It’s been a long wait but the first batch of COVID-19 vaccine arrived in Powell River and other rural sites within Vancouver Coastal Health this week. Long-term care residents and staff, as well as some frontline health-care workers in the hospital, will have the opportunity to get vaccinated.
Because they house our most vulnerable population, the first phase of vaccination in BC is focused on long-term care facilities. Data from BC Centre for Disease Control shows that when outbreaks have occurred in care homes, the rate of death from confirmed COVID-19 illness has sometimes been as high as 30 to 40 per cent. This is compared to an overall 1.7 per cent rate of death for all confirmed cases in BC so far (and close to zero per cent for children).
While advanced age is the greatest risk factor for severe COVID-19 disease and death, even young people can become seriously ill or have lingering symptoms for many months. Many younger adults are choosing to get vaccinated not only to protect themselves, but also the older people in their families and communities. In addition, they are making this choice to avoid missing long periods of work and help bring the pandemic to a close.
Vaccinations in long-term care will include health-care workers (nurses, care aides and doctors) and other essential workers needed to support residents day-to-day, such as custodial and kitchen staff. According to public health, the vast majority of long-term care staff and residents in our health authority are choosing to get vaccinated.
High-risk, frontline staff, such as those who work in ER, ICU and COVID units, are also a priority group and part of the first phase of vaccination. Priority groups are determined by provincial and federal guidelines based on risk of exposure, risk of severe disease and risk of passing the virus on to vulnerable populations. By January 11, close to 60,000 COVID-19 vaccinations had been given as part of the first phase.
While timelines may change, the second phase of the province’s vaccination plan is expected to roll out in February and March. Those eligible for vaccination during this time will include people in group-living environments (shelters, group homes, et cetera), chronic home-care clients, health-care workers and first responders who have not already been vaccinated, people over 80 years of age; and indigenous communities not in the first phase.
To the best of our knowledge, phase three should begin in late spring. At that point we expect vaccinations will be available for people in order of descending age groups (75 to 79, then 70 to 74, 65 to 69, et cetera), other essential workers and then the general public (toward summer/autumn). As each group becomes eligible for vaccination, this information will be widely shared.
Because initial vaccine studies did not include people who were immunocompromised, pregnant or under the age of 16 to 18 (depending on vaccine type), the vaccine is not officially approved for use in these groups. However, because of the known high risk from COVID-19 (and low theoretical risk from a vaccine), pregnant women and immunocompromised individuals may be considered for vaccination after a discussion with their health-care provider. This is also the case for those with a history of anaphylaxis.
According to Health Canada, side effects are similar to what might be expected with other vaccines and may include pain and swelling at the site of injection. Less commonly, one might experience nausea, chills or fatigue. As with all medicines or vaccinations, there is also a small chance of more severe reactions, such as anaphylaxis. These reactions are extremely rare (estimated one in 100,000 for anaphylaxis), and trained personnel will be on site to manage these if they occur.
While the two approved COVID-19 vaccines in Canada are new, mRNA vaccines have been studied for years. The speed of their development has been supported by past work, tremendous financial investment and unprecedented information sharing between countries. Studies suggest 80 to 90 per cent immunity two weeks after the first dose, and 94 to 95 per cent a week after the second dose (in BC, currently given about five weeks after the first dose).
Because these vaccines are new, it is still unclear how long immunity will last once someone has been vaccinated. Studies are showing that immune protection from vaccination is as good or better than it is from COVID-19 illness (with a fraction of the risk). In addition to initial studies, which involved more than 30,000 participants for both approved vaccines, millions of people have now been vaccinated against COVID-19 worldwide. Close monitoring of vaccine efficacy and safety is actively underway in many nations, including Canada.
Until we know how long immunity lasts, how well it reduces transmission of COVID-19, and how many people will choose to get vaccinated, we need to continue following public health guidelines and orders. This includes social and travel restrictions that have been extended until February 5. It will likely be many months before we can let down our defenses. Until then, our individual and collective action best protects us.
Each Wednesday evening, we are publishing an update that includes local case counts and vaccine updates, and other resources, at prcomplexclinic.com, or on Facebook at prdivisionoffamilypractice. Anyone with questions about vaccines can talk to their family doctor or nurse practitioner, or go to bccdc.ca/health-info/diseases-conditions/covid-19/covid-19-vaccine.
~ Powell River Physician’s COVID Steering Group