Why launching the COVID-19 vaccine could be “the hardest part” in Canada

Last week, Prime Minister Justin Trudeau said the country needs “a very sophisticated implementation plan” that will require “high degrees of logistical support”.

But determining who should get a vaccine first is extremely difficult without specific data on who could help the most.

“The implementation will be the hardest part of this vaccine and this is the part that I think everyone is starting to think about today,” Dr. The national team.

“If the vaccine data shows that the highest risk populations also have the highest reasonable benefit here, I think the prioritization scheme works very well and hopefully this is the goal for the first 10 million doses.”

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But who is most at risk for serious disease and COVID-19 transmission is still up for debate, which means Canada may need to develop several contingency plans.

“If we decide to start with healthcare professionals, it will be a completely different strategy than if we start by vaccinating the elderly in long-term care facilities,” Dr. Caroline Quach, pediatric infectious disease specialist and chair of the National Advisory Committee on Immunization (NACI), he said The current Tuesday.

“So it is currently difficult for provinces and territories to have a good idea and a good understanding of how they should take sides.”

The federal government has reportedly secured enough syringes and needles for provinces and territories to vaccinate all Canadians wishing to receive a COVID-19 vaccine, but Quach says specific plans are still unclear.

Canada’s Public Health Agency said in a statement to CBC News that the federal government is working with provinces and territories to approve and distribute a vaccine as quickly as possible.

“It is expected that in the early stages of the launch, the availability of the offer will be limited,” a spokesperson said.

“The quantity and timing of vaccine availability will be the subject of ongoing discussion with provinces and territories to manage expectations and delivery plans”.

The NACI has issued preliminary recommendations who prioritize the elderly and other people at serious risk of disease: health care workers, frontline staff and those with lower access to health care, including indigenous peoples.

But to know who should be first in line, NACI and government officials need to know who got sick in the vaccinated group versus the placebo group during clinical trials.

Without answers, governments across Canada will have to cover their bets.

“They may have to work on two or three floors in parallel,” Quach said. “Just in case one of those will be chosen as the first strategy.”

Logistic challenges

How to distribute a vaccine across the country, particularly in remote communities like First Nations, is also a key consideration.

Pfizer’s candidate vaccine should be stored at temperatures between –70 C and –80 C, but commercial refrigerators typically drop to a maximum of –15 C.

Given this strict temperature requirement, Chaga suspects Pfizer’s vaccine would be distributed very differently from a typical vaccine.

“We will likely have centralized hubs and teams coming out of those hubs to do mass immunization campaigns,” he said. “Rather than what we are seeing with the flu shot with pharmacies and doctors’ offices involved in the distribution.”

But Quach says that, unlike flu shots, there may not actually be enough doses of COVID-19 vaccines to have a significant impact, especially in the beginning.

“We don’t have enough vaccines to vaccinate all Canadians,” he said, adding that COVID-19 vaccines could be released in the next 12-18 months. “Implementation will be slow.”

Lack of plan concerning

Alyson Kelvin, an assistant professor at Dalhousie University in Halifax and a virologist at the Canadian Center for Vaccinology, says she is eager to see a vaccine launch plan for Canada.

“We need a good strategy to get it out, we need a strategy to get it to our frontline health workers, the people who keep our daily lives running, the grocery store workers, as well as we need to start thinking too. to underserved communities “.

Kelvin says she is discouraged that Canada hasn’t released preliminary implementation plans though US Centers for Disease Control and Prevention and the World Health Organization do it months ago.

“Just because we have a vaccine doesn’t mean we’re done. We have to think about how we’re going to get it into people’s arms and who should get it first,” he said. “This will be a huge undertaking … I am concerned that I have not seen a plan.”

Quach says that unlike the U.S. minimum requirement of 50 percent effectiveness for a COVID-19 vaccine, Health Canada hasn’t set a limit for approving a vaccine.

“Being close to our neighbor, we’re a bit stuck on what they’re going to decide,” Quach said.

Kelvin said the NACI recommendations were a good start, but they were not released in a way that is easy for average Canadians to understand. It is also not yet clear whether the federal, provincial and territorial governments will follow these guidelines.

“The information will need to be easily accessible to the public, policymakers and stakeholders for more effective use of a vaccine when it becomes available,” he said.

“Pharmacists and nurses or those authorized to vaccinate the public will need accurate information about the vaccine being administered and the launch plan as soon as it is in place.”

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