Vaccine hot spots aren’t static. If the intention is to vaccinate the highest risk neighbourhoods first, then there is a need for more real-time, dynamic prioritization.
The best use of an incremental dose of available vaccine is in moving postal codes in the upper left to the right as quickly as possible. As new data are released by ICES each week, I will be updating this blog to help track these moving targets. Which neighbourhoods are falling behind? Where do we need to focus our efforts? We can’t know unless we look at the data.
May 8 Update
Overall, Ontario’s hot-spot strategy appears to be working. When tracking began, hot-spot postal codes at higher risk of COVID infections were trailing lower-risk ones by a significant margin. That gap has closed. As of May 3, they’re neck and neck: 33.6 percent vs 33.7 percent vaccinated (median). However, that’s merely catching up. Due to the disproportionate risks faced by residents in the hot-spot zones, their vaccination rates need to be even higher. With the Ontario government’s decision to allocate 50 percent of vaccines to hot spots the weeks of May 3 and 10, I fully expect hot spots to surpass non-hot spot neighbourhoods when the new data is released by ICES next week, if all goes according to plan.
Movers of the Week
M1G, M1L, M1P, M3K: Scarborough made big gains this week (tip: any postal code starting with M1 is Scarborough). M1G (Scarborough Golf Club-Lawrence), M1L (Warden-St. Clair), and M1P (Kennedy-Ellesmere) all gained between 9 and 10 percentage points this past week. The vaccination team at the Scarborough Health Network has done a nice job of setting up a number of pop-up clinics across these hot zones, and they’ve made a difference. Having said that, all it means is that these high-risk areas have caught up with the rest of the field (they’re roughly at the Ontario median), and more work is needed to bring down community transmission risk through future rounds of vaccination.
Postal Codes of Concern
M1B, M1X, M9M, M9V: Not all parts of Scarborough are doing well. M1B (Malvern/Morningside-Sheppard) and its sister neighbourhood M1X (Morningside-Neilson) continue to lag. Earlier this week, Radiyah Chowdhury wrote an impassioned plea for Malvern, a neighbourhood used to being left behind. “Malvern has had some of the highest reported positivity rates in the city, currently at over 20 percent. Despite all this, the neighbourhood has seen an incredibly slow rollout of pop-ups and mobile vaccination clinics,” she wrote. M1B only got its first pop-up clinic on May 4, which does not show up in this week’s tracker.
Earlier this week, Fatima Syed wrote another in-depth feature on this hard-hit GTA region, with a penetrating look at the first week of pop-up clinics in Peel. To sum it up: there just wasn’t enough vaccines, which resulted in overwhelmed phone lines, frantic group texts, and frustration, as well as relief for those fortunate enough to receive their first dose. There are a number of postal codes of concern that require swift attention: L6P, L6R, L6T, L6V, L6X, L6Y, L7A, L4T (tip: any postal code starting with L6 is Brampton).
April 30 Update
Overall, the percent of residents vaccinated with at least one dose increased from 23.6 percent to 28.9 percent (median) over the most recent week in Ontario. And the gap between postal codes designated as hot spots and those that are not has continued to narrow: 28.1 percent versus 29.2 percent, respectively, when comparing the median.
The widening variation among postal codes observed over recent weeks has slowed down considerably, as measured by the interquartile range (IQR). However, among hot spots, variation has actually increased. This is likely due to focused vaccination efforts in some but not all hot spots, due to limited vaccine supply. More about this below when I discuss movers of the week and postal codes of concern.
Movers of the Week
M3J, M3L, M3M, M3N: So much progress has been made over this past week, it’s hard to have just one mover of the week. In the scatterplot above (slide 3 of 5), we see that several postal codes along the Jane Street corridor shifted dramatically to the right: M3J (Keele-Finch), M3L (Jane-Sheppard), M3M (Jane-Wilson), and M3N (Jane-Finch). This is the second week in a row that Jane-Finch has been a mover of the week, owing largely to pop-up and mobile clinics that have continued to be set up at various locations throughout the area, including at the Driftwood Community Recreation Centre and the apartment buildings at San Romanoway. However, the biggest contributor to all four postal codes making these gains has to be the decision by Humber River Hospital to abandon appointment booking at Downsview Arena starting April 20, essentially turning it into a low-barrier pop-up clinic for anyone over 18 in the surrounding postal codes. It was a bold decision that’s paid off.
