000 appointments in the first two hours. Guelph, Waterloo, Ottawa, Hamilton, Simcoe-Muskoka and Windsor have also launched their own booking systems and are starting vaccinations.

Toronto won’t follow suit because of the supply issue, the city’s top doctor said Monday – raising concerns about equity in the province’s largest city.

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Medical and political officials in Toronto said the municipality has been slower than some other places to shift to vaccinating people over 80 because the city has a greater proportion of high-risk individuals, such as 100,000 health care workers, who are higher on the province’s priority list.

The list also includes adults from First Nations, recipients of home care for chronic conditions, and the homeless.

AstraZeneca, Moderna or Pfizer? Take whichever COVID-19 vaccine you’re offered, experts say

Toronto’s mass-immunization clinics are scheduled to open on April 1.

Councillor Joe Cressy, who chairs the city’s board of health, said that while the list is based on vulnerable populations, vaccine supply is distributed on a per-capita basis.

“Because of the unique situation and the uniqueness of Toronto, we have a disproportionately large number of people who qualify in Phase 1 because they are more vulnerable,” Mr. Cressy said.

Toronto Medical Officer of Health Dr. Eileen de Villa said Monday that the city needs a strong supply to open up vaccinations to more people.

“Obviously, what we’re waiting for are larger supplies of vaccines, so we can get to that very big group here in Toronto, roughly about 120,000 people who are 80 years of age and older,” she said.

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Once the city receives significantly more vaccine doses and can begin inoculating its population of people over 80, Toronto’s size will pose its own difficulties. The city has more people over 80 than the entire population of Guelph, Dr. de Villa said.

Alexandra Hilkene, a spokeswoman for Ontario Health Minister Christine Elliott, said the vaccine program “will look a little different” across the 34 public-health units, each of which have unique needs and populations.

“Each public-health unit may vary their rate of vaccine administration based on local considerations and capacity,” Ms. Hilkene said, adding that the province is starting a “soft launch” of online booking with a handful of public-health units before opening it up provincewide on March 15.

Opposition parties took the government to task for the slow launch of the booking system.

“It’s really shameful that the government didn’t do the appropriate planning,” NDP Leader Andrea Horwath said. “There’s really no excuse for the government being so far behind when it comes to the centralized system.”

Green Party Leader Mike Schreiner said the delay shows “a gross level of incompetence.”

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Meanwhile, a health group from east Toronto is launching its own system for seniors 80 and older and homeless people, and will send mobile clinics to seniors’ buildings and to shelters.

Jeff Powis, medical director of infection prevention and control at Toronto’s Michael Garron Hospital, said the facility initiated a pilot project that will reach out to seniors in the community once vaccines are more widely available. It is also developing an online preregistration form for those 80 and older.

“I do worry about a fragmented system in the absence and void of a formalized provincial booking system. But at the same time, you have to weigh that risk, versus the risk of deferring, especially with more variants of concern around and concerns about a third wave,” Dr. Powis said.

The hospital on Monday vaccinated Toronto police officers. Connie Osborne, a spokeswoman for the Toronto Police Service, said 2,250 front-line officers who respond to emergency calls were moved into the first phase of the province’s priority list.

Toronto is planning a massive vaccination effort. Along with nine major city-operated clinics, residents will be able to get vaccinated at about 350 other locations.

The nine vaccination clinics are planned to open by April 1 at the latest. The timing for the others is less clear. The city said these are partnerships that will require co-ordination.

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Ontario’s science advisory table recently said in a report that prioritizing groups for vaccinations based on neighbourhood, as well as age, could prevent thousands of cases and reduce the number of deaths due to the pandemic.

Nathan Stall, a geriatrician at Mount Sinai Hospital in Toronto, who is on the advisory table, said he has concerns with the way Ontario has structured its vaccine prioritization. He said the province created “havoc” by not launching its booking system earlier with clear criteria for who should get their shots.

“That’s what’s most concerning to me about this. … It has the end result ultimately of slowing down vaccination coverage for older adults,” he said.

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