Opening Statement to the Standing Committee on Oversight of Government Operations and Public Accounts
COVID-19 Vaccines in Nunavut
(2023 Report of the Auditor General of Canada to the Legislative Assembly of Nunavut)
22 September 2023
Casey Thomas
Assistant Auditor General
Ullaakkut. Good morning. Mr. Chair, we are pleased to be here in Iqaluit today to discuss our audit report on COVID‑19 vaccines in Nunavut, which was tabled in the Legislative Assembly on May 30th, 2023. With me today is Mélanie Joanisse, the director responsible for this audit.
The COVID-19 pandemic was the most severe outbreak of infectious disease in more than a century. Timely access to vaccines was important to reduce the risk of serious illness, hospitalization, and death in the territory and lessen the impact on Nunavut’s health care system. Our report discusses how the government delivered vaccines across the territory. It also highlights successful strategies to support future public health emergency efforts and areas for improvement.
Overall, the Department of Health, the Department of Executive and Intergovernmental Affairs, and the Department of Community and Government Services worked together to overcome significant logistical and staffing challenges to quickly deliver vaccines across the territory. The departments actively engaged with Inuit organizations and community groups, which contributed to the successful rollout of vaccines. However, we found that vaccination efforts were made more difficult by the lack of a pandemic plan and information systems to track, monitor, and report on vaccine inventory.
On average, it took 2 weeks to deliver the vaccines to the 25 communities once the vaccines arrived in Nunavut. We consider this timely given that the departments had to hire and provide accommodation for nurse immunizers, secure planes to fly them into the communities, adapt to weather conditions, and comply with the temperature control requirements of the vaccine.
The Department of Health identified vulnerable populations to immunize on a priority basis, using national guidance and considering Nunavut’s context. Those identified to receive the vaccine doses first included Elders and individuals living in continuing care centres, correctional facilities, and shelters.
However, the Department of Health lacked an updated and current pandemic plan with a clear governance structure, goals, and objectives. This caused confusion about the roles and responsibilities of senior government officials during this public health emergency. There was also a lack of guidance on how the Department of Health was to collaborate and consult with Inuit and community stakeholders. This meant that the department had to create and implement its vaccine rollout plan while the rollout was underway.
The Department of Health did not have information systems to track, monitor, and report on vaccine inventory. The department reported that 15% of doses were wasted as of September 2022. However, we found that because of poor record keeping and the lack of inventory tracking, the department could not account for another 16% of doses. Although some wastage was expected, we found that the department may have wasted up to 31% of the doses that it received from the Public Health Agency of Canada.
We found that the department did not know the number of vaccine doses that it had received. When it came to monitoring, the department did not have a complete and consistent method of tracking the movement of doses between regional pharmacies and community health centres.
We also found that the department did not have systems to track inventory in the community health centres or to track wastage after May 2022. Instead, it relied on a time‑consuming, manual system for tracking the wastage of doses at regional pharmacies. Because of these weaknesses and inefficiencies, the department did not know whether the doses that it had marked as unaccounted for were wasted or held in inventory at health centres.
To strengthen its response to future health emergencies, including pandemics and mass vaccination efforts, the Government of Nunavut needs to set up modern information and inventory management systems to report on key aspects of vaccine rollouts and adverse events. This would improve the delivery of health care services to the territory’s population and reduce the burden on an overstretched workforce.
Mr. Chair, this concludes my opening statement. We are pleased to answer any questions the committee may have. Nakurmiik. Thank you.