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Report says delaying second dose of the Vaccine up to 42 days is OK, but some warn of risks

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TORONTO —
With just one per cent of Canadians vaccinated, and in the face of rising cases and strained hospitals, a new report from the National Advisory Committee on Immunization says provinces can accelerate the number of people being vaccinated by delaying the second dose for up to 42 days.

This would lengthen the specific waiting period between doses that has been proven to work in clinical trials for both vaccines.

The updated recommendations, released Tuesday by NACI, raise questions for Canadians anxiously awaiting the protection of a vaccine, as well as officials trying to speed up the rollout.

But the data is scarce on the impact of such measures, and scientists are split over whether they are worth the risks.

Dr. Caroline Quach, an epidemiologist and professor at the University of Montreal and chair of NACI told CTV News that it is a decision that could be made when regions “have no choice.”

“When you look at the epidemiological context where Ontario and Quebec are having huge community transmission, hospitalizations, complications, mortality, you have to wonder, do we have any data that would allow us to vaccinate more people at first,” she said.

She pointed out that the wave of cases is very high right now, pushing the need for more vaccines fast to cut down on overall transmission, even if the efficacy of those vaccines might wane due to the delay.

The two vaccines that have been approved in Canada so far — PfizerBioNTech and Moderna’s — both require two separate doses in order to achieve 94-95 per cent immunity for the patient.

These doses are spaced apart. Pfizer’s second dose is intended to be delivered 21 days after the first, while Moderna’s has a 28-day wait in between the doses.

The report from NACI says that while the ideal is to follow the vaccine manufacturers’ recommendations, people can wait longer — 42 days or so for the second dose — in order to allow double the number of Canadians to get some partial protection by receiving their first shot faster.

“We’re basically in a race against time,” Ashleigh Tuite, an epidemiologist and mathematical modeller with the University of Toronto, told CTV News. “And so the quicker we can get people vaccinated, the better.”

She pointed out that the need for fast immunization of the population is even more important in the wake of the news that the more transmissible U.K. variant of the novel coronavirus is in Canada.

Canada currently has almost 80,000 active cases of COVID-19, and more than 6,000 new cases were reported today. In a worrying trend, hospitalizations are also high, and long-term care homes are coming under fire again.

“Based on the data that we have on the vaccines, a week or two or three week delay in [doses] is unlikely to cause us a huge problem,” Tuite said. “And if anything, it’s still preferential to focus on getting those first vaccine doses in arms.”

It’s a plan endorsed by the World Health Organization, which said people can wait up to six weeks between doses to broaden coverage, with both the U.K. and the U.S. now releasing stored doses.

Both vaccines offer partial protection within 15 days of receiving the first shot, with Pfizer offering 52-per-cent efficacy and Moderna providing 80-per-cent efficacy.

But some scientists warn that relying on partial immunity and delaying the second shots may lead to viral mutations and inadequate immunity.

“The efficacy is likely not to be as high as we stretch out the time between the first and second dose,” Matthew Miller, an infectious disease specialist and associate professor at McMaster University, told CTV News.

“The further you get away from that first dose before getting the second dose, the greater your relative risk is [than] if you’ve got that second dose on schedule.”

He agrees that we should be vaccinating as many people as possible, without holding back the second dose in freezers, but believes we should only use up shipments on the first shot if there is the guarantee that more shipments of the second dose will arrive on time.

The very first people getting the vaccines are those on the frontlines and those at the highest risk from the virus, such as elderly people. This makes it all the more important that we get the vaccine rollout right, Miller said.

“We need to make sure that we give those people their vaccine doses on time in order to ensure that they enjoy sort of the maximum benefit and protection that the vaccines have to offer,” he said.

“I think right now where we’re still prioritizing the highest risk populations, it makes the most sense to stick as closely to the vaccine recommended schedule as possible.”

Both Pfizer and Moderna tell CTV News their shots should be delivered as studied and agreed upon by Health Canada.

“The safety and efficacy of the vaccine has not been evaluated on different dosing schedules as the majority of trial participants received the second dose within the window specified in the study design,” Pfizer said in an emailed statement, adding that there is no data “to demonstrate that protection after the first dose is sustained after 21 days.”

Moderna also stated that all of their trials included a second “boost” dose at 28 days, meaning they have no data on how long the efficacy of the first dose alone is sustained.

Health Canada’s position on the vaccination schedules is that Canadians “receive both doses of the same vaccine, as close as possible to the authorized dosing regimen for each vaccine.”

However, the organization noted in an emailed statement that provinces and territories may refer to NACI’s advice on the matter when making decisions on their vaccine rollout, and that NACI “has carefully weighed the scientific evidence and ethical implications” of all of their recommendations.

