The race is on to get as many people in B.C. and the Sea to Sky Corridor vaccinated against COVID-19 as soon as possible.
As the government unveils the next steps in the biggest vaccination campaign in B.C. history, we answer your questions:
WHEN CAN I GET THE VACCINE?
Vaccination clinics have been set up at major hospitals across B.C. as part of the first in a four-phase plan announced by the province.
PHASE 1 - December to January
Those first in line during Phase 1 of the province’s vaccination campaign include front-line health-care workers in COVID wards and surgical units, paramedics and emergency department personnel.
By Jan. 23, Fraser Health expects to immunize more than 6,000 medical and support staff, including those in dedicated support services in emergency departments, critical care units and COVID-19 units.
Health-care workers have also been going into long-term care and assisted living facilities to vaccinate current and incoming residents, as well as staff and essential visitors. Remote and isolated First Nations communities are also receiving vaccinations as part of the campaign’s first tier, which is expected to continue into February.
PHASE 2 - February to March
In Phase 2 of the vaccine rollout, lasting from February to March, the immunization program will work through seniors in the community, focusing on those age 80 and above.
Other groups slated to receive the vaccine in the second stage include:
● Indigenous communities not vaccinated in first priority group, especially seniors over 65
● People without a home or in a shelter
● Provincial correctional facilities
● Adults in group homes or mental health residential care
● Staff and recipients of long term home support
● Hospital staff, community doctors and medical specialists
Starting mid- to late-February, health officials will be reaching out to these populations with information on how to pre-register for a vaccination.
“We have enough vaccine to protect the most vulnerable by the end of March, and starting in April, to expand dramatically the access to vaccine to people across the province,” said Henry on Monday. “Our focus continues to be on all people who are at greatest risk.”
PHASE 3 - April to June
By April, the immunization campaign will transition into Phase 3.
With age as the “single-greatest factor for severe illness and death,” Phase 3 will begin vaccinating those ages 79 to 75, before working backwards in five-year increments all the way down to people 60 years old.
Anyone who misses their place in line - say if their health doesn’t permit it at the time - is eligible to be vaccinated at any time thereafter.
By the end of Phase 3, any extra vaccine supply is expected to work its way down the queue to other groups, including such essential service workers as first responders, teachers, bus drivers, and even those working in grocery stores.
PHASE 4 - July to September
Phase 4 is expected to begin in July 2021.
At this point, vaccines will be rolled out to the wider population, starting with those between age 59 and 55 and working back in five-year age groups until everyone over 18 is vaccinated.
Throughout the massive vaccination campaign, the province’s health-care workers will still be managing a pandemic, and that could necessitate vaccinating this younger cohort earlier.
Should an outbreak or cluster occur, say in work camps, prisons or factories, Immunize BC Operations Centre is reserving the flexibility to vaccinate clusters of people in order to control the spread of the virus.
The four-phase plan is based on already approved vaccines and Henry said Friday that the province has contingency plans should more vaccines get approved.
WHERE CAN I SIGN UP?
Most British Columbians do not have access to a COVID-19 vaccine yet.
But come March, segments of B.C.’s wider population can pre-register online or by phone. Anyone who pre-registers will get a reminder two to four weeks before they are eligible to book an appointment, with those deemed “clinically extremely vulnerable” first in line in April.
More information will be provided in the coming weeks, confirmed ImmunizeBC head Dr. Penny Ballem on Friday, Jan. 22.
Last week, Henry said MSP databases provide British Columbians’ ages and places of residences, and that has helped to decide where and how to allocate resources and prioritize populations as the months go by.
By March, vaccination clinics will be set up in 172 communities across B.C. Depending on the size of the community, vaccination clinics will take over stadiums, convention centres, arenas, community halls and school gymnasiums.
Mobile clinics in self-contained vehicles will roll into some remote communities and mobile teams will be available to reach home-bound individuals and hard to reach populations.
WHAT HAPPENS AFTER I GET MY FIRST DOSE?
After receiving their first dose, British Columbians will be provided with a paper copy showing they’ve been vaccinated and when to book an appointment for a second dose.
Information will also be provided about what side effects to expect and how to sign up to get a digital copy of their vaccine.
Reminders regarding a second dose will be sent out through email, text or over the phone, and booking can once again be done online or over the phone.
