As the share of Manitobans partially immunized against COVID-19 nears 70 per cent and second dose eligibility expands, the vaccine task force is adjusting its strategy to reach people on the fringes of the rollout.

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As the share of Manitobans partially immunized against COVID-19 nears 70 per cent and second dose eligibility expands, the vaccine task force is adjusting its strategy to reach people on the fringes of the rollout.

On Wednesday, Manitobans who received a dose of either the Pfizer or Moderna vaccine on or before March 29 became eligible to book an appointment for their second shot.

The change means between 45,000 and 55,000 people are able to book a second appointment, in addition to all Indigenous people and Manitobans with select health conditions who were previously eligible.

First, second dose eligibility

Manitobans who received either the Pfizer or Moderna vaccine on or before March 29 can book their second dose.

Second-dose eligibility does not yet include people who received the AstraZeneca vaccine.

Appointments can be booked online at https://protectmb.ca or by calling 1-844-626-8222.

People must know what type of vaccine they received for their first shot, as the province is only providing the same vaccine brand for second doses at this time.

Manitobans who received either the Pfizer or Moderna vaccine on or before March 29 can book their second dose.

Second-dose eligibility does not yet include people who received the AstraZeneca vaccine.

Appointments can be booked online at https://protectmb.ca  or by calling 1-844-626-8222.

People must know what type of vaccine they received for their first shot, as the province is only providing the same vaccine brand for second doses at this time.

All Indigenous Manitobans and people with select health conditions who received the Pfizer or Moderna vaccine are also eligible to book their second dose.

On Wednesday, Dr. Joss Reimer, medical lead for the vaccine task force, said that in many cases those who are fully vaccinated (14 days past their second dose) will no longer have to go into isolation if they are exposed to COVID-19 and have no symptoms. 

Reimer said Dr. Brent Roussin and the public health team are working on further policies for people who are fully vaccinated as the second dose campaign picks up speed. The task force expects that all eligible Manitobans (assuming 70 per cent uptake) will have received two doses by the end of July. 

Complete vaccine eligibility criteria is available on the Manitoba website.

All Manitobans who are at least 12 years of age continue to be able to book first doses.

Reimer assured Manitobans that regardless of what type of vaccine they got for their first dose, a second dose will be offered.

Reimer said the federal government continues to provide vaccine delivery forecasts that indicate enough supply will be available to offer second doses when people are due for their shot. 

For those who received AstraZeneca, Reimer said the task force is still waiting for the findings of a United Kingdom study on the efficacy of exchanging vaccine products.

She said some data may become available this week.

However, the National Advisory Committee on Immunization is recommending that when possible, people should receive the same vaccine for their second dose.

Reimer said the province is working directly with the national committee to develop the best course of action for Manitobans.

The move to open second-dose appointments for the general population is a shift of gears for the immunization campaign, particularly as first dose immunization rates increase.

On Wednesday, Johanu Botha, operations and planning lead for the task force, said it is possible that 13 mass immunization clinics the province runs, or will open in the next two weeks, will hit a "plateau" in terms of clients.

"Information that we’re getting from clinical experts… might suggest that beyond that 70 per cent uptake, we need to use different delivery models: ones that look different than super sites, that reach deeper into communities, that are delivered more by community partners," Botha said.

Botha said the change in delivery model will better serve people who are not necessarily vaccine hesitant but face barriers to immunization based on employment, language, connectivity, transportation and system barriers, such as the scale and location of the super site clinics, which can be intimidating.

Johanu Botha: "pivot moment."

RUTH BONNEVILLE / WINNIPEG FREE PRESS FILES

Johanu Botha: "pivot moment."

"We’re waiting for when that right pivot moment comes," Botha said, adding the task force is preparing to run pop-up clinics in communities that have lower uptake and handing the reins to pharmacists and health-care providers to provide shots to their clients.

Botha pointed to the urban Indigenous clinics and neighbourhood clinics as examples of outreach efforts that could better serve targeted groups.

Also Wednesday, Dr. Marcia Anderson, a member of the vaccine task force and the First Nations response team, provided updated data that showed racialized people continue to experience disproportionate infection rates throughout the third wave, in comparison to white people.

However, with the exception of First Nations, the province does not yet have data on vaccine uptake among racialized people who have been overrepresented through the second and third waves of the pandemic due to employment as essential workers and crowded or inadequate housing, Anderson said.

Dr. Marcia Anderson, public health lead, Manitoba First Nation Pandemic Response Coordination Team. THE CANADIAN PRESS FILES/John Woods

Dr. Marcia Anderson, public health lead, Manitoba First Nation Pandemic Response Coordination Team. THE CANADIAN PRESS FILES/John Woods

Racial and ethnic identity questions were only added to the vaccination consent form on May 10 and data that’s been collected to date has not yet been added into the public health information management system, Anderson said.

However, data collected on First Nations vaccination indicates more than 67 per cent uptake on reserves, Anderson said.

