OTTAWA—Shipments are ramping up, more COVID-19 vaccines are getting approved, and expert advice to stretch the gap between doses means millions of Canadians could get the protection of a first dose sooner than expected.
Taken together, those changes represent a significant shift from the delays and consternation that marked Canada’s national vaccine campaign in recent weeks.
But they have also left Ontario scrambling to keep up with the pace.
Facing criticism over failing to prepare for the long-foreseen surge of doses that Ottawa ordered from overseas, Premier Doug Ford’s government is now set to table an updated vaccination schedule on Friday.
The plan comes after a week that saw existing timelines — which were widely criticized as too vague and too slow — suddenly in flux.
Health Minister Christine Elliott said Thursday that Ontario residents should expect to get first shots sooner than initially forecast, after the National Advisory Committee on Immunization gave the green light to delay second doses for up to four months, and recommended that the recently approved AstraZeneva vaccine be used only for people under age 65.
The advice is already raising hopes that many Canadians will get the protection of a first dose of the vaccine weeks sooner than expected, with Nova Scotia Premier Iain Rankin declaring Thursday that all residents of his province should get at least one shot before the end of June.
Health Canada also signalled another boost to Canada’s vaccine effort is on the horizon, with officials in Ottawa stating Thursday that they expect to approve the Janssen/Johnson & Johnson shot within about a week. Canada has ordered 10 million doses of that vaccine, with options to purchase 28 million more.
“There are still some little things to finalize, so we should have some good news in the coming days,” Dr. Marc Berthiaume, director of the bureau of medical science at Health Canada, said in French during a federal vaccine briefing.
The anticipated addition of a fourth approved vaccine comes as Canada receives its biggest weekly shipment so far, with almost one million doses arriving in recent days. Another 3.1 million doses are slated for delivery before the end of March, with millions more in the weeks that follow, said Maj. Gen. Dany Fortin, the head of logistics for the federal government’s vaccine drive.
And while Prime Minister Justin Trudeau has stuck to his government’s deadline of getting enough vaccines for the entire population by the end of September, Fortin said the longer gap between doses means “you could anticipate we meet that target effectively and sooner.”
The changes were greeted as good news by Premier Doug Ford — but his government is not scheduled to have a province-wide online and telephone appointment booking system up and running until March 15.
That fuelled concerns Ontario is not ready despite months of preparation time.
“The clock is ticking,” New Democratic Party Leader Andrea Horwath said in reference to the snags, which include an April 2 expiration date for a large proportion of the AstraZeneca shipment.
“This government is scrambling instead of having a well thought-out plan.”
Horwath said the government has had all week to nail down details after requesting federal guidance Monday on delaying second doses, and instead has left residents frustrated with a plan that has not specified when anyone under 60 will get vaccinated.
“We are recalibrating our timelines now,” Elliott told reporters, saying some pharmacies will be pressed into service next week to deliver AstraZeneca vaccinations in Toronto, Kingston and Windsor.
In the meantime, about one-third of Ontario’s regional public health units and several local hospitals have set up appointment systems to help get vaccines into the latest priority group — adults over 80 living on their own.
But Toronto — one of the areas hardest hit by COVID-19 and still under a stay-at-home order — has not had enough vaccines to inoculate 80-plus residents, as is happening in a dozen other areas, because of the high number of health-care workers and nursing-home residents who were higher on the priority list.
“We know we need to provide Toronto with doses to make sure that we can cover people based on age,” said Elliott.
With a patchwork of booking systems, including separate ones for individual pharmacies, it’s no wonder many Ontarians are puzzled as to how they will be able to get a shot, said Liberal MPP John Fraser (Ottawa South), his party’s health critic.
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“That’s confusing,” he added, noting that many people — those under 60, many essential workers such as grocery store clerks, and people with disabilities or underlying medical conditions that put them at greater risk from COVID-19 — have not been told where they fit into Ontario’s vaccination hierarchy.
“People need a clear plan about what are the exact priorities in the population.”
The situation in Ontario comes after weeks of delayed shipments and political criticism aimed at the federal government, which is purchasing hundreds of millions of vaccine doses and distributing them to the provinces and territories once they are approved and shipped to Canada.
Now, experts predict provinces and local health officials will be tested to administer vaccines as fast as they can be delivered, amidst the ongoing threat of more contagious variants of the coronavirus and ever-changing evidence and official advice about how best to inoculate their populations.
“It’s going to be really challenging for the provinces,” said Dr. Isaac Bogoch, an infections diseases physician and scientist at the University of Toronto, who is also a member of Ontario’s vaccine distribution task force.
The first and most obvious hurdle is for provinces to keep up with the supply of vaccines they are given so that the highest number of people get their shots as fast as possible, Bogoch said.
“This should be an all hands on deck moment,” Dr. David Fisman, an epidemiologist at the University of Toronto’s Dalla Lana School of Public Health, said by email Thursday.
“I have seen that some countries now have 24-hour vaccination clinics. That speaks to the urgency of getting the population protected.”
Another challenge for provinces will be how to adapt to rapidly evolving data on how the COVID-19 vaccines — which were created, tested and approved with unprecedented speed in less than a year — are performing against the coronavirus after being injected into millions of people around the world.
That evidence has already prompted the national advisory panel on vaccines to make recommendations with major consequences, including by advising provinces to prolong the time between doses so that more people can get the protection of their first shot as soon as possible.
“The data is growing and evolving quickly, and the policy has to keep up—and that’s tough,” said Bogoch.
Not only is it important to be “nimble” so that vaccines are put to best use, he added, but provinces must make the best decisions based on the best data — and communicate their decisions clearly — to maintain public trust in the inoculation campaign.
“I’m not going to pretend that it’s easy to do, but it could certainly be improved in Canada,” Bogoch said.
But the evidence that prompted the recommendations will continue to change, making it difficult to predict how the vaccine campaign will roll out over the coming weeks and months.
“It’s really important that people know that this is going to be changing … We have multiple vaccines that are authorized, we have huge mass vaccination campaigns that are ongoing around the world,” Sharma told reporters in Ottawa on Thursday.
“Definitely the messaging would be simpler if we had one set of data, and we had one message and it never changed, but that’s not what science does.”
Another variable is that disruptions are possible even as supplies of vaccines delivered to Canada are scheduled to increase. Shipments were already slashed by hundreds of thousands of doses in January and February over production issues at facilities in Europe. And other countries have shown they are willing to prevent doses made within their borders from being exported — most recently on Thursday, when Italy blocked a shipment of 250,000 AstraZeneca doses to Australia.
European leaders have assured Canada that vaccines made there will be allowed to be exported to fulfil Canadian orders, said Youmy Han, a spokesperson for International Trade Minister Mary Ng.
The government has also said it has no reason to worry about Canada’s AstraZeneca supply, the bulk of which is slated to come from the United States, where the Biden administration has repeatedly said it will prioritize its citizens for made-in-America shots.
Alex Ballingall is an Ottawa-based reporter covering federal politics for the Star. Follow him on Twitter: @aballinga
Rob Ferguson is a Toronto-based reporter covering Ontario politics for the Star. Follow him on Twitter: @robferguson1
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