Postal Codes of Concern
M1X, M6M, M9M, M9N, M9V: Progress has stalled in several postal codes with high rates of COVID infections. These include M1X (Neilson-Morningside/Scarborough), M6M (Keele-Eglinton), M9M (Weston-Sheppard), M9N (Jane-Lawrence), and M9V (Kipling-Finch/Rexdale). These areas are heavily populated by racial minorities and low-income individuals who work in essential industries.
Toronto’s northwest has gotten a lot of attention lately, so let’s talk M1X in Scarborough. It’s the area immediately north of Malvern (some locals might even consider it to be part of Malvern). Individual income here is $33,432 (pre-tax), which is significantly below the median of $52,255 for all Toronto postal codes. It’s very likely that a significant portion of the population works in essential jobs. M1X is also home of the City of Toronto’s only Amazon fulfilment centre (known as YYZ9). This massive warehouse has been in active outbreak for nearly a month, the city’s largest, with 38 COVID cases and counting. It seems sensible to me that all residents and essential workplaces of M1X should have immediate access to the vaccine.
Peel: Postal Codes of Concern
Peel continues to lag behind the province for vaccination, especially in hard-hit areas like L6P, L6R, L4T, L6X, and L7A. These postal codes continue to move upward (meaning infections are rising) while a significant proportion of residents continue to be unvaccinated. More about this on Monday, with another deeply-reported story by Fatima Syed about Peel’s vaccination efforts.
April 23 Update
In early April, the Ontario government released a list of 114 “hot spot” postal codes for priority vaccination. According to the government, individuals aged 18 and over in designated hot spots are eligible for vaccination through mobile teams and pop-up clinics.
Since then, there has been considerable debate about the merits of several postal codes—some neighbourhoods at higher risk of COVID have been excluded while lower risk ones have been included. My view is that these debates lose meaning with each passing week due to the rapidly evolving nature of risk and immunity; a high-risk neighbourhood from eight weeks ago might no longer be high risk if a significant portion of the population has been vaccinated.
If the intention is to vaccinate the highest risk neighbourhoods first, then there is a need for more real-time, dynamic prioritization. This requires some understanding of a neighbourhood’s propensity for COVID infections (based on cumulative cases per capita), as well the degree of protection it has from the virus (percent of residents vaccinated). See scatterplot below.
The best use of an incremental dose of available vaccine is in moving postal codes in the upper left to the right as quickly as possible. That will avoid the most infections, hospitalizations, and deaths. As new data are released by ICES each week, I will be updating this blog to help track these moving targets
Overall, percent of residents vaccinated with at least one dose increased from 19.2 percent to 23.6 percent (median) over the most recent week in Ontario. And the gap between postal codes designated as hot spots and those that are not is closing: 22.7 percent versus 24.1 percent, respectively, when comparing the median.
However, variation has widened with each passing week, as measured by the interquartile range (IQR). This means that the gap between under-vaccinated and over-vaccinated areas is increasing, and has been since measurement began on March 29. The variation in Toronto is especially pronounced (see scatterplot for Toronto).
Mover of the Week
M3N (Jane-Finch): Over the most recent week, this neighbourhood in Toronto’s northwest went from 11.8 percent to 20.4 percent vaccinated. On the Toronto scatterplot, look at the speed with which this dot moves from left to right in the most the recent week. That’s what we want to see for all the high-risk postal codes. This progress is due largely to last weekend’s pop up vaccination clinic, which administered 3,140 doses to M3N residents, the majority of whom were Black and Vietnamese Canadians.
Postal Codes of Concern
M9V (Kipling-Finch/Rexdale), M9M (Weston-Sheppard/Humbermede): These two postal codes have high rates of COVID infections and very low vaccine coverage relative to the rest of the city. They’re also heavily populated by racial minorities and low-income individuals. On April 21, the City of Toronto announced a plan to “triple vaccine access in 13 hot spot neighbourhoods,” including M9V and M9M. We’ll have to wait until next week to see whether or not that’s made a difference in terms of moving these dots to the right.
Earlier this week, Fatima Syed wrote an in-depth feature about how Peel has been neglected at every step of the pandemic, including how under-vaccinated it is. Peel currently accounts for 20 percent of all cases in Ontario, yet they’ve only received 7.5 percent of the vaccines. The scatterplot shows five postal codes of concern in Peel that warrant attention: L4T (Goreway-Rexdale), L6P (Goreway-Castlemore), L6R (Bramalea-Sandalwood Parkway), L6X (Chinguacousy-Williams Parkway), and L7A (Hurontario-Bovaird).
The Local’s ongoing vaccination coverage is made possible through the generous support of the Vohra Miller Foundation.