Clinics have been held on nearly all 63 reserves in Manitoba to offer first and second doses to all adults; Anderson said doses of Pfizer will be sent to communities to offer shots to children between 12 and 17 starting next week.

Anderson said it is too early to say to what extent any differences in vaccine coverage can be attributed to hesitancy as opposed to timelines for eligibility and accessibility.

Evidence from other jurisdictions has shown lower vaccine uptake in racialized communities and similar patterns are likely to develop in Manitoba, Anderson said.

"When we look at how the proportions of cases have shifted prior to vaccine rollout and since between white people and all other (racialized) communities combined, the main difference actually is the vaccine rollout," Anderson said.

"While we need to respond to concerns about hesitancy with trusted information from trusted messengers, we also need to be increasing accessibility to ensure that everyone who does want a vaccine has a safe, welcoming and accessible space to receive the vaccine," Anderson said.

The medical lead for the province’s vaccine task force said while uptake has been high it has not been consistent.

"We have to very seriously think about who is not being well served by our existing structures," said Dr. Joss Reimer. "We want to make sure that everybody has equal access to the vaccine and for many people, that means we need to put more effort into bringing it to them."

Moderna supply unpredictable

Uncertainty about the Moderna vaccine supply is an increasing point of concern for Manitoba's COVID-19 vaccine task force. 

As of Wednesday, the federal government had not provided the province with a confirmed delivery schedule for the Moderna shot, said Johanu Botha, the operations, planning and logistics lead for the task force.

Currently, no deliveries of Moderna are scheduled to arrive in Manitoba in the coming weeks.

Uncertainty about the Moderna vaccine supply is an increasing point of concern for Manitoba's COVID-19 vaccine task force. 

As of Wednesday, the federal government had not provided the province with a confirmed delivery schedule for the Moderna shot, said Johanu Botha, the operations, planning and logistics lead for the task force.

Currently, no deliveries of Moderna are scheduled to arrive in Manitoba in the coming weeks.

“Just seeing zeros in our future for Moderna is worrisome,” Botha said.

Botha said overall federal supply projections for Moderna have not changed and the province still expects to receive enough doses by the end of July to complete the second-dose campaign.

However, without arrival dates or confirmed shipment sizes, planning is challenging, Botha said. He suggested the timeline to immunize 70 per cent of the 12-and-older population with a single dose may be pushed back two days to June 9.

The timeline to finish second doses in July will also likely be pushed back.

“We’re still waiting from any information from Ottawa, and we understand that our federal partners are working actively with Moderna to get information as well — but unless this changes it will start impacting… our timelines,” Botha said.

The country’s supply of Moderna has been unpredictable during the past month.

On Saturday, Premier Brian Pallister appealed to the president of the United States to approve and fast-track the delivery of surplus vaccines to Canada.

“The United States has millions of vaccines in freezers. They need to be in arms here in Canada. This is a call to arms,” Pallister said. The premier referenced the recent supply crunch related to Moderna during his appeal.

Pallister said Manitoba’s immunization team could vaccinate an additional 100,000 people in the next 10 days if it obtained vaccines from North Dakota, adding there are trucks with freezers ready to pick up vaccines in the U.S. immediately should they be allowed to do so.

On Wednesday, Botha said the main operations of the task force is based on receiving vaccine from the Canadian government.

When asked to provide specifics on how the task force has prepared to transport vaccines from the U.S. if permitted, Botha did not specify the type or quantity of resources on standby for the job.

"We have Materials Distribution Agency that does this as its main line of business and that can be marshaled in all sorts of ways should we have to pick up vaccine somewhere by road," Botha said. "But our main focus is the confirmed shipment deliveries that we're getting from the federal government." 

The agency is a special operating agency of the Manitoba government.

On April 23, the province shifted its rollout to target hot spot communities, which were selected based on COVID-19 rates, housing, income and the proportion of racialized residents. The final eligible communities were announced May 4.

While community eligibility was expanded late last month and early in May, vaccine appointments were available one to two weeks in the future and immunity takes at least two weeks to develop.

Provincial data showed that in April, 63 per cent of COVID-19 infections, where a person provided their ethnicity, were among those who identified as racialized. So far in May, the proportion is 66 per cent.

Asked Wednesday whether the move to immunize people in hot spot communities came too late in the third wave, Reimer said the province was working with the vaccine supply available at the time with an emphasis on protecting people at risk of hospitalization and death.

"The pivot came when we had enough supply that the number of Manitobans immunized could actually potentially impact transmission patterns," Reimer said. "It’s simply not effective if only five or 10 per cent of the population in any community is immunized to try to target transmission."

"If we had had doses earlier to be able to reach a large population, I think it could have had a huge impact on what we saw with wave three," Reimer said.

danielle.dasilva@freepress.mb.ca

Danielle Da Silva

Danielle Da Silva
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Danielle Da Silva is a general assignment reporter.

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