Why is B.C. on its 1st age group when Alberta is opening vaccination to anyone 65+?

Why will all Alberta seniors be eligible for a COVID-19 vaccine Monday, the same day British Columbia begins giving out its first doses to seniors aged 90 and over who live outside long-term care?

It’s a question that’s been peppering social media on the West Coast as B.C. prepares to give the first shots of its mass vaccination program.

Under B.C.’s regime, bookings opened last week for seniors over the age of 90, then 85, with bookings for the over 80 group scheduled to open this week. There are limited exemptions to this timetable for some smaller, rural B.C. communities, details of which can be confirmed with your local health authority.

Limited supplies of AstraZeneca vaccine are being targeted to essential workers in at-risk workplaces.

In Alberta, bookings for anyone 65 and older will open Monday, while the province began giving the AstraZeneca vaccine to residents aged 50-64 on March 10.

That’s despite the fact that Alberta had, as of March 12, administered 346,135 doses of vaccine, nearly 35,000 fewer than the 380,743 B.C. has.

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Demographic factors

One of the biggest pieces of the puzzle is demographics, according to Lorian Hardcastle, an associate professor of law in the faculty of medicine at the University of Calgary.

“B.C. has an older population than Alberta, and so it’s going to take longer to get through B.C.’s, say, eighty-five-pluses before it would take to get through Alberta’s. B.C. also has more Indigenous people who were also prioritized in both provinces.”

According to the 2016 census, the differences are stark. British Columbia had more than 109,000 seniors over the age of 85, nearly 10,000 of them older than 95.

Alberta had just over 63,000 seniors older than 85, about 5,000 of them older than 95.

It was a factor B.C. Premier John Horgan was quick to point to Friday when asked about the pace of B.C.’s vaccine rollout.

“Many of the elderly in British Columbia used to be residents of Alberta and they made the decision in their elder years to spend quality time in beautiful British Columbia, move their residences here, and that’s absolutely fine by me,” he quipped.

“We have an older population than other provinces across the country, so that’s why we had to start with the 90-plus.”

That same census counted about 12,000 more Indigenous people living in B.C. than Alberta, further accounting for a difference in the speed of the aged-based rollout for the general population.

Different priorities

The other major difference, according to Hardcastle, was the differing ways B.C. and Alberta have chosen to use their limited supply of vaccine on priority groups.

Both provinces made an early priority of vaccinating long-term care residents and staff, home-care workers and hospital workers who may come in contact with patients infected with COVID-19.

But B.C. went further, adding priority groups.

Those included essential visitors to long-term care facilities in its Phase 1. In Phase 2, this group expanded to include all hospital staff, doctors working in the community, and vulnerable groups living or working in some congregated settings such as jails or shelters.

The province is also moving to immunize the entire adult population of Prince Rupert amid persistent clusters of the virus there.

“Alberta has really focused up to this point on an age-based strategy,” Hardcastle said.

Vaccine prioritization was a key reason given by B.C.’s Ministry of Health, when asked about the discrepancy between B.C. and Alberta cohorts.

“We are focusing on immunizing B.C.’s highest risk population first and we have been administering vaccines as quickly and safely as possible as vaccine supply arrives to B.C.,” a spokesperson said in an email.

Alberta also decided to use its supply of AstraZeneca vaccine differently than B.C., she said.

The vaccine is believed to be less effective in seniors, and so it has been flagged for deployment to other adult groups —  in Alberta, that translated to adults over 50, as of March 10.

“I’m not sure that I agree with the decision to give it to healthy people in their 50s who are working from home and aren’t otherwise at risk,” she said.

“I do tend to prefer B.C.’s approach, which was to try and target groups that had some level of risk, for example, to workplace exposure.”

British Columbia is scheduled to begin administering the AstraZeneca vaccine this week.

B.C.’s first shipment will be used to target outbreaks and clusters in at-risk workplaces while a provincial panel will decide which priority groups will get the next shipments.

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Gap could widen

As B.C. and Alberta continue down their respective paths, Hardcastle said the gap between which age cohort is up for immunization could widen, especially in the current phase.

But while that might be frustrating for most British Columbians hoping to get back to life as usual, Hardcastle said B.C.’s approach is not necessarily a bad idea.

“There are thousands and thousands of family doctors, and so that could put B.C. behind in terms of its age groups even further than Alberta,” she said.

“But I don’t necessarily think that’s a problem — I think those workers are certainly exposed to it. And we don’t want health-care workers in the community getting sick and not being able to work.”

Rather than which age group is getting their shot at the moment, she suggested the public look instead at how many doses of vaccine the province has actually administered.

“And if they fall behind, I think that’s a good metric on which to hold their feet to the fire as opposed to focusing on the fine-grained details of why particular provinces are ahead with respect to specific groups, because there may be demographic reasons or other choices about who’s at risk that might lead to that,” she said.

The province is aiming to have immunized 400,000 people by early April.