Mobile clinics, in-house visits and digital records are set to play a critical role for the province as it seeks to immunize 4.3 million British Columbians against COVID-19 by the end of September.
The province unveiled its vaccination plans for the general population Friday (January 22) amid delivery delays for the Pfizer Inc. (NYSE:PFE) vaccine and a slow trickle of Moderna Inc. (NYSE:MRNA) doses.
The initial phase of the vaccine rollout has been underway since mid-December, targeting vulnerable groups and workers most exposed to infection. About 105,000 doses have been administered so far.
The latest plans from the province are the most detailed provided by government over the past month, outlining everything from efforts to launch local vaccination clinics to ensuring British Columbians pre-register for appointments.
Clinics will be set up beginning in March across 172 B.C. communities in partnership with municipalities, businesses and volunteers.
“We’ll utilize our arenas, our convention halls, our community centres to make sure that we can get everyone who wants a vaccination, a vaccination,” Premier John Horgan said during a Friday media briefing.
At peak immunization capacity, the province will be relying on 715 full-time immunizers across all five health regions as it seeks to administer about 100,000 doses per day.
Those immunizers are expected to see 140 patients a day to administer doses.
Mobile sites will also be deployed where necessary and home visits will be made possible for those unable to attend clinics.
The province will open pre-registration two to four weeks before someone is eligible for an appointment.
Those looking to pre-register will be able to do so via phone, mobile device or computer.
“We have a lot of very active, techno-savvy seniors but there’s still some people who are not comfortable with using an online registration and there will be a call centre — phone mechanism — for them to get assistance with registration,” said Penny Ballem, the executive lead of the B.C. immunization team.
She will be working on a central planning health platform to partner with health authorities to lay out plans to immunize on an age basis.
These efforts will require assistance from immunizers, charge nurses, administrative staff, security workers and data entry workers.
Those who get vaccinated will get a paper record of each administered dose, and they can also sign up for a provincial program to access their records electronically.
“Their vaccination record is not dependent on them carrying around that paper card, but that it is a [digital] provincial data set,” Ballem said.
The concept of a deploying a “vaccine passport” to prove one has been vaccinated to receive any government services is not being considered by the province.
The initial Phase 1 rollout, which began in December and runs until the end of January, is focused on residents and staff and long-term care facilities, essential visitors to those facilities, residents and staff and assisted living residences, higher-risk hospital staff and paramedics, as well as those living in remote or isolated First Nations communities.
After the top-priority groups receive their vaccines, health officials plan to administer vaccines to elderly British Columbians above the age of 80, indigenous seniors over the age of 65 and other hospital staff.
Those first two phases are set to conclude by the end of March.
Vaccination efforts for the general population will then commence in April, requiring 7.4 million doses to be administered across the province by the end of September when the preceding doses are taking into account.
The third phase will start with those 75-79 years old and then carry on in descending five-year age brackets.
The province plans to vaccinate everyone who is 60-79 years old, as well as 16-69-year-olds that are considered extremely vulnerable, by the end of June.
People considered extremely vulnerable include those with specific cancers, such as leukemia or lymphoma; people with severe respiratory issues; people on immunosuppression therapies; and adults on dialysis or with chronic kidney disease.
The remaining ages groups — 18-59 years old — will then commence vaccinations in July in descending five-year age brackets, save for the final 18-24-year-old bracket.
Those under 18 are currently not eligible for vaccination.
“It’s not necessarily a concern in that the evidence still supports that young people are much less likely to get infected and less likely to have severe illness,” B.C. provincial health officer Dr. Bonnie Henry said.
“The probability is it is very likely that once we have more traditional vaccines, they will be made available for younger people, and we’ll be looking at that and watching that carefully.”
About 2 million doses are expected to arrive in the province each month between July and September and the government is developing contingency plans in the event more vaccine comes in earlier and the opportunity presents itself to scale up the inoculation efforts.
More than 1.5 million will need to be vaccinated within the Fraser Health region, followed by just over 1 million in the Vancouver Coastal health region and the 740,000 in the Vancouver Island health region.
All vaccines approved in Canada so far require two doses, meaning there will be a different number of first and second doses administered any given month.
For example, 600,000 first doses will be administered in May and 280,000 second doses will be administered that same month.
Despite delays to the Pfizer vaccine, Canada still remains on schedule to receive six million doses from both Pfizer and Moderna by the end of March.
Another 20 million doses from both manufacturers are due to be delivered by the end of September.
“We’re confident with the speed with which Pfizer and Moderna came online will be good news for those other companies that are in the preliminary stages of approval,” Horgan said.
“We’re confident by the end of February that the backlog that we’re experiencing — the federal government is experiencing — with Pfizer will be corrected.”
The country also has orders in from five other manufacturers to supply the country a total of 194 million doses.
Those other manufacturers’ vaccines have not yet been approved by regulators, however, the government estimates the AstraZeneca plc vaccine will get the nod from Health Canada sometime before the end of March.
But once approved, the AstraZeneca doses are not expected to arrive in B.C. until the spring.
Henry said the Pfizer shortages may present health officials a situation in which they’ll have to decide whether to administer a second dose using the Moderna vaccine or extend the wait for the second Pfizer dose even further.
She said the data is inconclusive right now about the efficacy of the second dose in those situations.
And it still remains unclear at what point British Columbians should feel comfortable taking off their masks and joining large gatherings.
“I would love to be able to say July 1. I think there’s a whole lot of unknowns,” Henry said.
“The one wrench in the works is the fact that we are now seeing transmission of variants across the world. Some of these make the virus more transmissible to others.”
She added that by the summer we should have “some types of our normal lives back again” but it’s more likely that it won’t be until the fall that normal types of social interaction will return in earnest.
The B.C. Teachers’ Federation Teri Mooring said in a statement she was “disappointed” the vaccination plan did not prioritize frontline workers.
“There had been hope in prior announcements that such prioritization would be possible. However, the vaccine supply limit is beyond our control and those among us who are most vulnerable of death and serious illness must be vaccinated first,” she said, echoing the rationale government officials used for prioritizing vaccinations based on age groups.
“Hopefully more vaccines are approved and this immunization strategy will be appropriately adjusted and accelerated.”
She’s calling on the province to introduce a mandatory mask mandate, implement better physical distancing measures and upgrade ventilation systems in classrooms.