In Feb. 2021, the National Advisory Committee on Immunization (NACI), the body that makes recommendations for Canada’s vaccine rollout, recommended Indigenous adults and adults in racialized communities who have been disproportionately affected by the pandemic should be prioritized for their first dose of a COVID-19 vaccine.
These guidelines were especially relevant to Toronto, where racialized and low-income residents have had higher rates of COVID-19 since the pandemic began.
In response to high rates of COVID-19, the Greater Toronto Area (GTA) has one of the most robust vaccination rollouts in Ontario. On May 25, the City of Toronto announced that 65 per cent of all Toronto adults aged 18 or older had received their first vaccine dose.
But as more and more Torontonians receive their first dose of a vaccine, gaps in access for marginalized communities—like people of colour, unhoused people, and sex workers—grow wider.
Now, leaders across the city are taking it upon themselves to get their communities vaccinated.
New approaches for racialized communities
Rates of vaccine hesitancy are higher for racialized communities in Canada. In March 2021, Statistics Canada revealed that 77 per cent of Black Canadians said they were unlikely to get a vaccine, compared to 49 per cent of Canadians overall.
Experts have stressed the need to understand that this distrust of medical institutions isn’t baseless. Systemic oppression against Black, Indigenous, and other racialized patients in the Canadian medical system is both historic and ongoing.
While the City of Toronto has made some attempts to address these barriers, community groups have made the biggest impact on encouraging racialized residents to get their shot.
The Black Health Vaccine Initiative is a collaboration between the Black Physicians Association of Ontario (BPAO) and local organizations dedicated to Toronto’s Black community. Since vaccine doses became available to all adults in Toronto, these organizations have been hosting pop-up clinics across the city specifically geared towards Black, African, and Caribbean residents.
Friends of Chinatown Toronto (FOCT) and the Chinatown BIA have partnered with local clinics to coordinate outreach, recruit volunteers, and promote availability for pop-up vaccine clinics specifically for Toronto’s Asian community. The Kensington-Chinatown region has one of the lowest vaccination rates in Toronto, making this area all the more vital for outreach.
Like many other racialized communities, the Latin American community has been disproportionately affected by slower vaccine rollouts. The Latin American COVID-19 Task Force has taken the initiative to vaccinate community members through partnerships with local clinics and hospitals.
The task force initially began as a tool for education and resource sharing—since many members of their community speak Spanish, it committed to making public health information accessible and widely broadcasted in the language.
“We’ve had many Facebook live events, webinars and presentations. And we have even had help from the Spanish media to help us get our message across,” Laura Guerrero, a member of the task force’s coordinating committee, told The Pigeon in an interview.
The task force completely relies on volunteer work. Volunteer outreach—done mostly through social media—has proven successful, with the latest pop-up vaccine clinic attracting 130 volunteers.
“It feels amazing to do this work,” said Fernanda Yanchapaxi, a community member who has volunteered for the task force before. “With the vaccine rollout, in the beginning, my friends and I began to realize that a lot of people in our community did not have things like the technology or email to book vaccines. We decided to book vaccines on their behalf.”
Eventually, Yanchapaxi and her friends began to research different pop-up vaccine clinics and sometimes transported community members to the clinics, either by driving them or calling and paying for an Uber for them.
“We have been working for the community for a long time and we know how people have suffered during the pandemic,” she said.
She also mentioned that because of social distancing, community members have been cut off from their support networks. The task force has stepped in and created new networks that members have come to rely on.
“A lot of members of our community who are immigrants only have family in their home countries,” Yanchapaxi added. “Giving these vaccines to the people gives them hope to one day see their families again.”
“For me, it’s a very significant job.”
Pandemic health disparities continue
When Guerrero isn’t working on LATF’s coordinating committee, she’s a health administrator and CEO for WellFort Community Health Services, a health centre serving communities in Peel Region.
She said WellFort has seen firsthand the difficulties Latin American residents in Toronto face trying to access the healthcare system.
“We definitely all knew our community was going to be hit hard—it was never a surprise that we would be impacted,” she said. “However, when we started to see the data, which revealed the extent of the impact, it was frightening.”
In Toronto, Latin Americans are 7 times more likely to be infected with COVID-19 than white residents. They also make up the highest hospitalization rates of any other community.
Many members of Toronto’s Latin American are also undocumented or have refugee status, which presents an added barrier to pandemic healthcare.
The Ontario Health Insurance Plan (OHIP) covers access to walk-in clinics, emergency rooms, and family doctor visits. Undocumented people with precarious immigration statuses—for example, people who have overstayed their visas, or who have made the decision to stay to avoid potential danger in their home countries—are forced to pay for every hospital and walk-in clinic visit.
Though refugees are officially covered under OHIP, Guerrero said that many in her community are still exploited into paying.
Yanchapaxi added that since undocumented workers do not have OHIP, they are often contracted to do the most precarious jobs.
