Vincent Lam is an author and a physician. He is the medical director of the Coderix Medical Clinic. Currently, he is assisting with the COVID-19 vaccination efforts of Michael Garron Hospital, Toronto Public Health, and Unity Health.
Yelling over thumping tunes spun by DJ Clymaxxx, I asked a woman whose arm I was set to jab about the line-up to get into the Scotiabank Arena, where a massive vaccination effort was under way. She said it was difficult to find the start of the line, which stretched up York Street in downtown Toronto, but once she did, things moved quickly. “It took half an hour to get in. That’s not bad – same thing if you go to a concert, or watch a game.”
It did feel like the same kind of thing – crowds surging toward an arena, except in this case to receive a COVID-19 vaccine. After administering the shot, I reminded her that it takes two weeks to achieve maximum immunity, “so continue to be cautious.” This phrase was calibrated to temper any sense of invincibility among the “double-vaxxed,” and to allow sufficient ambiguity for public health guidelines that will certainly change. Yet I also wanted to leave room for optimism – for the things we will cautiously bring back into our lives. I directed her to the bleachers saying, “You can sit in a really expensive seat!” Before heading over, she stood and took a panoramic photo from centre ice, a sea of tables, masks, syringes.
From the gold seats, people waited for 15 minutes of safety observation. Instead of athletes, they watched vaccinators on the playing surface collectively deliver an average of more than 30 shots a minute for 14 hours straight. Score! Carlton the Bear and the Raptor busted dance moves. Mayor John Tory got his second shot for all to see. Former Maple Leaf captain Wendel Clark made an appearance. Radio host Devo Brown provided running commentary. Every 30 minutes someone won tickets to an actual sports game in the eagerly awaited near-future.
And there was cheering! This sound – the raucous clamor of wordless exultation, of hands thrown together – was almost foreign I had not heard it in so long. Although muffled by masks, it contained both nostalgia for “the time before COVID-19,” and hope for the future.
We are drawn to record-setting feats – the fastest 100-metre sprint, the largest pumpkin. Pre-pandemic, I was once part of an unsuccessful attempt to set a world-record in snow-angel making. So when asked to participate in Toronto Vaccine Day – an attempt to set a one-day record in vaccinations led by Michael Garron Hospital and University Health Network, run by more than 1,500 staff and volunteers from at least 31 organizations – I signed up.
And I did so despite having spent much of the past three months giving shot after shot in every possible setting: a church parking lot slanted such that our vaccine carts kept rolling away, the dim hallways of an apartment building whose occupants sat in chairs outside their doors, schools circled by lines of people snaking through the neighbourhood, a pop-up where our tent was picked up and blown away by the wind. After all that, I wasn’t going to miss “the Big One.”
The appeal of mass-participation record attempts is the prospect of doing something individual, perhaps ordinary, but which becomes part of something momentous. One could argue this is true of every vaccine given and received during this pandemic.
It was remarkable to witness how much had changed since the early vaccinations. When the first doses arrived last winter, a handful of vaccinators would drive to a nursing home, a vaccine cooler in the trunk. In the spring, when mass vaccination clinics began, the mood was predominantly relief, as if shipwreck survivors had spotted a rescue boat. Now, thousands of people surged through an arena, and every few minutes we gave as many shots as we would have during an entire day at a nursing home. The mood was joyful anticipation, as if the boat had almost reached home.
When I give first doses, I methodically address each relevant health question. Giving second doses, I know that discussion has already happened once. I simply ask, “Any questions for me, or changes in your health since the first dose?” Usually, the answer is “No,” and the shoulder is bared.
One person told me, “Yes,” and related a serious diagnosis unrelated to COVID-19 or vaccination that they recently received. They told me that they were grateful it was caught early, and that the timing of the second shot fit well into their schedule of required treatments. I was reminded that, beyond COVID-19, other important health care issues continue to unfold, as do all of our lives. After eight hours of vaccinating, I switched to a support role, answering questions and providing emergency medical backup. I helped a woman who was nervous about needles, making sure she was fine until she was ready to leave. As she departed, she told me, “Thank you, I felt safe,” and I thought, “This is why we are here.”
Late in the day, an announcer faced the crowd in the bleachers and asked who had received their second shots. Every hand that I could see went into the air, almost like a stadium wave. When he asked who had just received their first shots, I didn’t see any being raised. Therein lies the next challenge. Almost 70 per cent of Canadians have received at least one dose of COVID-19 vaccine, but slightly more than 30 per cent have not yet received any shot. Only 3.6 per cent of the vaccines given at Scotiabank Arena on June 27th were first doses.
This takes nothing away from a fantastic day. It demonstrates that people who were enthusiastic to receive first doses are eager to receive second ones, and that the existing rollout strategies worked for them – but it also reveals that we will soon hit a friction point where everyone who is eager has had two shots. We need to think creatively about how to keep first-shot numbers rising. At one point, attendees shared that they were shouted at and called “sheep” by a group of anti-vaxxers outside the arena.
Most people who have not been vaccinated are not of this ilk. They are uncertain rather than opposed, or are potentially agreeable to being vaccinated but not able or willing to hunt for a shot. Perhaps they face systemic barriers to access. Even as we ramp up the pace of delivering second shots, we need to engage the unvaccinated by addressing doubts and questions with high-quality information through social media, by facilitating vaccination in family doctors’ offices, and by bringing vaccines to the most convenient locations possible – including high-traffic public venues as they open.
The target for June 27 was 25,000 vaccine doses administered. Every few thousand shots, an announcement was made in the jumping cadence heard during professional sports games, and the massive score board proclaimed what records had just been “Smashed!” The final tally: 26,771 – a North American record for most COVID-19 vaccinations given at a single clinic in one day. Like much of the past year, the huge force of a collective occurrence met the individual person and each of our desires to be safe.
When it was all finished, I found my way out of the cold stadium and emerged into a sultry summer evening. It felt like an old memory of something normal and familiar, yet it was also newly strange to be in a square full of people. Someone walking past said, “Thank you so much!” and I realized that my stethoscope still hung around my neck. I replied, “Thank YOU!”
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