COVID-19 vaccine delayed for Maimonides Geriatric Centre residents in Montreal

Maimonides Geriatric Centre resident Mendy Fellig is disappointed.

After being one of the first people in Quebec to receive the Pfizer vaccine three weeks ago, Maimonides residents were supposed to get their second dose of the Pfizer BioNtech vaccine this week.

But officials are now asking them to wait.

“I wish they would have told us earlier. It would’ve made a difference. I plan my other medication (for multiple sclerosis) around the COVID vaccine,” said Fellig.

Fellig no longer knows when he will get his second shot.

The province has decided it’s going to redirect those second doses and any vaccine they get in the next few weeks to as many people as possible.

“This decision was made following a recommendation formulated by the Quebec Immunization Committee at the Institut national de santé publique du Québec,” a statement issued by the province’s health ministry read.

“According to this recommendation, it’s no longer necessary to keep the second dose in reserve.”

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Priority will go to people who work in long-term care centres in the CIUSSS West-Central.

The remaining doses will be evenly distributed among that same local health authority, the MUHC and St. Justine hospitals.

“In these three institutions, including our own CIUSSS, priority for first doses will go to members of staff who come into contact with COVID-19 patients in hot zones, Intensive Care, operating rooms, dialysis clinics and similar locations,” said Dr. Lawrence Rosenberg President and CEO CIUSSS West-Central in a statement.

The decision was taken as the number of daily cases in Quebec is on a rapid rise.

On Monday alone, the province recorded 2,546 new cases.

Dr. Rosenberg says he realizes it’s disappointing for those who were expecting that second dose.

But defended the decision and said it was supported by Pfizer.

“Please rest assured that this change will not affect your health or well-being. In fact, research has shown that the Pfizer vaccine achieves 90% effectiveness two weeks after the first dose has been administered. The second dose is a “booster” shot that enhances the already high level of protection,” Dr. Rosenberg wrote in a statement.

Fellig is worried.

“Even though they say 90 per cent effective, there is a reason why Pfizer gave two doses so not sure about that,” Fellig said.

Pfizer says it can only support the usage of the vaccine according to the label indication agreed upon with Health Canada and the data from their vaccine trial, “which is to administer the two vaccine doses 21 days apart,” said Pfizer spokesperson Christina Antoniou. “There are no data to demonstrate that protection after the first dose is sustained after 21 days.”

One immunology expert and front-line worker applauds the province’s decision.

Dr. Don Sheppard, chair of the McGill University’s Microbiology and Immunology department says the province’s new policy is the right move in order to break the second wave.

“If we want to actually increase the use of the vaccine and protect as many people as possible, the bang for your buck is with the first dose and if we give twice as many people one dose as opposed to  giving people two doses, we’re going to have a much bigger effect on protecting people, keeping them out of the hospital and saving lives,” Dr. Sheppard said.

The Pfizer and BioNTech covid-19 vaccine trial study showed that some protection starts as early as 12 days after the first dose.

The study also found that vaccine efficacy between the first and second doses was 52 per cent.

Seven or more days after the second dose, vaccine efficacy went up 95 per cent.

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However, Dr. Sheppard argues that the efficacy of the first dose depends on how you interpret and analyze the findings.

“When the FDA (The United States Food and Drug Administration) says the first dose was only effective at a 50 per cent level, when they are looking at how many people get an infection after they are vaccinated, they are including everyone who has been vaccinated and that means that if you got COVID the day after your vaccine, that is counted as a vaccine failure. Of course the vaccine doesn’t work in one day,” Dr. Sheppard says.

Dr. Sheppard adds that it usually takes about 14 days after the first dose of a vaccine for your immune system to kick in. However, he says the study doesn’t provide a fair comparison.

“When they are comparing the effect of the first dose and the second dose it’s not a fair comparison because when you get the second dose you are already protected from the first dose. When you get the first dose you have no protection for the first fourteen days and indeed, that’s when we see all of the cases in the people who’ve been vaccinated,” Dr. Sheppard explained.

“If you look at everybody after that 14-day period you see a protection rate that is in the 90 per cent range which is exactly the same as what you see with two-doses.”