From vaccine envy to vaccine overload! Last week brought a stream of encouraging updates for Canadians wondering when in the name of
god fact-based medicine we were going to get our COVID-19 shots. A lot sooner than expected is the answer after Canada became the first country in the world to approve four different vaccine options. No question there is reason to celebrate. But before you go RSVPing to that mask-free multi-person makeout party, "we can be optimistic as long as we remain cautious," says Dr. Krishana Sankar, a scientist and science communications lead at COVID-19 Resources Canada. And by that she means there are still plenty of ways we could eff this whole thing up.
Last week, Joe Biden announced Americans would get the vaccine by spring and Canadians were green with envy. What happened?
It’s true that just a few days ago, things were looking pretty bleak. Canada’s vaccine intake stalled big time back in mid-February, and the positive news out of the U.S. just made our own lack of vax power hurt more. You can read the Globe and Mail’s great deep dive on the various ways in which Canada may have screwed the pooch on procurement and production. Or you can just be happy that at long last our ship (read: shipments of millions of vaccines) is coming in. The good news parade started in late February when Health Canada approved the two-dose AstraZeneca vaccine. It continued last Wednesday when our National Advisory Committee on Immunization changed its recommendation to allow four months between shots instead of four weeks. Then on Friday, came the double woot whammy that Pfizer had agreed to speed up our deliveries and Health Canada gave the go-ahead to the Johnson & Johnson vaccine.
People are calling the Johnson & Johnson vaccine a gamechanger. What makes it different?
For starters it’s a “one and done” model, meaning there is just the single dose and no need for a followup shot (required with Pfizer and Moderna as well as the AstraZeneca versions). This removes a lot of the headaches around scheduling and stockpiling and means the focus can be on getting vaccines to as many people as possible ASAP. The other key difference with J & J (as well as AstraZeneca) is that they don’t require the same subarctic storage conditions as the original two offerings. “This is a gamechanger in terms of being able to get the vaccine to people in remote communities and also potentially to target communities where we are seeing a lot of spread,” says Sankar. It also means that you don’t need a multi-million dollar refrigeration system on site to take part in vaccine administration, which is why pharmacies, immunization clinics, doctors offices, and mobile facilities will be offering vaccinations.
Sounds awesome. So when can I get my COVID vaccine?
Depending on your circumstances (age and other relevant health or job factors), your place in the pecking order will vary, but generally speaking, those of us under 60 are part of the final Phase 3, which will begin with the 55-59 bracket and move down. Timelines may also vary a bit depending on your province, but current estimates say that any Canadian who wants a vaccine should have one by the end of June. That is three entire months earlier than we were looking at last week and may move up even more depending on shipment timelines for the two new vaccines, which haven’t been firmed up yet.
Can I book my vaccine appointment now?
Well isn’t that a question we would all love a clear answer on. It’s tricky though given that provinces and also cities are overseeing various complementary aspects of a multi-pronged vaccine strategy. And if it currently feels like a bit of a clusterfug, that’s because supply is coming in hot, and plans are shifting accordingly. At the moment, pre-registration is open for people in the Phase 1 bracket (people over 80, along with healthcare workers, LTC residents and staff, and Indigenous adults), but that could change quickly. Just this week Toronto announced three vaccination facilities coming soon and similar ramp ups can be expected across the country. Note, if it’s not your phase yet, don’t bother trying to jump the queue. You’ll just clog up the system and make it harder for people who are waiting their turn.
Do I get to pick which vaccine I get? I’ve heard some are more effective than others.
“Vaccine shopping,” is the new terminology for anyone treating immunization like a trip to The Gap denim section, and turns out it’s not only dangerous, but also pretty dumb. It’s true that both the AstraZeneca and J & J vaccines have lower efficacy rates than Prizer and Moderna (62% and 72% compared to 95% for the other two), but it's also true that those numbers are highly misleading. “What is important is that when tested for preventing serious health outcomes — i.e., hospitalization or death — all four vaccines scored 100%,” says Sankar. And the new kids have upsides of their own: “AstraZeneca and Johnson & Johnson have both been tested on groups exposed to variants of concern, which wasn’t true to Moderna and Pfizer.”
Are the variants of concern still concerning?
They most definitely are, and a big part of why many public health experts are still prepping for a third wave, vaccine windfall notwithstanding. “We know that some of these variants are at least 50% more contagious than the original virus,” says Sankar. “What we don’t want is a third wave where one of those virants becomes the dominant strain.” That’s what happened in the UK and there is evidence in Quebec, Ontario, and Alberta to suggest that the variants of concern are heading in that direction.
Suddenly, I’m not feeling so optimistic.
Fair, but maybe let yourself feel at least a little bit hopeful. There is plenty of reason for cautious optimism, says Dr. Sankar, “we just need to put an emphasis on the caution.” With spring in the air, a loosening of restrictions across the country, and all of the excellent vaccine developments, the worry is that Canadians will start to let our guards down, which is exactly what we shouldn’t be doing right now. “The end of June is still four months away,” Sanka says, meaning there is still loads of time for more infection, hospitalization, and death. Nevermind that the vaccine rollout will inevitably come with new and unpredicted pitfalls. Or maybe it will be totally perfect.
Once I do get the vaccine, can I hug my grandma or have a giant sweaty dance party?
TBD. The science is still out on the extent to which people with the vaccine can still be spreaders. "We know that your vaccine protects you, particularly from the serious health outcomes" says Dr. Sankar. "What we are less certain of what it means for transmission." Hence the current public health recommendations around post-vax protocol: continuing to follow all of the relevant public health measures (wear a mask, wash your hands, practise social distancing) even after the fact. That said, if you can get yourself a vaccine crew, you’re all good. The latest CDC guidelines out of the U.S. say that people who have been vaccinated can gather together indoors and mask free. (The Public Health Agency of Canada has yet to weigh in on post vaccine indoor gatherings...or giant sweaty dance parties for that matter.)
So it's safe to plan my "no more COVID" party for early July?
Well, way to jinx it. But yes, top docs like Theresa Tam and Bonnie Henry are saying the summer 2021 may bring a semblance of life as we knew it. In all likelihood larger gatherings (big concerts, sporting events, clubbing) are still a ways off, but at this point, just being able to see friends and family without worrying about potentially fatal health implications sounds like the bender we’ve all been waiting for.