Second-dose delay to help seniors

Province will focus vaccinations on long-term care residents

With worsening long-term care outbreaks in some parts of the province and a slowdown in COVID-19 vaccine shipments, the Ontario government is delaying second doses for some to focus on long-term care and high-risk retirement-home residents.

Provincial health officials said Monday that every long-term care resident in the province will get at least one dose of COVID-19 vaccine by Feb. 5 or sooner, as will residents of high-risk retirement homes. That is 10 days earlier than its previous target, which was criticized as being too slow.

To accelerate those immunizations, and to cope with a delay in vaccine shipments from Pfizer, the province will push back second doses for some people and will put on hold plans to immediately expand immunizations to high-risk health-care workers and other groups. Pfizer has temporarily slowed delivery of vaccines to Canada while it retools its European factory

Long-term care, retirement home and Indigenous eldercare residents will continue to receive a second dose of COVID-19 vaccine between 21 and 27 days, as originally recommended by PfizerBioNTech.

But anyone else awaiting a second dose of vaccine could have it pushed back as long as 42 days because of the vaccine shortage and the state of emergency, say health officials.

Canadian and international health authorities have authorized doing so in urgent circumstances. People do not have full immunity against COVID-19 until they receive two doses of the vaccine.

“Due to the delay in the next shipment of Pfizer vaccine doses, we are ensuring all available doses are redirected to those who need them most: our residents in longterm care and retirement homes,” said Premier Doug Ford.

“I know this will mean that some people may have to reschedule their vaccine appointments, but it is critical that our most vulnerable seniors receive the protection they need as soon as possible.”

The province has been criticized for not making sure long-term care and retirement-home residents — who have accounted for the vast majority of COVID -19 deaths in the province — were vaccinated sooner.

Ontario's failure to act more aggressively to get Pfizer vaccine directly to long-term care residents as soon as it was available in December, as other Canadian provinces and other international jurisdictions did, has been singled out as a symptom of the province's lack of urgency.

The delay cost lives, the province's Science Table said last week. It released modelling showing that the lives of hundreds of long-term care residents would have been saved by speeding up immunizations to that most vulnerable group. It called on the province to accelerate immunization of longterm care residents.

On Monday, Ottawa South Liberal MPP John Fraser said the province's move to accelerate vaccinations to long-term care residents could have been done weeks earlier.

Fraser said Pfizer, which initially required its vaccines to remain in hospitals in Ontario, changed its protocol on Dec. 18. The province, noted Fraser, paused vaccinations over Christmas and waited almost three weeks to move the Pfizer vaccines out of hospitals into longterm care homes.

“Since the first vaccine delivery, Ontario has been moving too slow to protect our most vulnerable seniors living in long-term care,” Fraser said. “There was no sense of urgency to get the vaccines into homes as quickly as possible.”

On Monday, retired general Rick Hillier, who heads the province's vaccine task force, said the province acted as quickly as it could once Pfizer allowed the vaccines to be moved.

“We wanted to be comfortable that we had it right,” he said, noting that the Pfizer vaccines, which require ultracold storage, are fragile.

Hillier has taken responsibility for a pause in vaccinations over the Christmas holidays.

Canada is currently receiving shipments of two COVID-19 vaccines — from Pfizer and Moderna. Shipments from Moderna are continuing as expected. But Pfizer, which is supplying more vaccine to Canada, has halted deliveries this week and will send a reduced shipment next week. Provincial health officials say they still are not certain when shipments will return to normal after that.

The uncertain vaccine supply comes at a time when there are several growing, deadly outbreaks in long-term care homes in parts of the province that faced initial delay getting vaccines for long-term care residents while the province focused on the hot zones of Toronto, Peel, York and Windsor Essex.

Doses of Moderna vaccine expected by the Simcoe-Muskoka Health Unit were rerouted to Toronto to vaccinate long-term care residents there. The health unit is home to one of the worst ongoing long-term care outbreaks in the province — at Roberta Place, where at least 40 residents have died and the more contagious B117 strain of COVID -19 has been identified.

Many residents of the home have now been vaccinated, but a local public health official said last week that if the region had been able to vaccinate sooner, the outbreak would probably not have been

Ontario has been moving too slow to protect our most vulnerable seniors living in long-term care.

as severe. Other regions also had doses of Moderna rerouted away from them. Ottawa never received the Moderna vaccine. Those with the Moderna vaccine were able to begin vaccinating long-term care residents immediately.

Ottawa and other parts of the province with only Pfizer vaccine supplies could not begin vaccinating long-term care residents until early this month, weeks after the vaccines arrived in the province. Ottawa became the first jurisdiction in the province to do so, by creating mobile vaccination teams to go into long-term care homes.

Residents of all long-term care homes in Ottawa and some highrisk retirement homes have received one dose of vaccine.

On Monday, provincial officials said about 50,000 of around 67,000 long-term care residents in the province have been offered or given one dose (around 3,000 refused). That leaves 17,000 or 18,000 residents who have not yet been vaccinated.

Overall, 280,000 doses of vaccine have been administered — it is unclear how many individuals that represents since some have already received two doses.

During the first weeks of the immunization rollout, vaccinations went to long-term care workers, essential caregivers and healthcare workers in regions of the province with access to vaccines. Rural front-line workers, family doctors and others at high risk have complained about a lack of information and transparency around when they can expect to be vaccinated.

Ontario will receive no Pfizer vaccines this week and is expecting 26,000 next week, compared to the planned shipments of around 80,000. There continues to be uncertainty about numbers in coming weeks, provincial officials say.

The province extended the declared provincial emergency for another 14 days, until Feb. 9.