About 6,000 York Region residents with second dose COVID-19 Pfizer vaccine appointments will be having them rescheduled to a later date to accommodate the province's new vaccine distribution priorities.
Southlake Regional Health Centre is sending notifications — most by email — to residents who received their first dose at the Ray Twinney Recreation Complex vaccination clinic that their appointments to receive a second dose will now be up to 16 weeks, or 112 days, after the first shot.
"Those who had a second-dose appointment in the coming days have already been contacted. Everyone else can expect to be notified over the next week via email with their new appointment date and time. We will also follow up by phone with those 80 years of age and older," said Matt Haggerty, a Southlake spokesperson.
The rescheduling is being undertaken in accordance with a directive from the provincial government, but the move has some residents concerned about the extended period between doses.
Newmarket's Paul Burns, who received his first dose last week, said it's hard to have confidence that the decision is grounded in science and not politics when there is so much disagreement about whether delaying the second dose is a good idea. He noted that both the CEO of Pfizer and chief medical advisor to the U.S. president Anthony Fauci have publicly argued against a long delay between shots.
"The provincial and federal governments are under a lot of pressure. It seems like the same kind of pressure the province were under from retails to open up too soon only to have us go back into lockdown again, I see this as the same kind of thing," said Burns.
"The government is lagging behind in vaccinations and getting things set up, so they are taking so they are taking a shortcut that isn't supported by the company that developed this vaccine," he added.
Canada's National Advisory Committee on Immunization (NACI) had previously advised that the time between the first and second doses of the Moderna vaccine should be four weeks, three weeks for Pfizer, and 12 weeks for the Oxford-AstraZeneca vaccine.
NACI is now recommending that jurisdictions extend the interval of the second dose up to four months when supplies are limited.
At regional council meeting on Thursday, York Region medical officer of health Dr. Karim Kurji said that getting the first dose gives people 92 per cent protection against COVID-19 after two weeks. The second dose increases the protection to 94 or 95 per cent, but also extends the vaccine's effectiveness by several months.
"The purpose of the second dose is to push it up a little bit and to extend the effect over many more months," he said. "But in the short term, everyone gets pretty good protection with just one dose."
The priority now is to extend that protection to as many people as possible as quickly as possible, Kurji said.
"If you have 20 people and 20 doses to distribute. You could give 10 people two doses while ending up with three deaths in the population, assuming all of them were exposed to heavy doses of COVID-19. If, on the other hand, you give one dose to all 20 people, you would not have any deaths.
"So this is a situation where it is better for the individual to receive two doses, but when you look at it from a population basis, it is better to distribute the doses, so everyone gets protection," Kurji said.
While Burns said he understands the intention to protect as many people as possible, he remains troubled by the apparent lack of consensus on the move, questioning whether four months is too long for seniors for whom keeping the vaccine effectiveness is a matter of life and death.
There is no guarantee that the vaccination clinics will be at their current location four months from now. Some of the agreements with municipalities for use of the spaces will have expired, so some rescheduled appointments may be at different locations.
"This is going to cause us some grief," Kurji said. "We don't have a good line of sight on what the future will be."
This problem impacts the decision on whether to adopt the provincial booking system that was launched earlier this week. Kurji said that the provincial system is more streamlined but less flexible, which could be a problem if locations change.
It is also quite possible that over the next several weeks, there will a large enough supply of Pfizer vaccine that people won't have to wait the full four months, said Kurji.
"A better approach may be to have a communication campaign at that point saying, 'OK, whoever wants a second dose, we are ready, just book yourself an appointment.' We are still trying to figure out the best approach," he said.
For the moment, however, vaccine supplies remain "precarious," said Kurji, and will remain that way until at least the week of March 22, after which York Region is expecting to receive between four and six times as many doses as at present.
"I expect things to be much, much better then," he said.
York Region isn't expecting any AstraZeneca vaccine deliveries, for now it is only being distributed to certain pilot sites, none of which are in York Region.