While several other jurisdictions have proposed or gone forward with so-called ‘vaccine passports,’ those who are not yet vaccinated in British Columbia will not be denied services, confirmed Henry Friday.
However, anyone vaccinated can sign up for a personal digital “immunization card” that can be printed. Vaccination records will also be stored in the Provincial Immunization registry, which can be accessed by the patient, public health and doctors.
HOW DOES THE VACCINE PROTECT ME?
Building up immunity takes time. Over the course of two doses, an immunized person’s cells build up the immune response necessary to fight off a coronavirus infection.
In the case of the Pfizer vaccine, the first dose primes the immune system — leading to at least six weeks of protection — and 35 days later in B.C., a second dose provides more durable, long-lasting protection.
Pfizer and Moderna vaccines are both mRNA vaccines, which, unlike some vaccines, don’t contain actual virus or bacteria. Instead, they introduce instructions to teach human cells how to make antigen proteins to trigger an immune response.
Waiting allows the body to build antigens and for the body’s cells to recognize the virus, explained Henry in a closed briefing last week.
Clinical trials showed that two weeks after the first dose, the Pfizer vaccine was 92.6% effective, while Moderna vaccine achieved 92.1% effectiveness.
“That is, quite frankly, amazing,” said Henry.
The long-term goal is to develop herd immunity, the point where enough of the population has been vaccinated that community spread is effectively neutralized. But health officials are still not sure if the currently approved vaccines will lead to that threshold, which usually sits at a 70% vaccination rate, but could reach 90% in a virus as infectious as COVID-19.
More importantly, said Dr. Julie Bettinger, a vaccine safety scientist at the Vaccine Evaluation Centre at BC Children’s Hospital Research Institute and a member of the National Advisory Committee on Immunization: “We know they prevent symptomatic disease, but we don’t know if they stop transmission of COVID-19.”
WHY ARE WE SLOWING DOWN VACCINATIONS?
As of Jan. 21, 104,901 doses have been administered across British Columbia, including both the Pfizer-BioNTech and Moderna vaccines, as part of the provinces Phase 1 immunization plan.
But a slowdown is expected in coming weeks as Canada’s deliveries of the Pfizer doses come to a temporary halt as the company ramps up capacity for its European customers.
“It is a bit of a setback, but it is only a delay,” said provincial health officer Dr. Bonnie Henry earlier this week. “It’s not a matter of months, it’s a matter of weeks.”
She said the shortfall will add up to 60,000 doses over three weeks — or about half of what was expected — before being made up in March. That’s expected to lead to a slower rollout of the vaccine for many hospital staff members over the next two weeks as available vaccine is earmarked to ensure people receive their second dose on time.
Already in Fraser Health, the province’s biggest health authority, staff and residents at 151 long term care facilities have been vaccinated, a push that occurred because dozens of care homes were facing coronavirus outbreaks in some of the most vulnerable populations in the province, including long-term care homes in Port Moody, Coquitlam and Port Coquitlam.
WILL THERE BE ENOUGH VACCINE FOR ME?
The federal government has said it’s looking to achieve widespread vaccinations in the Canadian population by the end of September, and has announced contracts with seven suppliers to buy between 214 million and 398 million COVID-19 vaccines.
Of those, Canada expects to receive 60 million doses of the Pfizer and Moderna vaccines — enough for 30 million people — by September.
The remainder of the country’s 38 million people is expected to be covered by vaccines from manufacturers like AstraZeneca and Johnson & Johnson, though both are still under review for use in Canada.
In B.C., the volume of COVID-19 vaccine is expected to ramp up significantly over the coming months, from just under 800,000 doses earmarked for delivery between mid-December and mid-March to 2.64 million doses from April to June.
By the third quarter, that number is expected to skyrocket to 6 million doses — not including 20 million new Pfizer-BioNTech doses recently secured by the federal government and the possible inclusion of several more vaccine candidates.
To manage the “significant and massive scaling up,” Health Minister Adrian Dix said last week the province is expanding its immunization team and has appointed Dr. Penny Ballem, chair of Vancouver Coastal Health, to lead the province-wide effort.
In a call with reporters, Ballem described the drive to vaccinate the 4.3 million eligible British Columbians by the end of September as “one of the most important initiatives we’ve been tasked within the history of the health sector in B.C.”
