TORONTO -- Just as residents of Ontario’s Peel Region were beginning to see a significant drop in the number of COVID-19 cases, the provincial government has paused its hotspot vaccine strategy.

“The reason we’re seeing numbers go down is finally, after pleading and begging, we got a focus on the hotspots,” Brampton Mayor Patrick Brown said in a phone interview. “We can’t take our foot off the pedal.”

But that’s exactly what’s happening, said the mayor. Brown explained that in the first two weeks of May, Peel Region was receiving 19 per cent of Ontario’s vaccine supply, more than the 11 per cent considered to be the per capita allocation. This was part of a province-wide strategy meant to target hotspot zones by sending 50 per cent of Ontario’s vaccine supply to these communities.

Peel Region is now expected to receive less than 11 per cent of the province’s vaccines over the next few weeks.

“With the adjustments in the weeks to come, it's anticipated that this will return to a roughly per capita total dose allocation,” said Dr. Lawrence Loh, the medical officer of health for Peel Region, in a phone interview. “The hope would be that [the province] might revisit the hotspot strategy and there might be flexibility in allocation to ensure that our community can continue to be prioritized given how long we've been in lockdown and how hard hit we’ve been.”

According to Loh, both the region and city of Brampton will likely be scaling back on vaccine offerings at clinics as a result of this shift in supply. This could also mean reduced hours of operation at fixed clinics and scheduling delays in the rollout of pop-up and community outreach clinics.

Alexandra Hilkene, spokesperson for Ontario’s Ministry of Health, said in a statement that the province’s hotspot-focused vaccine strategy has already “brought significant new supply to the region [of Peel],” home to 25 of the 114 postal codes that were given priority. In fact, she explained there is now an excess of vaccines in the area, stressing that the province is also focused on helping other communities hit hard by the pandemic.

"Our government has been clear that our vaccine rollout will be focused on older adults, those at risk of serious illness and hot spot areas,” she said. “With this increase in allocation, Peel Region remains significantly oversupplied compared to the rest of Ontario.”

Thisincrease in supply seems to be helpful in reducing the region’s positivity rate. During the week of April 25, Peel reported the highest COVID-19 test positivity rate in the entire province, with 16.83 per cent. The overall positivity rate for Ontario at the time was about half that amount (8.71 per cent), and just over 84,000 vaccine doses were administered within the region.

Fast forward to the week of May 9, Peel’s COVID-19 test positivity rate came in at 12.68 per cent. That week alone, 127,322 doses were administered in Peel.

The biggest contributor to high positivity rates in many Brampton postal codes continues to be workplace outbreaks. During the week of May 9, the city reported a 14.5 per cent positivity rate, about double the amount calculated for the entire province at the time. Brown remains adamant that the hotspot vaccination strategy must continue with a focus on essential workers.

“The job’s not done – the average age of an essential worker is 36 [years old] in Brampton, we still have a long way to go to get that cohort vaccinated,” he said. “I would say we have at least half of our essential workers still to vaccinate.”

Many essential workers in Peel are having to contend with additional factors that make them especially vulnerable, said Dr. Amanpreet Brar, a general surgery resident at the University of Toronto, in a phone interview. Having grown up in Brampton, her parents still live in the city and she continues to monitor the pandemic’s impact on one of the hottest zones in the province.

As of May 25, more than one million vaccine doses have been administered across Peel Region and 67 per cent of adults have received at least one dose. But these numbers don’t paint the whole picture. Brar points to Brampton postal codes like L6P with a COVID-19 test positivity rate of about 16 per cent as of the week of May 9, more than double Ontario’s overall rate of 6.94 per cent at the time.

Factors include a lack of adequate paid sick leave, as well as job insecurity faced by temporary agency workers, and a short supply of linguistically and culturally diverse information related to vaccines for many racialized residents. These barriers, said Brar, make it especially difficult for essential workers in Peel to access vaccines, particularly workers with low income and multiple jobs.

“[The provincial government] is failing to realize the conditions these workers are working in and also failing to understand their perspective and protect them,” she said. “Essential workers’ lives haven’t been regarded as essential during the pandemic, but their work has always been considered essential.”

Brar also points to the success of community pop-up clinics in getting residents, including essential workers, vaccinated. But with the province no longer providing hotspots with increased vaccine allocations, the doctor said she worries the city may not have an adequate supply of vaccines to reduce case counts, and Brampton residents may get left behind.

Still, Loh insists that essential workers shouldn’t be worried about a lack of access over the next few weeks.

“While these workplace pop-ups may not be happening as frequently or quickly, and may be delayed or deferred, they will eventually come,” said Loh. “It's just a matter of moving a bit more slowly over the next few weeks, but still making sure that we get to those populations.”

Outreach to Brampton’s most vulnerable communities will also remain a priority, he said, with places like the Bramalea City Centre pop-up clinic targeting the Black African and Caribbean communities, as well as the Embassy Grand clinic targeting the South Asian community not expected to see changes in operation.

Vaccinating the city’s remaining essential workers will ultimately pave the way for less concern over reopening the province, Brown said.

“We know where the spread is happening – it’s happening in these busy factories,” he said. “There’s no reason that every essential worker shouldn’t be vaccinated who wants to be.”