What three million initial vaccinations mean for Canada
OTTAWA – When longterm care home resident Gisèle Lévesque, 89, received Canada’s first COVID-19 vaccine, it marked the beginning of the end of this pandemic.
The first injection of the Pfizer vaccine, produced in a facility in Belgium, shipped through a logistics hub in Kentucky and carefully prepared before going into her arm in Quebec last month, means the long war with this pandemic is entering its final battles.
Like the rest of the world, Canada has been in a crouch since the pandemic began. Vaccines are the first opportunity to do anything but hide from the virus. But will life be getting back to normal anytime soon as the vaccine rollout begins?
Lévesque’s age puts her at significantly higher risk from COVID-19. Research by the American Centers for Disease Control and Prevention found anyone over 85, has a risk of death from COVID 19, that is 630 times greater than someone between the ages of 18 and 29.
In Canada, about 70 per cent of the death toll from the virus has been in those over 80.
The government expects four million doses of Pfizer’s vaccine to be available to Canadians between now and the end of March, with an additional two million doses of Moderna’s similar vaccine set to roll out in roughly the same time frame.
Both vaccines require two doses, meaning three million Canadians could be fully immunized against the virus by the end of March.
The government’s forecast suggests Canada will have to wait until April at the earliest before the vaccine is available on a more widespread basis and it will be fall 2021 before all Canadians who want a vaccine get it.
Three million of more than 38 million Canadians is little more than a dent. Estimates vary between U.S. President Donald Trump’s outgoing administration and the incoming administration of Joe Biden, but America could vaccinate nearly a third of its population in that time and will definitely be ahead of Canada.
The U.K. has said it plans to have most of its at-risk population vaccinated by March or April. Canada’s estimate is that eight per cent of Canadians will be vaccinated in the first quarter.
Even if the supply is initially limited, experts say, given where those early doses are going, they have huge potential to change the impact the virus has.
Provinces will make their own choices, but the federal government’s advisory committee on immunizations is recommending the first shots go to long-term care residents and workers, front-line hospital staff and Canadians over 80.
“It’s going to be extremely profound to see those groups immunized, plus those people who have taken care of them,” said Dr. Zain Chagla an Infectious disease physician in Hamiliton, Ont., and professor at McMaster University.
“That’s a big amount that’s actually taken off the table. That essentially makes this much more of a manageable disease.”
Currently, the country is seeing about 100 deaths from COVID every day, that should fall considerably when the first vaccinations roll out.
According to Statistics Canada, there are around 1.7 million Canadians over 80 in the country. Data from the 2016 census found 224,000 people living in a long-term care or nursing homes and an additional 127,000 living in some type of retirement residence.
The number of front-line health care workers is harder to define, but those first three million doses of the vaccine should be enough to cover most of the people in those three categories.
Isaac Bogoch, an infectious disease physician and member of Ontario’s task force for the rollout, said that is potentially huge for the course of the virus.
“By protecting those in long-term care, and reducing the rate of infection in longterm care, you also have significant positive ripple effects in the general community,” he said. “If you just have fewer people in long-term care sick with this infection, that will result in fewer people being transferred to hospitals.”
More than a third of the COVID cases that have required hospitalization are also over 80 and more than half are over 70, which is the eventual target of the vaccine rollout.
“It’s certainly not going to solve all the problems, but it will certainly provide some relief to the health-care system,” said Bogoch. “This gives the health-care system a lot more wiggle room to work with.”
The first two vaccines, Pfizer and Moderna, have the potential to vaccinate 30 million Canadians with the confirmed orders so far.
AstraZeneca’s vaccine is in the final phase of clinical trials and early data showed it offers between 62 per cent and 90 per cent efficacy, depending on the dosing regime. Johnson and Johnson has a vaccine that can be administered in a single shot and Canada has ordered 38 million doses. Early trials showed it was safe and generated an immune response in 98 per cent of the people who received it.
More data and possible approval of those vaccines is expected sometime in January or February next year.
Prime Minister Justin Trudeau said he is hopeful Canada will have more doses next year, but the regulatory process has to play out.
“We’re expecting millions of doses in the first month of 2021 through Pfizer and Moderna, but at the same time, there are two other vaccine candidates, going through the Health Canada rolling review regulatory process as we speak,” he said. “We are certainly optimistic that there will be more vaccines approved with more doses.”
Chagla said he expects restrictions to begin falling, especially as more approved vaccines could allow for more members of the general population to get immunized. But he said it won’t be immediate.
“There is an end to these restrictions. There’s an end to this lifestyle, so holding on for longer just gives us time to get that vaccination out there,” he said. “There’s going to be a point where you cross where that risk starts settling down to something that’s very tolerable.”
Bogoch said he expects a gradual change, with more and more businesses able to safely reopen.
“It’s not going to be like a light switch. I don’t think it’s going to be one day they’re going to say ‘OK It’s back to normal,” he said.
He said summer of 2020 saw a steady rise in infections, but they were concentrated among younger people and didn’t lead to spikes in hospitalizations. He said with vaccines keeping the vulnerable healthy, he expects next summer to be even looser with most restrictions gone and life returning to normal.
“It’s not going to be like summer of 2019. But it’ll certainly be closer to summer of 2019 then summer of 2020.”