“It’s a mammoth task,” she said.
IS IT SAFE?
As the first vaccine to receive Health Canada regulatory approval, the Pfizer-BioNTech vaccine underwent a rigorous review of evidence documenting its effectiveness and safety.
And while the process has been sped up, “no corners have been cut and all regulatory or approval processes have been followed to ensure the safety and efficacy of the vaccine for all Canadians,” notes ImmunizeBC.
Since then, the Moderna vaccine has been approved under the same process.
At this time, Health Canada has not approved the Pfizer vaccine for use in pregnant women and children under the age of 16 as studies documenting its safety and effectiveness have yet to be completed for these populations. Studies are also still working to determine its safety and effectiveness in people with compromised immune systems.
For the same reasons, the Moderna vaccine has so far been approved for people 18 and over.
Pfizer and Moderna vaccines are both mRNA vaccines, which instead of containing virus or bacteria, introduce instructions to teach human cells how to make antigen proteins to trigger an immune response. “You can’t get infected from mRNA vaccines,” writes Health Canada.
Clinical trials observed side effects similar to other vaccines and were mild to moderate.
“These are common side effects of vaccines and do not pose a risk to health,” writes Health Canada.
Known as an inflammatory response or reaction, these temporary side effects occur as the body works to build immunity against the disease.
As part of the body’s natural response, they can last from a few hours to a few weeks after you have been vaccinated and can include: a mild fever, redness, soreness or swelling around the place on the body where the vaccine was administered, as well as flu-like symptoms like chills, fatigue, joint pain, a headache or muscle aches.
In some rare cases, vaccines can provoke an allergic reaction known as anaphylaxis. This affects about one in a million people, usually occurs right after getting vaccinated and can be treated, notes Health Canada.
Symptoms can include a rash, swelling in the face, a drop in blood pressure, abdominal pain and vomiting, as well as sneezing coughing and difficulty breathing.
To monitor for these symptoms, health care workers will ask you to stay at vaccination for at least 15 minutes after it’s administered.
NORWAY COVID-19 VACCINE DEATHS
Last week, the Norwegian Medicines Agency reported 13 fatalities due to side effects from the Pfizer and Moderna vaccines — all of them occurring in nursing homes and all were over the age of 80.
The agency listed fever and nausea as side effects which “may have led to the deaths of some frail patients,” Sigurd Hortemo of the Norwegian Medicines Agency said in the body’s first report of the side effects.
More than 30,000 people have received the first shot of the Pfizer or Moderna coronavirus vaccine in the Scandinavian country since the end of December, according to official figures.
“We are not alarmed by this. It is quite clear that these vaccines have very little risk, with a small exception for the frailest patients,” Steinar Madsen, medical director with the agency, told Norwegian broadcaster NRK.
“Doctors must now carefully consider who should be vaccinated. Those who are very frail and at the very end of life can be vaccinated after an individual assessment,” he added.
Health Canada along with the Public Health Agency of Canada and provincial health authorities, continue to monitor the safety of the COVID-19 vaccines. Further, vaccine manufacturers are legally required to submit reports of adverse effects and inform Health Canada
IF I ALREADY HAD COVID-19, DO I NEED A VACCINE?
People have been shown to gain natural immunity to COVID-19 after being infected. But there’s still a risk you could get it again.
For that reason, health officials recommend everyone get the vaccine as soon as it is made available to them.
Last week, Henry said people who had been exposed in an outbreak situation but were not yet symptomatic were still being given the vaccine. Should they indeed fall ill with the virus, “it protects them from that second generation of cases,” she said.
IF I GET IMMUNIZED, CAN I LEAVE MY MASK AT HOME?
ImmunizeBC says it’s “likely” people can still carry and spread the virus even after getting the vaccine.
It is therefore unlikely all restrictions will be lifted any time soon.
British Columbians are encouraged to continue to wash their hands regularly, stay home when sick and maintain physical distancing.
Current public health orders are in place until at least Feb. 5 at midnight, and require the use of a face mask in indoor public spaces, ban social gatherings outside your household or “core bubble.”
“The risks remain high all over British Columbia,” said Henry Monday. “We can’t yet rely on vaccine to protect all of us.”
