A nurse prepares a vaccine dose at an immunization clinic for long-term care workers in Nanaimo earlier this month. (Island Health photo)

A nurse prepares a vaccine dose at an immunization clinic for long-term care workers in Nanaimo earlier this month. (Island Health photo)

Island Health making hard choices about vaccines and ‘who gets into the lifeboat’

Vaccine delivery delays keeping chief medical health officer awake at night

COVID-somnia is a new term that’s started appearing in medical literature, says Dr. Richard Stanwick, and it’s a phenomenon with which he’s personally familiar.

Island Health’s chief medical officer said at a press conference Wednesday, Jan. 27, that he’s found himself awake late at night worrying about case counts, and recently, vaccine rollout.

Island Health has a plan for mass vaccination in 33 different Vancouver Island communities. However, things aren’t going exactly to plan as vaccine doses are in short supply.

“It’s really disappointing because we had really good plans to roll it out to the most vulnerable populations to really blunt the possibility of seeing the outbreaks we are,” Stanwick said. “Had vaccine been available in greater amounts and we were able to deliver it sooner, we wouldn’t be seeing the 500 cases in the last two weeks.”

The doctor said Island Health has provided 24,065 doses of vaccine so far, and and has immunized all residents who wished to receive vaccine in long-term care and licenced assisted-living facilities. Individuals in acute care who are eligible for long-term placement are among those next in line for vaccine.

Along the way there has been some re-prioritization, for example vaccination of members of Snuneymuxw First Nation and seniors from the Cowichan Tribes, as Island Health and the First Nations Health Authority have worked together to try to respond to and control outbreaks.

Island Health is also making adjustment to its immunization plan for health-care workers. Stanwick said “we have to ration it right now” to workers who are dealing with COVID-19 cases or who are most likely to come into contact with COVID patients.

“It’s gotten to the point where we may even have to ration it to only those hospitals where there are COVID units,” Stanwick said. “The big frustration is the degree to which we’re playing who gets into the lifeboat, who gets out of the lifeboat in terms of vaccine and this is not something that we ever anticipated that we’d be facing this early on.”

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The health authority isn’t expecting any more Pfizer vaccine for the next two weeks and then a small amount in the third week. Supply of the Moderna vaccine seems to be more secure, Stanwick said, but Island Health won’t know exact dose numbers until it receives delivery.

With vaccines delayed, health officials are continually re-assessing timing of the second doses. Stanwick said virologists believe a booster six weeks after the first dose might be OK, and that’s an important consideration when health officials are making life-and-death decisions to “protect the greatest number of people and approach this in a fashion that is fair and consistent for the entire province.”

The arrival of COVID variants is also a concern, as a more transmissible virus would alter previous calculations around herd immunity. And Stanwick said other health and safety precautions remain important, as one in 20 people still won’t be immune even after two vaccine doses.

Despite reasons for COVID-somnia and concerning case counts, Stanwick said Vancouver Island is “still in an enviable position” and Island Health is continuing to prepare as if the vaccine manufacturers will come through with deliveries.

“We are really anticipating that we will be in a position to offer a lot more vaccine to a lot more people,” he said. “The only question is when.”

For more details about the provincial government’s immunization plan, click here.

READ ALSO: Canada to get 20% of promised Pfizer vaccines in next few weeks; feds look at vial size

READ ALSO: B.C.’s 1st case of COVID-19 confirmed a year ago today



editor@nanaimobulletin.com

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