B.C.’s COVID-19 immunization plan

Fraser Health began its COVID-19 immunization plan on December 15^th 2020, beginning with individuals in provincial priority populations. Additional information on COVID-19 vaccine and updates is available below.

Campaign launch and progress to date

The B.C. COVID-19 immunization plan was launched in mid-December. Fraser Health has followed the Ministry of Health guidelines to offer vaccine to the following priority populations to date:

• Residents, staff, and medical staff of long-term care and assisted living facilities.

• Staff and medical staff in acute care who work in critical care, high acuity, emergency departments and COVID-19 cohort units, and paramedics.

• People awaiting long-term care placement in acute and community settings.

• Remote First Nations communities.

Ministry guidelines on priority populations can be found on their website.

As more vaccine is delivered to BC over the coming months, additional priority groups will be offered vaccination. Community Family Physicians, Nurse Practitioners and Medical Specialists will be notified when you will be invited for vaccination.

Given recent national announcements related to vaccine supply, we are unable to anticipate the timing of these invitations. The province is working with the federal government to ensure our supply gets back on track, but we will have extremely limited vaccine available for the next two weeks.

COVID-19 vaccines

Two mRNA vaccines, Pfizer BioNTech and Moderna, are approved for use in Canada. Both of these vaccines contain mRNA or genetic code for the spike protein of the SARS-CoV-2 virus. The antigen is encapsulated in a lipid nanoparticle capsule that enables the delivery of the mRNA into muscle cells. Within the cells, the mRNA works with the cellular machinery to produce the spike protein which migrates and adheres to the outside of the cell. The recipient’s immune system recognizes this antigen as a foreign protein thereby generating a protective humoral and cellular immune response against the SARS-CoV-2 virus. Vaccine efficacy against symptomatic laboratory-confirmed infection is 95% after a 2-dose series of either vaccine. Protection beginning 14 days after one dose of either vaccine is >90%. The duration of protection from one or two doses is not yet known but is being actively monitored.

Recommended interval between the two vaccine doses is 21-28 days as per product monographs. However, the World Health Organization and the Canadian National Advisory Committee on Immunization (NACI) support up to 42 days between doses, and other jurisdictions are using a longer time between doses, up to 12 weeks. This allows a greater number of people to receive the important protection from a first dose of vaccine. Learn more about the evidence and the decision to defer the second dose of COVID-19 vaccine in B.C.

As stated in this week's announcement by the provincial government, as a result of the limited supply of vaccine in the next two weeks, we will be delaying second doses up to day 42.

Contraindications

The only contraindication to either vaccine is a known, severe allergy to polyethylene glycol, another component of the vaccine, or an anaphylactic reaction to a first vaccine dose. Polyethylene glycol is a component in some cosmetics, skin care products, laxatives, cough syrups, and bowel preparations for colonoscopy.

While the product monographs identify a number of precautions because these populations were not included in the original vaccine trials, in the context of ongoing risk of COVID-19, the following individuals can be offered vaccination:

• Pregnant or breast-feeding women

• Those who have recently received any other immunization or a TB skin test

• Those with immunocompromising conditions or on medications that weaken their immune system

Vaccination of individuals with a history of laboratory-confirmed COVID-19

Individuals with a history of COVID-19 should be immunized with a two-dose series. However, as vaccine quantities are currently limited, those with a history of laboratory-confirmed COVID-19 within the last 3 months are expected to have protection for the short-term, and can have their vaccinations deferred.

Vaccine handling

Both mRNA vaccines require special storage and handling:

• The Pfizer-BioNTech vaccine is distributed and stored at -70°C with a limited shelf life of 5 days at -28°C.

• The Moderna vaccine is distributed and stored at -20°C, though it can be maintained at -28°C for 30 days.

Role of community physicians in the vaccination campaign

Many community vaccine providers have already supported our immunization campaign through participation in local and outreach clinics. Given the current limited vaccine inventory and unique storage and handling requirements, distributing vaccine to physicians for use within your offices is not currently possible. We appreciate your support in answering your patients’ questions, clarifying any misinformation they may have, and in recommending vaccine to eligible individuals. At this time there is no further need for additional volunteer immunizers.

COVID-19 Vaccine information for physicians

For more information on COVID-19 vaccines for physicians, please visit the BCCDC website.