How will vaccines affect U of T? Salvatore Spadafora provides an update on COVID-19 planning

The arrival of vaccines that are effective against COVID-19 has given many hope that the end of the pandemic may finally be in sight.

As the head of the University of Toronto’s COVID-19 response and adaptation group, Professor Salvatore (Sal) Spadafora is leading U of T’s response to the COVID-19 pandemic, including considering how the university might be able to harness its resources and expertise to support the largest vaccination campaign in Canadian history.

Spadafora, a physician, is senior adviser to the dean of the Temerty Faculty of Medicine and was recently named special adviser to the president and provost on COVID-19.

An anesthesiologist, he also served several terms as vice-dean in the Temerty Faculty of Medicine, with a special focus on post-graduate medical education and, more recently, strategy and operations, including the recovery and adaptation of academic operations during the COVID-19 pandemic.

As the country prepares to ramp up vaccination efforts in the wake of a supply-chain crunch, Spadafora cautions that some growing pains are to be expected. But he says there is light at the end of the tunnel.

“Right now, the days are short and our outlook looks dark,” he says. “But I believe as the days get longer and spring arrives, there will be a resurgence of hope and optimism coinciding with a much larger shipment of vaccines.”

Spadafora recently spoke to U of T News about how the university is preparing for what lies ahead.

What is your prognosis for this year?

You can't turn anywhere without hearing about vaccines. But I really think that there are going to be pivots in what we hear. Initially, we were hearing vaccines described as the great hope – a sort of knight in shining armour, and that everything was going to be great and vaccinations would happen quickly. Then reality sunk in when we began the roll-out.

The hope now is that, in March, vaccine suppliers will make up all the doses that we missed during the weeks when delivery of vaccines fell short of what was on order.

Everything could change really quickly as we begin to see the arrival of large volumes of vaccines, and as more vaccines are approved for use in Canada. Yet, the complications won’t end once we have a more abundant supply. Society will have to have a dialogue about where vaccines might be mandatory. One might see vaccines required to attend large gatherings such as sporting events. We may see them being required to work in specific patient-care settings in hospitals. It will be an evolving storyline that we will need to anticipate and adapt to as we go along.

How will the new variants of the virus behind COVID-19 affect our plans?

We’ve heard a lot about the variants of concern, and we know they’re in Canada. The real question is: Will a variant become the dominant strain? Most modellers and experts believe this is indeed the case. The reason we are concerned about that is that some studies suggest the variant is a true curve ball in dealing with COVID-19.

The variants are thought to be more infectious and potentially lead to more adverse outcomes, or at least cause more severe disease. I don’t think we’ve got enough data on the variants to really comment definitively on them yet – but suffice to say the more infectious something is by the numbers, the more cases of severe disease we may see. Vaccine administration in as rapid a fashion as possible, particularly to our most vulnerable populations, is of utmost importance.

Given the university's close ties to local hospitals, will U of T have a role to play in administering vaccines?

The university is not a health-care delivery institution, although we do have many faculty, researchers and students working on the front lines of the pandemic.

Under the provincial plan, 19 hospitals in the province are hosting vaccine clinics, including many of our affiliated hospitals. Additional hospital sites and public health units are providing vaccines, and that may be expanding as more vaccine becomes available. 

Although we will not be receiving a supply of the vaccine or delivering it ourselves, U of T is offering space for vaccinations as needed – just like the City of Toronto has done with the immunization clinic in the Metro Toronto Convention Centre. It might also be possible for our health profession students – in medicine, nursing, pharmacy and the like – to assist in some manner.

The bottom line is that we are committed to doing what we can to assist with the immunization campaign at all three of our campuses, but it’s still early days. We should have a better idea of what our role will be in the coming days ahead.

Do we know if students will need the vaccine in order to attend in person classes once they resume?

In this matter, as with other health and safety requirements, U of T will follow the guidance of the province.

I’m hopeful that the province and our community will work collaboratively on a framework to determine where vaccines are recommended and where they are optional.

Do we know which members of our community will qualify for a vaccine in one of the earlier phases?

The province has released the ethical framework guiding the vaccination campaign based on principles of fairness, transparency, equity, legitimacy and maximizing benefits while minimizing harm.

The phase one group prioritizes health-care workers in hospitals, long-term care homes and retirement homes, other congregate care settings and remote Indigenous communities. If you are a member of the phase one group, you may have been notified already.

So, the earliest members of our U of T community to be vaccinated will have been our alumni who are in long-term care.

Another fairly large group will be our faculty and students who are affiliated with our teaching hospitals and engaged in front-line care. The timing depends on whether they are patient-facing or not. If you’re a pre-clinical medical student, we want you to be immunized as you enter a clinical setting, but you may have to wait for the availability of vaccine doses.

Is there anything else you wanted to add?

I think one important lesson to come out of the vaccine story is the importance of supporting our universities. The mRNA technology used to create the Pfizer-BioNTech and Moderna vaccines isn’t new – it’s the product of decades of research. The reason we were able to develop a vaccine for a new virus in less than a year speaks to why we should invest in discovery research that can expand our knowledge.

It’s times like these that remind us why such research is so vital and the important role universities play in society.