No vaccines for most community medical clinics, Alberta government decides

The Alberta government has announced that it will permanently halt the distribution of publicly funded vaccines to most community medical clinics, with only a few select clinics continuing to receive them. This decision has raised concerns among healthcare providers.

Earlier this year, the Alberta government stopped shipments of publicly funded vaccines to community medical clinics after a distribution contract expired in April. No replacement contract was put in place, leaving family physicians without COVID-19 and flu vaccines for the fall immunization campaign. Clinics have also been unable to access several other publicly funded vaccines, including the pertussis (whooping cough) vaccine.

After months of uncertainty, during which the government suggested the disruption was temporary, the Alberta government has confirmed it is ending the broader distribution program. This program was launched in 2021 to improve access to vaccines.

"As we continue to move past the pandemic, we have re-evaluated and have determined that we will return to distributing provincially funded vaccines to the select community medical clinics that previously administered vaccines," a statement from the health minister’s office explained.

The statement added, "To ensure we limit vaccine waste as much as possible while maintaining access, we will focus on serving the most vulnerable populations, those in rural and remote areas, and on clinics administering the highest volume of vaccines."

Going forward, the province plans to distribute influenza, pneumococcal, and Tdap vaccines (which protect against pertussis, tetanus, and diphtheria) to 20 to 25 community medical clinics. Prior to the halt, between 500 and 600 clinics were administering publicly funded vaccines, according to government data.

A Growing Concern

Dr. Mareli Powell, a family physician based in Fox Creek and Edmonton, expressed disappointment with the government's decision. "This response falls far short of what we need to see... We need all community medical clinics to be able to administer appropriate vaccinations to their patients," Powell said.

She explained that the change will impact a wide range of clinics, including family doctors offering flu shots, clinics providing tetanus shots alongside stitches, and maternity clinics that offer vaccines as part of prenatal care.

"It's not acceptable that this service cannot be provided through medical clinics anymore," Powell, a past president of the North Zone Medical Staff Association, added. "If we consider that about 300,000 patients get their vaccinations through medical clinics, this will affect vaccination rates and further strain our acute care system as the flu season picks up."

Alberta's flu vaccine uptake last year was the lowest in a decade, at just 24%.

Dr. Christine Luelo, a family physician in Calgary, expressed alarm at the scale-back. "When I hear the number of 20 to 25 [clinics] as a provincial number, I'm a little alarmed that that is a tiny drop in the bucket," she said. "Best case scenario, they don't actually understand the implication of not including primary care providers as a key enabler to vaccination... Worst case scenario is that they're actively working to be quiet about vaccines. And that's pretty alarming, to say the least."

Luelo stressed that making vaccines as accessible as possible is crucial at a time when immunization rates are declining. She also expressed concern that the change would force patients to seek vaccines elsewhere, creating unnecessary barriers. "I've had many situations where a patient just needed a few extra questions answered, they're ready to go, and now I'm sending them away from my clinic in the hopes they won't change their mind en route to the pharmacy."

The Alberta Medical Association (AMA) has also voiced concerns over the move. "We are concerned that vaccines will not be available through community family or rural generalist clinics... This removes the opportunity for Albertans to obtain advice and immunization from their most trusted source of medical information," Dr. Shelley Duggan, president of the AMA, said in a statement.

"About four per cent of immunizations were administered this way last year, and that's still significant: every person vaccinated means improved safety for everyone," Duggan continued. The AMA is consulting with its members and plans to keep pressing the government to consider alternative solutions.

The provincial government, however, emphasized that it will continue to monitor vaccine uptake and adjust if necessary. "We want to be clear that there continues to be good access to immunization services in Alberta," the statement noted.

Influenza, COVID-19, pneumococcal, and Tdap vaccines are still available at approximately 1,600 community pharmacies and 150 Alberta Health Services (AHS) clinics. According to the province, 97% of those immunized against the flu last year received their shots at these locations.

The government also clarified that COVID-19 vaccines will no longer be shipped to community medical clinics in order to prevent waste, as there are multiple doses in each vial. The selection criteria for which clinics will continue to receive vaccines is still being developed, and shipments from the provincial vaccine depot are expected to begin between the end of November and mid-December.