And some seniors in Quebec are considering suing because their second doses of the vaccine have been delayed — with some of them having contracted COVID-19 in the meantime.

How much the strategy of delaying the second doses could speed up vaccination is an unknown. Ottawa says 80 million doses are to arrive this year — but exactly when they will be in the arms of the public is still up in the air.

Source:- CTV News

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COVID-19 vaccination ramps up in several provinces as supply worries ease – CTV News

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Several provinces began expanding their COVID-19 vaccination programs to members of the general population on Monday, as new recommendations on the use of the AstraZeneca vaccine suggested it should be targeted at younger Canadians.

A national panel of vaccine experts said provinces should not use the newly approved vaccine on people 65 and over out of concern there is limited data on how well the vaccine will work in older populations — even though Health Canada approved the vaccine for all adults.

Rather, the recommendations issued by the National Advisory Committee on Immunization noted that the AstraZeneca vaccine could help speed up vaccination for younger age groups, who otherwise would have to wait longer for protection.

The arrival of a third vaccine raises the prospect of further accelerating Canada’s efforts to inoculate the general population, which hit a new gear Monday in several provinces.

Ontario, Quebec and B.C. started or announced plans to start vaccinating older seniors living in the community on Monday, after a first phase that focused largely on health-care workers, remote communities and long-term care.

In Montreal, mass vaccine sites including the Olympic Stadium opened their doors to the public as the province began inoculating seniors who live in the hard-hit city.

The government announced last week it would begin booking appointments for those aged 85 and up across the province, but that age limit has since dropped to 70 in some regions, including Montreal. The province has already finished vaccinating long-term care residents with a first dose and was almost finished in private seniors homes, the premier said Saturday.

There were long lineups and some frustration among vaccine recipients at the Olympic Stadium, but at another site, Montreal’s downtown convention centre, people reported a swift process.

Julie Provencher, a spokeswoman with the regional health authority asked people not to be too harsh. “For the first day of the biggest mass vaccination in the history of humanity, I think it’s going OK,” she said in an interview.

Several Ontario health units were also set to begin giving COVID-19 vaccines to their oldest residents after a provincial website for appointment bookings opened in six regions.

Some health units reported thousands of bookings and high call volumes, as regions such as York, Windsor-Essex and Hamilton began taking appointments for seniors aged 80 or 85 and up, depending on the region.

In York Region — where those aged 80 and older could start scheduling and receiving their shots on Monday — vaccination clinics were fully booked just two hours after they started taking appointments, according to a spokesman.

“At this time residents are urged to remain patient and will be notified as more appointment bookings become available,” Patrick Casey said in a statement.

A similar problem occurred in Nova Scotia, where the COVID-19 vaccination-booking web page was taken off-line Monday after it experienced technical issues the first day it opened to people aged 80 and over. The Health Department said high traffic to the site prompted the slowdown and suggested people could book by phone in the meantime.

In British Columbia, Premier John Horgan and provincial health officer Dr. Bonnie Henry outlined the next phase of the province’s immunization plan, which covers all seniors 80 and over and Indigenous seniors 65 and up.

Despite the good news, Horgan warned that the province still has several difficult months to come. “Although there is light at the end of the tunnel, we’re far from out of this,” he said.

The Public Health Agency of Canada is expecting delivery of about 445,000 doses of the Pfizer-BioNTech vaccine this week and none from Moderna — numbers that are down from last week’s all-time high.

It’s unclear when the first doses of the AstraZeneca vaccine will arrive in the country, but a senior government official told The Canadian Press on background Sunday it could be as early as midweek.

The advisory committee’s recommendations raise the prospect of younger Canadians getting vaccine much earlier than originally planned.

There are no concerns that the vaccine is unsafe, but the panel said the mRNA vaccines from Pfizer-BioNTech and Moderna are preferred, especially for people 65 years old and above, “due to suggested superior efficacy.”

The advisory committee said AstraZeneca should be offered to people under 65 as long as the benefits of getting a good vaccine early outweigh any limitations the vaccine may have in terms of effectiveness. It also noted that because AstraZeneca, unlike the first two vaccines, is stable at normal refrigerated temperatures, it allows for “a variety of alternate vaccination sites.”

Both Pfizer-BioNTech and Moderna reported about 95 per cent effectiveness at preventing COVID-19 overall, while AstraZeneca reported its vaccine to be about 62 per cent effective.

B.C. announced it would extend to four months the time between first and second doses of COVID-19 vaccine in order to allow the province to vaccinate more people sooner. Henry said the decision was based on evidence that showed the first two approved vaccines provide “a high level of real-world protection” after one dose.

Ontario confirmed Monday that it is considering following suit, adding that it’s asking the federal government for guidance on possibly extending the intervals between doses.

