Canada’s vaccine advisory committee is now recommending people living in long-term care, assisted living, retirement homes and chronic care hospitals be vaccinated for the coronavirus first, along with the people who take care of them.
The National Advisory Committee on Immunization (NACI) first issued preliminary guidelines about a month ago. They included general categories of “key populations” who should get the vaccine first, but no ranked system of who among those should top the list.
Committee chair Dr. Caroline Quach-Thanh tells Global News once the NACI learned Canada would be getting even fewer doses of the vaccine than expected in the first round — six million, enough for three million people with two doses required — it “had no choice” but to recommend a ranked system.
Quach-Thanh said that after people connected to long-term care are immunized, elderly Canadians over age 80 should be next.
If there are enough doses, the NACI recommends the age window drop in five-year increments to vaccinate Canadians who are age 70 and older.
The other two priority groups include health-care workers, starting with those on the front lines, and people in Indigenous communities.
“Not those in offices, really those who are in contact with patients, ideally those taking care of COVID-19 patients,” Quach-Thanh said of the health-care worker triage.
Quach-Thanh said those four priority groups should add up to a little more than three million people, noting that the NACI understands vaccine uptake won’t be 100 per cent.
While Quach-Thanh was clear long-term care should be at the top of the list, followed by people over 80, when asked whether the other groups were listed by order of NACI-recommended ranking, she said she suspects the roll-out for those groups to happen in parallel.
Decisions around who gets the vaccine first are complicated — in addition to considering the disease and individual vaccines, the NACI also considers “economics, ethics, equity, feasibility and acceptability,” according to its preliminary recommendation report.
And the NACI’s recommendations are just that — recommendations, not binding. They’re also still dependent on final data about specific vaccines, which isn’t available yet.
“One has to just bite the bullet and see how we’re able to best deploy. I think provinces and territories need to have a signal so that they also know what foot to stand on,” Quach-Tan explained of the NACI’s new ranked recommendations.
It’s provinces and territories that make the decisions about their own population and who gets vaccinated in which order.
Quach-Thanh said some jurisdictions may make different decisions from the NACI’s recommendations, as an example, putting health-care workers at the front of the line if that’s a more pressing need in a particular place.
“You really have to allow each province to look at their own epidemiology and apply their own values and preferences because they know their population better.”
But a decision still needs to be made as to how the total number of vaccines is divvied up among provinces and territories in the first place.
Prime Minister Justin Trudeau told reporters Tuesday there were “a number of perspectives” when he spoke with premiers about it.
“But there seemed to be a consensus that we should all agree, across the country, on what that list looks like, and make sure that it is applied fairly across the country,” Trudeau said.
Those conversations are ongoing, said Trudeau, who promised to keep Canadians up to date about the order of priority, and stressed he trusts the expert panel on the file.
Canada’s chief medical officer of health, Dr. Theresa Tam, said the government will now be “getting more granular with the planning for the delivery to those specific groups” identified by the NACI in its preliminary recommendations.
Tam said that after people at high risk and those likely to spread COVID-19 to those at high risk are vaccinated, targeting Canadians by age would be the “easiest and the most scientifically sound way” of protecting the population. Tam did not reference or make any comment about the new NACI ranked recommendations, which offered more specifics.
Meanwhile, the NACI is paying attention to any new data with “continuous vigilance.”
“This is going to be a never-ending work until all of Canada vaccinated,” Quach-Thanh said.