Pictures of smiling seniors and hard-working health-care staff getting some of the first COVID-19 vaccine doses have become messages of hope after 11 long pandemic months.
Many jurisdictions around the world, Canada and its provinces included, have rushed to make sure that those most at risk are being protected first, giving initial doses to people such as Anita Quidangen, a personal support worker at a long-term-care centre in Toronto, and Sahra Kaahiye, a respiratory therapist in Edmonton.
But with more doses anticipated soon — the prime minister announced Tuesday that Canada could see as many as 168,000 doses of a second vaccine, the Moderna candidate, arrive this year assuming it’s approved by regulators — many are wondering, who will be next in the vaccination pecking order, and, more self-interestedly: When is it my turn?
“It’s like a 5,000-piece jigsaw puzzle,” Shannon MacDonald, an assistant professor of nursing and PhD at the University of Alberta, says of the challenge of deciding who should get a vaccine and when. She’s leading a research team that is surveying people who were identified as most high risk and likely to be high up on any priority list.
Provinces have not yet released much information about who will be called up after the initial high-risk groups. MacDonald says it’s likely they don’t know yet exactly who will be given the opportunity or in what order, because much is going to depend on where the virus has spread, who is catching it and even the vaccines themselves.
Health care in Canada is the job of the provinces and territories. So while the federal government was in charge of locking down a vaccine supply and distributing doses based on population, the final decision about who rolls up their sleeve and when now rests with the provinces, and most aren’t talking in specifics just yet.
The National Advisory Committee on Immunization has released guidelines on general priorities, including people of “advanced age,” health-care workers and those, like personal contacts, who are likely to spread COVID-19. But provinces are already making tweaks in response to their own regional challenges, MacDonald says.
In Alberta, where hospitals are “overflowing,” health-care workers have been first, whereas Quebec has given doses to residents of long term care homes, a particularly hard-hit segment of the population.
“Nobody would really argue with saying the people who are dying of COVID should get the vaccine first,” she says. “But when it comes to a decision about whether or not your cashier at the grocery store should get it versus your first responders, then you get into a lot of different opinions and values.”
It’s unlikely that we’ll see a uniform approach across the country, MacDonald says.
Leadership of the territories asked to not get any Pfizer vaccines at all because of the challenge of transporting them — they must be stored at about -70 C — so they’ll be first in line for the first Moderna vaccines, which are easier to get into remote areas, Prime Minister Justin Trudeau said Tuesday. He said supplies, including freezers, are already being shipped so they are ready once the vaccine is.
“Certainly there has been the argument that it should be the same in every province, and I can see the value of that, but I can also see the fact demographics are different, geography is different, the way this disease has unfolded has been different in every province,” MacDonald said.
“I think the key is that the communication about how decisions have been made have to be extremely clear, so that the public doesn’t feel like it’s a black box.”
In total, federal officials have said they expect to see six million doses, some Pfizer, some Moderna, arrive before the end of March. That’s enough for almost 10 per cent of the population to get the required two doses.
So how will you know when it’s your turn?
“This is not available to the general public just yet,” Dr. Isaac Bogoch, an infectious-diseases specialist at the Toronto General Hospital and member of Ontario’s COVID-19 Vaccine Distribution Task Force, told the Star last week.
“When we have more access to vaccines, it certainly will be; but it’s going to be in a prioritized manner.”
Right now, it’s fairly easy for officials to identify people who are at the front of the line. They’re living or working at long-term-care centres, or hospitals, MacDonald said. Most of the people getting a vaccine dose this week have been personally notified.
At a certain point, health authorities will likely have to switch to a system in which they identify eligible people, who are then asked to show up to a specific site or sites, and identify themselves, though there may be issues around validating that people are actually part of the identified group, she notes.
The good news is that federal officials have a finish line in mind.
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Trudeau said late last month that the “majority” of Canadians should have access to a vaccine by September. According the vaccination plan posted online, the program itself is scheduled to wrap up by the end of the year.
Said Bogoch, “At some point, and I don’t know when, anyone who wants a vaccine in Canada will have easy access to it.”
With files from The Canadian Press
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2020-12-16 00:07:33Z
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