Despite the positivity surrounding vaccines, some Canadians were returning to lockdown on Monday.

Those included residents of the Thunder Bay and Simcoe Muskoka health regions in Ontario as well as Prince Edward Island, which entered a 72-hour, provincewide lockdown Monday meant to stop two clusters of COVID-19 cases from spreading.

This report by The Canadian Press was first published March 1, 2021.

— With files from Mia Rabson, Stephanie Marin and Holly McKenzie-Sutter

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COVID-19: Here's how to get your vaccination shot in B.C. – Vancouver Sun

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Here is what you need to know to get your jab.

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The vaccines are coming. After a long wait, B.C. is gearing up for one of its largest mass immunization efforts in history.

On March 1, Premier John Horgan unveiled Phase 2 of the province’s COVID-19 rollout plan and announced that seniors over 80 and Indigenous people over 65 will start receiving their vaccinations on March 15.

Here’s what you need to know to get your jab.

Q: Who has been vaccinated so far?

A: Phase 1 of B.C.’s COVID-19 immunization rollout, which started late December, targeted front-line health-care providers and people living in long-term care and assisted living facilities.

As of Feb. 26, 252,373 doses of COVID-19 vaccine had been administered in the province, 73,808 of which were second doses.

The B.C. government has promised that approximately 4.3 million British Columbians over 18 will be vaccinated by September, equating to 8.6 million doses of the COVID-19 vaccine.

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Q: How do I book an appointment?

A: As part of the Phase 2 rollout, seniors who are 90 and older and Indigenous people who are 65 and older will be able to book their vaccinations starting March 8, while seniors 85-89 can book starting March 15, and seniors 80-84 can book beginning March 22.

Booking information — including health authority contact details, complete call-in schedules, hours of operations and step-by-step instructions on how to call to book an appointment — will be available on March 8 at www.gov.bc.ca/bcseniorsfirst.

The government has promised that seniors would also be able to make one call to book their appointment through their health authority call centre.

Here is the contact list of regional health authority call centres, which will be open from 7 a.m. to 7p.m., seven days a week:

• Fraser Health: 1-855-755-2455
(Fraser Health also has online booking: Fraserhealth.ca/vaccinebookinginfo)
• Interior Health: 1-877-740-7747 ‡
• Island Health: 1-833-348-4787
• Northern Health: 1-844-255-7555 ‡
• Vancouver Coastal Health: 1-877-587-5767

People will be given a list of local vaccination clinics to choose from and the call centre agent will confirm the appointment time and location.

People should only call in when they are eligible. Anyone who misses their age-based dates can still call, book and be vaccinated at any time after they become eligible.

Q: What information will I need to provide to call centre?

A: The call centre will ask for:
• Legal name;
• date of birth;
• postal code;‡
• personal health number (PHN) from the back of B.C. driver’s licences or BC services cards;
• current contact information, including an email address or phone number to receive texts.

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To avoid fraud, the province is warning people that the health authority will never ask people for their social insurance number, driver’s license number or banking and credit card details.

Q: When can I get vaccinated?

A: Vaccination for the general population is expected to take place from April until September 2021. The vaccines will be administered by age in five-year increments, starting with people aged 75 to 79.

British Columbians will register and book their appointments to receive their first and second doses of the COVID-19 vaccine through an online registration tool. The province has not yet revealed details or a website for the online registration system.

The provincial government provided this estimate of when appointment slots would open for various age ranges:

Phase 3:

• people 75 to 79: First shot April; second shot May
• people 70-74: First shot April; second shot May
• people 65-69: First shot May or June; second shot June or July
• people 60-64: First shot June; second shot July
• clinically vulnerable people 16-69: first and second shots between April and June

Phase 4:

• people 40-59: First shot July; second shot August
• people 35-39: First shot July; second shot August
• people 30-34: First shot July; second shot August
• people 25-29: First shot July or August; second shot August or September
• people 18-24: First shot August; second shot September

Q: What if I’m a front-line worker, am immunocompromised or have other serious health conditions? Can I get the vaccine earlier? 

A: The province had said that once additional vaccines are approved by Health Canada and become available, front-line essential workers or workers who belong to specific industries may be included in the later part of Phase 3 or 4. Chances got better last week after Canada approved the Oxford-AstraZeneca vaccine. It has secured 22 million doses, which are expected to arrive between April and September.

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People age 16 to 69 who are deemed to be clinically extremely vulnerable can get appointment slots in April and June.

Q: Where can I get vaccinated?

A: Vaccination clinics will be set up in gyms, arenas, convention halls, and community halls. Residents of rural communities may be able to access mobile clinics, which can also provide vaccinations to people who are homebound with mobility challenges.

Vaccines are not expected to be administered at doctors’ offices.

Q: What do I need to bring to my appointment?

