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COVID clarity: Feds say 42-day gap for 2-dose vaccines OK as provinces race to immunity

‘Realities on the ground’ means that provinces, territories will have difficult choices to make
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A health-care worker prepares a dose of the Pfizer-BioNTech COVID-19 vaccine at a UHN COVID-19 vaccine clinic in Toronto on Thursday, January 7, 2021. THE CANADIAN PRESS/Nathan Denette

The National Advisory Committee on Immunization (NACI) is still recommending that COVID-19 vaccines be given on manufacturer guidelines, but is now okaying an up to 42 day gap due to the “realities on the ground.”

Deputy chief medical officer Dr. Howard Njoo made the announcement during a federal technical briefing on vaccines on Thursday (Jan. 14).

“The supply is limited at the current time,” he said, at the same time as the country sees rates of infection, hospitalizations and deaths rise. Canada has seen an average of 7,727 new cases each day over the last week, with 4,509 in hospital each day, 839 of those in intensive care. The average daily death toll last week was 145.

Manufacturer guidelines recommend a 21-day gap between first and second doses of the Pfizer vaccine and 28 days for the Moderna vaccine. However, NACI has allowed that on-the-ground-realities may lead provinces and territories to take a different tack.

“While efforts should be made to vaccinate according to the recommended schedules… some jurisdictions considering vaccine delivery logistics, current epidemiological status and projections, and healthcare system capacity may maximize the number of individuals benefiting from a first dose of vaccine by delaying the second dose, until further supplies of the vaccine become available, preferably within 42 days of receipt of the first dose,” NACI stated. The World Health Organization has provided a similar recommendations.

Neither NACI nor WHO recommendations are binding for the provinces, which are in charge of getting vaccines into their residents’ arms. B.C. has said it is going for an up to 42-day interval, citing clinical trial data.

Njoo said that the question broke down to whether it was better to protect more people with the level of immunity provided by the first dose or if it was better to get fewer people fully immunized.

“That question is not something that’s unique to Canada,” he added.

As to Quebec, which is reportedly planning for a 90-day interval between vaccine doses for some people, Njoo said they should monitor people who receive their shots more than 42 days apart.

Maj. Gen. Dany Fortin, vice president of logistics and operations for the public health agency of Canada, said that Canada still expects to get six million doses by the end of March. Canada announced earlier this week that it had secured an additional 20 million doses of the Pfizer vaccine, bringing the country up to 40 doses of that vaccine.

Fortin said that Canada can expect to receive one million vaccine doses per week starting in April, for a total of 20 million in the second quarter of the year. The federal government said Canada has 80 million doses of vaccine scheduled to arrive in 2021, which will allow Canada to meet its pledge to immunize everyone who wants a COVID vaccine by September of this year.

Currently, Canada has received 548,950 doses, about two-thirds of that being the Pfizer vaccine. According to a shipment schedule posted on the federal government’s website, Canada is expected to 625,950 doses of the Pfizer vaccine and 171,700 doses of the Moderna vaccine between the start of this week and the end of January.

The country is then scheduled to get 1.47 million doses of the Pfizer vaccine and 480,000 doses of the Moderna vaccine by the end of February.

More to come.


@katslepian

katya.slepian@bpdigital.ca

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we do have a limited supply

pandemic is getting worse - rates of infection are increaseing,d eaths as well

do you protect more people with an initial dose that provides some level of protectoin

that question is not somtehing that’s unique to canada

scarcity of vaccines in the first quarter

6M