WILL VACCINES WORK AGAINST THE ‘UK VARIANT’?
To date, there's no evidence that currently approved COVID-19 vaccines won't be effective against the U.K. variant. What concerns infectious disease experts is the speed at which it is spreading: without enough vaccine to go around, another highly contagious wave of COVID-19 could sweep through the population before it reaches herd immunity.
British Columbia could see up to 5,000 cases per day by March should a highly contagious variant of the coronavirus establish itself in the province, according to recent modelling conducted by an SFU infectious disease researcher.
Mathematician and epidemiologist Caroline Colijn has been tracing the trajectory of the virus in everything from B.C.’s schools to the wider population. Her latest model, seen by the Tri-City News, assumes a highly transmissible variant from the United Kingdom moves into community transmission in B.C. by Jan. 25.
“The picture looks like what we have now until late February and then it kind of just skyrockets,” said Colijn. “It’s pretty worrying.”
By Jan. 14, four cases of the U.K. variant — known as B.1.1.7 — have been found in B.C.
Fellow UBC mathematician and disease modeller Daniel Coombs, who has reviewed Colijn’s model, said a threshold of 20 to 50 cases would almost certainly indicate the new variant is here to stay.
As a highly transmissible version of the virus, B.1.1.7 has been shown to spread from 50 to 70% faster than the strain currently in B.C. It has overwhelmed many U.K. hospitals and led to widespread travel restrictions and bans on passengers from the country.
Considering where B.C. is in its vaccine campaign, Colijn did not integrate vaccination into her model; the effect of B.C.'s immunized population, she said, would be negligible because health officials are targeting those most at risk of dying and not populations most likely to spread the disease.
“Right now that’s not what we’re doing,” said Colijn. “If this thing really has a 50%, a 40%, a 30% increase in transmission, vaccinations won’t be quite enough.”
But while Coombs said he doesn’t think B.C. can keep the U.K. variant out of the province indefinitely, he still holds hope vaccine campaigns could keep B.1.1.7 at bay.
“The more shots we can get in arms before it takes over the better chance we have at undercutting explosive growth of the U.K. variant,” said Coombs. “There’s sort of a race going on.”
Meanwhile, at a press conference on Monday, Jan. 18, Henry said whatever the trajectory of the new variant, measures to stem its spread are based on the same logic the province has been following since the start of the pandemic.
“No matter what variant of the virus is circulating in the community, we know we need to stop the spread in the same way we’ve been doing for the last 11 months,” she said.
WHEN CAN IMMUNOCOMPROMISED PEOPLE GET A COVID-19 VACCINE?
“Hopefully soon,” writes ImmunizeBC.
With 150 vaccines in development across the world — including seven contracted with the Canadian government — health officials are waiting for trials to ensure specific vaccines are safe and effective for people with compromised immune systems.
However, ImmunizeBC notes that for some groups, a healthcare provider may offer a complete COVID-19 vaccine series if their health care provider determines that the benefits outweigh the possible risks.
If you have a weakened immune system, it’s recommended you speak with your health care provider for more information.
WHAT ABOUT CHILDREN?
There are roughly 900,000 British Columbians under 18 in B.C. Unfortunately, no vaccine has yet been approved for this population in Canada.
That is likely to change as clinical studies progress. For example, Moderna is currently conducting studies in children as young as 12, said Henry Friday.
The good news? Children are less likely to get infected and less likely develop severe illness due to COVID-19.
SHOULD I WAIT TO GET A COVID-19 VACCINE?
ImmunizeBC recommends speaking to a health care provider before receiving a COVID-19 vaccine if you:
● Have an immune system weakened by disease or medical treatment
● Have an autoimmune disease
● Are pregnant, may be pregnant or are planning to become pregnant
● Are breastfeeding
● Have received a monoclonal antibody or convalescent plasma for treatment or prevention of COVID-19
● Have received a vaccine in the last 14 days
● Have symptoms of COVID-19
If you have a new illness preventing you from your regular activities you should likely wait until you have recovered. This will help to distinguish the side effects of the vaccine from a worsening illness.
Ultimately, getting the vaccine is a personal choice, but one that can affect the health of roughly 5.2 million British Columbians around you.
— With files from the AP, Canadian Press and Elana Shepert