A: Make sure you wear mask, bring your Personal Health Number (if you have one) and wear loose fitting clothing. The intramuscular injection will be made into the arm, close to the shoulder.

It is recommended to arrive a few minutes before your appointment time. After checking in, you will get your vaccine dose then have to wait in an observation area for 15 minutes.

Q: Will I be given a record of my vaccination?

A: Most people will receive an immunization card that they’ll need to bring with them when they get their second shot.

You’ll also have an option to receive a digital copy of your immunization record that will be available on the province’s Health Gateway site, which you can register for by using the BC Services Card app on your phone.

Health Gateway is available to anyone 12 and older with a BC Services Card.

Q: When do I get my second dose? 

The province has extended the timeline between the first and second dose to 16 weeks or 112 days. The vaccine manufacturers recommended a timeline of 21 to 28 days between doses, but the B.C. Centre for Disease Control says “extending the time between first and second doses does not reduce vaccine protection over the long term and for most vaccines, a slightly longer interval is better.”

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After you get your first dose, you will be notified by email, text or phone when you are eligible to book an appointment for the second dose.

Q: What vaccines are available? What are the side effects and how effective are they?

A: Canada has approved three vaccines: The Pfizer-BioNTech vaccine, the Moderna vaccine, and the Oxford-AstraZeneca vaccine.

Possible side effects include redness or pain at the injection site, fever, chills, or fatigue.

Pfizer and Moderna say their vaccines provide a 94 to 95 per cent immunity when two doses are administered.

The AstraZeneca vaccine has a lower efficacy rate at 62 per cent, but is 100 per cent effective in preventing serious cases of COVID-19, hospitalizations and death.

Q: Is it mandatory to be vaccinated against COVID-19?

The vaccine is not mandatory, but it is highly recommended by health officials. The provincial government says everyone who would like a vaccine and who is eligible to receive it will have the opportunity to be vaccinated.

The COVID-19 vaccine is free for everyone living in B.C. who is eligible to receive it.

chchan@postmedia.com

twitter.com/cherylchan

With files from Scott Brown and Katie DeRosa


Get the latest COVID-19 news delivered to your inbox weeknights at 7 p.m. by subscribing to our newsletter here.


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COVID-19: BC seniors aged 90+ can start to sign up for vaccination on March 8 – Victoria News – Victoria News

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B.C. seniors born in 1931 or earlier will be first up for the COVID-19 community vaccination program, with registration for appointments starting next week, public health officials said Monday.

Anticipating a huge demand from seniors living at home and their relatives for the coronavirus vaccine, the province has arranged a rolling schedule by age for people to contact their regional health authority for appointments. It begins with people aged 90 and up booking appointments starting March 8, with appointments starting March 15. Then 85 and up can call starting March 15, with vaccinations starting March 22. People aged 80 and up or their relatives can call starting March 22, with vaccinations starting March 29.

Phone numbers will be activated starting March 8, officials said at a news conference March 1. Health authority call centre information and a step-by-step process are available on the provincial website at gov.bc.ca/bcseniorsfirst and also on websites for Fraser Health, Interior Health, Northern Health, Island Health and Vancouver Coastal Health. Relatives or friends of elderly people are allowed to call for appointments on their behalf when they are eligible.

The Fraser Health region, with more people and more seniors than the other four B.C. regions, will have online bookings available as well, in an effort to ease a rush of phone calls that provincial call centre staff may be unable to keep up with at first.

Provincial health officer Dr. Bonnie Henry said almost complete vaccination of staff and residents in long-term care and assisted living facilities has provided almost blanket protection for frail elderly residents, and immunization is nearing completion for remote Indigenous communities. Indigenous people aged 65 are included in the community vaccination program set for those 80 and up in the general population, due to higher risk that has been shown.

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Callers are urged to wait until their age group is eligible for appointments, and have the necessary information ready: First and last name, date of birth, postal code, B.C. personal health number, and contact information (email or mobile phone number of the senior or support person). People will be given a list of clinics close to home.

Officials warn everyone that health authority call centres will never ask for a social insurance number, driver’s licence number or banking and credit card details. If anyone asks for that, hang up immediately and contact your local health authority.

Henry said Health Canada’s approval of a third vaccine from AstraZeneca may allow an earlier vaccination date for people under age 80, assuming the delivery dates for all manufacturers are met. First shipments of that vaccine will be targeted to paramedics and other first responders not yet reached by the first stages of protection for health care workers and seniors.

“This is a vaccine that is fridge-stable, which means we can use it in the community in a much more agile way,” Henry said.

Results from first doses of Pfizer and Moderna vaccines are better than expected, and have allowed the province to extend the time between doses up to four months, Henry said.


@tomfletcherbc
tfletcher@blackpress.ca

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