“These are essential services like cleaning services, factories, warehouses, and farm work,” she said. “These are the sites where there have been less measures taken to protect workers from COVID-19.”
Guerrero mentioned that many members of her community experience trepidation when engaging with the healthcare system because of its systemic barriers.
She mentioned that two weeks ago, she heard that a member of her community—a man working for a roofing company—contracted COVID-19 and died in hospital because he accessed care too late.
“You have a system that’s built for this […] people have other priorities—they have to go to work and put food on their tables. And not having paid sick days exacerbates this problem,” Guerrero said. “People can only get healthcare by paying for it [which] creates a barrier for people whose income is compromised.”
Clinic misuse shows vaccine privilege
Though the LATF pop-up vaccine clinics are meant to combat health inequity and are specifically targeted towards members of the Latin American community in need of their first vaccine dose, clinic volunteers have seen these spaces misused.
LATF volunteers have reported white residents showing up at clinics and demanding a second vaccine dose, which has also been reported at clinics for Asian residents in the city. Volunteers added these groups have been a hindrance to their work.
Victoria Chávez-Barzaga is a 14-year-old Toronto resident who volunteered at the Glen Long Community Centre on May 16. She told The Pigeon she saw multiple white people come to the centre requesting second doses.
Chávez-Barzaga recalled encountering a woman who remained insistent despite being told multiple times that the clinic only provided first doses.
“She kept on saying, ‘No no no. My doctor said it was here, like I have to be here,’” Chávez-Barzaga said. “It was a very uncomfortable situation.”
Sebastián Mendoza-Price volunteered at the same clinic. She said that some volunteers overheard groups of white people seeking second doses mentioning they wanted second doses to go on vacation and “visit cottages” for the summer.
Volunteers recalled some of the white vaccine-seekers complaining that the clinic was discriminating against them for being white—even though these vaccines were meant only for people getting their first vaccine.
Volunteers also said they overheard some people in line demanding Spanish-speaking volunteers “speak in English.”
Guerrero described the entire situation as upsetting and frustrating. She said it’s a clear sign that these people felt entitled because of their race and their citizenship.
“How can you come into a space that’s not your own and demand people to speak in your language? It was very oppressive,” Mendoza-Price added.
Other marginalized community leaders step up
Racialized communities aren’t the only marginalized groups that need vaccine campaigns tailored to their needs. The intersections of income, housing, and profession have created further inequalities in the way Toronto residents access vaccines.
The ongoing COVID-19 disparities in Toronto’s Peel region, where workplace exposures, multigenerational families, and the necessity of work for low-income residents combined, show exactly how privilege factors into pandemic equity.
Unhoused residents, too, have been hard to reach in Toronto’s vaccine rollout.
For sex workers, vaccine hesitancy and fear of medical institutions have compounded vaccine access as well. Jenny Duffy, the board chair at Maggie’s Toronto Sex Workers Action Project, told The Pigeon the Ontario government has lost a lot of community trust since COVID-19 began.
Maggie’s is a sex worker justice organization serving Toronto’s downtown east side. The organization typically focuses on legal support, political organizing, and peer support, but has recently branched out into new territory—vaccinations.
In May, Maggie’s partnered with community-based organizations in Toronto to hold two barrier- and surveillance-free clinics for marginalized communities. Now, they’re hosting a third at Zanzibar, a Yonge street strip club, on June 4.
“We know that the need continues for marginalized communities to be able to access a barrier-free and surveillance-free clinic,” Duffy told The Pigeon in an interview.
When it came to choosing a location for their third clinic, Duffy said picking a strip club was an intentional choice.
“The government has called our workspaces dirty and unnecessary, but we are workers who deserve to be treated with dignity and respect,” she explained. “So having a vaccine at a strip club is a public demonstration of that.”
Duffy added that making sure these clinics are more approachable than traditional models was a priority for Maggie’s.
“It’s incredibly important for folks in the community to feel comfortable, especially communities who have experienced historical stigma and surveillance when they are accessing health services,” she said. “It makes a huge difference to be in the company of their peers.”
“It’s not a system where we’re hurrying people through […] people are able to access the vaccine in a way that feels safe and comfortable for them.”
The vaccine rollout has revealed the City of Toronto’s mishandling of the health and safety of marginalized communities. Government inaction and negligence have pushed community members to take matters into their own hands, whether through clinics or advocacy.
Community leaders across Toronto say the City of Toronto and the government of Ontario need to do more to ensure equitable vaccine access to marginalized communities across the city. But vaccine equity is only a portion of the larger issue.
“This problem isn’t going to go away immediately after everyone gets their second dose. These problems are still going to exist in our communities,” said Guerrero.
“The government of Ontario has at least been putting adequate investment into high-priority communities—but that investment needs to be ongoing. Communities are still going to need support.”
With files from Tegwyn Hughes.