An audit of the Yukon government’s handling of the COVID-19 vaccine rollout has found the response lacked adequate planning and First Nation collaboration, though it says the government managed vaccine distribution in an effective and equitable manner overall.

A joint statement from Health and Social Services Minister Tracy-Ann McPhee and Community Services Minister Richard Mostyn said they believe the territory’s response effectively protected the lives of Yukon residents.

They also pledged swift action on the recommendations in the report from the Office of the Auditor General of Canada (OAG).

“We are committed to incorporating the OAG’s recommendations into our work, with a particular focus on improving emergency plans and vaccine distribution protocols,” their statement reads.

Deputy Auditor General Andrew Hayes was in Whitehorse on Tuesday to present the report.

Though the Yukon government was effective in its vaccination efforts, he said, it lacked up-to-date pandemic plans.

It also had issues with monitoring and reporting on vaccine supplies and did not give the opportunity for First Nations to participate meaningfully in the planning and delivery of these efforts.

“The Government of Yukon needs to put actions behind its words and work in partnership early, often and meaningfully with First Nations, not just in emergencies but across the spectrum of programs and services it provides,” Hayes said.

Premier Ranj Pillai defended the government’s work with First Nations during the pandemic.

In a statement to the Star Thursday, he said the pandemic was discussed with First Nations’ governments at several forums and in frequent bilateral calls and meetings between chiefs, ministers and the Yukon’s chief medical officer of health.

“Throughout the pandemic, our goal was to maintain close communication with First Nations and municipal governments,” Pillai said.

The premier also noted a community outreach team was created to send government representatives out ahead of the arrival of vaccination clinics.

The teams were sent to prepare communities and act as liaisons between the First Nations and Yukon government agencies, assisting in addressing vaccine hesitancy by distributing vaccine uptake information to communities.

What the Yukon got right

The report did applaud the government Health and Community Services departments for many aspects of their vaccination programs.

It said the territory was able to manage the program in an effective and equitable way, with a speedy rollout that was able to get vulnerable populations vaccinated on a priority basis.

“Within weeks of receiving the first shipment of doses, the departments vaccinated vulnerable groups in Whitehorse and set up a mass vaccination clinic in the capital to progressively reach all age groups,” Hayes said.

“In Parallel, mobile health teams travelled to remote communities so that anyone 18 years and older could be vaccinated near their home community.”

These mobile teams had turned the vaccine delivery work over to local health centres by December 2021, according to the report.

The report also says the government overcame barriers affecting some high-risk populations – such as individuals experiencing homelessness – who lack access to phones or computers to sign up for appointments.

Overall, the report shows slightly better vaccine coverage for the first two doses in the Yukon versus the rest of Canada, with 85 per cent of residents taking the first jab and 81 per cent taking the second.

This represents a two-per-cent better rate for the first and one per cent better rate for the second.

What needs work

One of the prevailing themes of the report is how the government needs to better collaborate with First Nations governments in pandemic preparedness.

Part of this is linked to how these communities are involved in actually planning and providing the physical vaccines and setting up clinics, while another aspect relates to how data are collected in those communities to better understand how to increase vaccine coverage.

Data were collected and released on vaccine coverage geographically, but there was no effort to collect data on First Nation status, therefore leaving no information about how many First Nations members received a vaccine. The reason given in the OAG report is that this could increase vaccine hesitancy in those groups.

“It would be prudent and good practice for the government to plan forward for that and to work with First Nations to talk about what information can be collected,” Hayes said.

“At the end of the day, it will also be individual choice because that is personal information.

“So you can ask. And that is what we are suggesting the government should have done.”

Hayes went on to say this could be solved with “meaningful engagement” with First Nations communities, something that was lacking, particularly in the early stages of the rollout.

The statement from ministers McPhee and Mostyn says the development of data-sharing protocols is underway.

Pillai’s message echoed this, adding the government has now established a Cultural Safety Team within the Department of Health and Social Services to work directly with First Nations communities and make sure health services are delivered in a culturally sensitive way.

“Our goal is to ensure First Nations communities can trust and comfortably utilize our health care services, as this will lead to better overall health outcomes for Yukoners across the territory,” Pillai said.

Hayes linked the audit’s findings of a lack of collaboration with First Nations to the overall need for better pandemic planning.

The report says First Nations were not given a chance to have input into the Yukon’s initial COVID-19 vaccine strategy in December 2020.

“In some cases, we saw that the lack of understanding of roles and responsibilities and the stakeholders to consult led to information being provided late,” Hayes said. “For example, to First Nations groups.”

The pandemic plan the territory was using had not been updated in about 10 years, and some sections of the plan were underdeveloped and missing information.

“We saw that there were plans for emergencies and pandemics that had been put in place a decade ago and had not been updated,” Hayes said.

“There was an update to one of them early in the pandemic, but that update really only amounted to deleting references to the H1N1 pandemic.”

During the initial rollout of vaccines, the report also says, there was confusion about which workers providing services for higher-risk populations would be given priority for vaccinations and why.

These were people working in places such as long-term care facilities or prisons, some of which were prioritized over others for the first doses of vaccine.

An example given says the Whitehorse Emergency Shelter got its workers vaccinated first and had the first mass vaccination clinic set up at the site, while other organizations providing similar services had to wait. The OAG report recommends these organizations all be treated in an equitable manner in the future in terms of vaccine distribution.

The other main criticism in the OAG report is linked to how the territory manages vaccine stocks, saying the Yukon lacked a proper inventory system, causing wasted doses.

“While the territorial government’s approach to the rollout was effective at getting people vaccinated, we found weaknesses in the monitoring of and reporting on the vaccine rollout,” Hayes said.

Problems with managing vaccine stocks stemmed initially from the territory using manual excel spreadsheets to keep track of doses.

That caused problems, as some vaccine vials can actually have an extra dose of vaccine extracted. Because of this, the report says the government could not tell how many doses it had in stock with any accuracy.

When booster shots became available, the government also over-estimated the number of shots that would be needed.

It assumed that after a significant outbreak of COVID-19, the previous summer booster coverage in the fall of 2021 would be similar to that of the first two doses.

The government had expected 75 per cent of Yukoners to get the booster, when in the end only 50 per cent took the shot. This wasted 4,544 doses due to expiration.

The OAG suggests next time that smaller vaccine orders are placed – instead of the three large orders made by the government – so they can alter their orders to suit demand.

Another way for these doses to be saved would be to transfer them to other territories and provinces. But the report says the Yukon lacked adequate storage facilities for this purpose at the time.

Hayes noted this did not hinder the effectiveness of the Yukon’s vaccination campaign this time, but could have implications for the future.

“In the future, if vaccines are even more of a scarce commodity, any wastage or any lack of tracking of those vaccines would become a problem,” he said.

The government has nearly completed an electronic inventory management system according to the statement from McPhee and Mostyn.

Hayes added that overall, he hopes this audit helps to improve the response in any future pandemic.

“Using the lessons learned can help everyone understand the benefits or the reasons to get vaccinated and to increase coverage,” Hayes said.

In his statement to the Star, Pillai says this is also what the government plans to do.

“We will continue to improve our systems and protocols so that we can be even better prepared for future such emergencies, because we can never be ‘too prepared’ for the next global crisis,” he said.