An attendee of a local vaccination clinic organized by North York Toronto Health Partners and North York General Hospital.

By: North York General Hospital's Corporate Communications and Public Affairs team

When COVID-19 vaccination began in early 2021, the goal of the North York Toronto Health Partners (NYTHP), which includes North York General (NYGH), was to get as many people as possible vaccinated as quickly as possible, beginning with those at greatest risk.

Given that North York is one of the most ethnoculturally diverse populations, with the highest proportion of older adults in our region, we knew an all-hands-on-deck approach was needed.

The province's vaccine rollout began with high-risk health care workers and vulnerable populations, including those living in long-term care homes.

"The focus of our work to instill vaccine confidence has centred on safety – for those we provide care to and for healthcare workers who deliver that care," said Mitch Birken, NYGH's Vice President & Chief Human Resources Officer. "We used a variety of strategies because no single approach would be effective for everyone in a diverse workforce."

Hand in hand with making vaccination as accessible as possible to staff and physicians, we worked to build vaccine confidence within our team members. One approach was to link healthcare workers with peers and COVID-19 vaccination experts. Since last winter, NYGH's "Ask Me" and "Who I am Protecting" campaigns have allowed staff to easily identify experts onsite to ask about vaccination and to hear from a cross-section of colleagues about their personal motivations for getting vaccinated. 

This fall, to support the remaining team members to get vaccinated, the "Ask a Vaccination Expert" campaign provided staff with the opportunity to have confidential personal conversations with different expert colleagues in fields such as infection prevention, pharmacy and obstetrics by phone, Teams or email. Having a safe and personal conversation with a trusted expert gave some staff the knowledge and the confidence to make an informed decision about getting vaccinated.

Similarly, a mix of tactics was used to address vaccine hesitancy in the public. Virtual "Ask A Doc" sessions allowed community members to talk openly with health professionals about some root causes of their hesitation. Culturally specific learning materials were also shared through community networks and chat groups.

Alongside our efforts to enhance vaccine confidence, the NYTHP team worked to make vaccination as accessible as possible by removing obstacles such as lack of transportation and language barriers.

"We were committed to doing everything possible to get people vaccinated - whether this meant going to local parks, parking lots, hosting webinars, or bringing our vaccinator bus to neighbourhoods," said Dr. David Eisen, NYGH Chief of Family and Community Medicine. "We met people — our community at large and health care professionals — where they were and communicated with them in the ways that they told us work best for them. At the end of the day, the success of these efforts lies in developing a trusting, human relationship with physicians or colleagues they can relate to, listen to, and rely on for accurate, factual information about their health."

Pictured left: A participant of North York General’s ‘Who I’m Protecting’ campaign that encouraged team members to share why they got vaccinated against COVID-19.

Equity, diversity and inclusion were and continue to be central to our local vaccination effort. Through listening to leaders and people from different communities, patients, and caregivers, the team learned that some health care workers and members of the public were being held back by the same beliefs and experiences related to vaccination. The NYTHP vaccination team invested in understanding the unique needs of different groups, the particular difficulties people had accessing vaccination, and the sources of distrust.

During Team Toronto's Last Mile campaign, the NYTHP vaccination team turned to the Vaccine Engagement Team (VET) Project to help reach the last 20 percent of people who had yet to be vaccinated. The VET Project is a collaboration between the NYTHP, City of Toronto (which funds the project) and Toronto Community Housing among other organizations. It uses specially trained Ambassadors to promote confidence in vaccination, working closely with local charities, health care, and faith groups on the ground.

VET Ambassadors are experts in community engagement as well as experts in the communities of North York. This especially helped improve communications and support in groups disproportionately impacted by COVID-19, including those belonging to Black Indigenous and People of Colour (BIPOC) communities.

Other successful strategies included:

• Empowering Ambassadors from neighbourhoods with low vaccination rates to determine how best to address local needs and concerns.
• Reducing practical barriers to vaccination such as helping with appointment booking, transportation and operating hyper-local clinics.
• Simplifying information and delivering it in multiple languages and formats.
• Providing expert COVID-19 vaccine information sessions hosted by trusted community leaders in different languages.
• Barrier-free, no-questions-asked clinics for undocumented workers and other vulnerable people.

Building vaccine confidence is hard work and can take time.  But this work has helped increase vaccination rates in North Toronto with success based on effective partnerships, listening to and understanding people, and taking impactful, personalized approaches.