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COVID-19 Vaccine Bulletin - February 18, 2021

Volume 4 – Issued February 18, 2021

COVID-19 Vaccine Bulletin

Everyone is a priority and everyone who wants a COVID-19 vaccine will get one but it’s going to take time. Decisions regarding vaccine distribution are based on thorough risk assessment to determine who is at highest risk of severe illness, death and spread of COVID-19. By ensuring that population groups at greatest risk to COVID-19 are immunized first, our communities will fair better overall as serious illness and deaths will be reduced, and community disruption during the pandemic will be minimized.

Planning

The Porcupine Health Unit continues to work with various community partners and First Nations communities, in a collective effort to plan, distribute and administer COVID-19 vaccines across the district.  

The Porcupine Health Unit

Vaccine rollout continues to require intensive planning and collaboration with community partners. Additionally, COVID-19 vaccine program planning, and delivery is dependent on factors such as vaccine availability as well as provincial guidelines and local needs.

  • In collaboration with the Regional Advisory Task Force, decisions about the sequencing of vaccine distribution throughout the district continues within each phase and each population group identified by the provincial government to align with the principles of Ontario’s COVID-19 Vaccine Distribution Task Force’s Ethical framework for COVID-19 vaccine distribution.
  • The local COVID-19 Vaccine Implementation Committees assist the health unit in developing strategies and plans for community vaccine administration.
  • Planning continues for the second dose COVID-19 vaccine clinics, which are scheduled to start next week for long-term care homes, high-risk retirement homes and First Nation elder care residents.
  • Human resource capacity building is ongoing in preparation for arrival of additional vaccine doses and expansion of vaccine distribution.
  • Planning for development of mass immunization clinics throughout the health unit district in anticipation of increased vaccine deliveries.
  • The health unit will be meeting with primary care providers across the district on February 18 to strengthen partnerships and co-develop plans for COVID-19 immunization.
  • COVID-19 community immunization clinics for all adult residents in Moosonee are ongoing. Residents in this community can book immunization appointments online on the Porcupine Health Unit website.

Vaccine Rollout

The Porcupine Health Unit has been given further direction by the Government of Ontario for the next target groups in Phase 1 of the Ontario’ Vaccine Distribution Plan once long-term care homes, high-risk retirement homes and First Nation elder care residents receive the second dose of COVID-19 vaccine. Vaccine distribution will include the following target populations over the coming weeks as gradual increases in vaccine supplies become available from the federal government:

  • Staff and essential caregivers in long-term care homes, and high-risk retirement homes and First Nations Elder Care Homes, and any residents of these settings that have not yet received a first dose.
  • Alternative level of care patients in hospitals who have a confirmed admission to a long-term care home, retirement home or other congregate care home for seniors.
  • “Patient-facing healthcare workers” (i.e. healthcare workers in direct and sustained contact with patients in high-risk settings) in accordance with the updated Ministry of Health’s Guidance for Prioritizing Health Care Workers for COVID-19 Vaccination, starting with the “highest priority” group as defined by the Ministry.
  • Indigenous adults in northern remote and higher risk communities (including on-reserve and urban communities).

 On February 12, 2021, the Government of Canada announced positive updates regarding vaccine procurement:

  • Canada expects 6 million doses of COVID-19 vaccine by the end of March 2021.
  • Canada has purchased 84 million vaccine doses which are anticipated to arrive by the end of September 2021.
  • Negotiations have been made to accelerate delivery of Pfizer-BioNTech COVID-19 vaccines. Canada will receive 2.8 million additional doses between April and June and an additional 6.2 million doses between July and September than originally planned.
  • All 40 million of previously secured doses will be received in Canada by the end of September from Pfizer-BioNTech.
  • Canada has purchased an additional 4 million doses of Moderna vaccine which are expected be available by the end of September. The total number of purchased Moderna vaccine is now 44 million.

Special Populations - Updated Guidance Document

The Ministry of Health and Long-Term Care has released an updated COVID-19 Vaccination Recommendations for Specific Populations guidance document which provides additional advice and information for these specific populations:

Pregnancy:

Pregnant individuals were not included in Moderna or Pfizer-BioNTech COVID-19 vaccine trials, therefore, there is limited information available on the safety and effectiveness of the vaccines during pregnancy. However, women who are pregnant are encouraged to speak to primary care provider, and receive counselling on the risk and benefits of vaccination. Verbal confirmation of counselling will be required at the time of immunization and the counselling received must include:

  • review of the risks and benefits of vaccination
  • review of the risks and consequences of COVID-19 infection during pregnancy
  • review of the risk of getting COVID-19 during pregnancy
  • acknowledgment of the insufficiency of evidence for use of the COVID-19 vaccine in those who are pregnant

Breastfeeding:

Breastfeeding individuals were not included in the Moderna or Pfizer-BioNTech COVID-19 vaccine trials, therefore, there is limited evidence available on the safety and effectiveness of the vaccines in those who are lactating, or the effects of these vaccines on the breastfed infant or milk production. COVID-19 mRNA vaccines are not live vaccines. In theory, scientists suppose the mRNA vaccines to not be a risk to the breastfed infant. Therefore, the mRNA vaccines should be offered to breastfeeding individuals with the acknowledgment and understanding of the lack of evidence currently available. 

 

Autoimmune Conditions & Immunocompromised persons

Individuals who were immunocompromised (due to disease or treatment) were not included, and those with autoimmune conditions had small representation, in the Moderna or Pfizer-BioNTech COVID-19 trials. Therefore, there is limited information available on the safety and effectiveness of the vaccines in these population groups.

  • Individuals with autoimmune conditions, immunodeficiency conditions, or those immunosuppressed due to disease or treatment that are receiving stem cell therapy, CAR-T therapy, chemotherapy, immune checkpoint inhibitors, monoclonal antibodies, and other targeted agents, who do not have contraindications should be offered the vaccine after thorough counselling by their treating provider. Verbal confirmation of counselling will be required at the time of immunization and the counselling received must include:
    • review of the risks and benefits of vaccination
    • review of the risks and consequences of COVID-19 infection
    • review of the risk of getting COVID-19
    • acknowledgment of the insufficiency of evidence for use of the COVID-19 vaccine in this population group
    • timing of immunization in relation to treatment for the underlying condition and possible decrease in vaccine effectiveness due to immunosuppressive treatments
  • All other individuals with autoimmune conditions, immunodeficiency conditions, or those immunosuppressed due to disease or treatment, and do not have contraindications, may choose to receive the vaccine after counselling that includes:
    • review of the risks and benefits of vaccination
    • review of the risks and consequences of COVID-19 infection
    • review of the risk of getting COVID-19
    • acknowledgment of the insufficiency of evidence for use of the COVID-19 vaccine in this population group as well as the possible decrease in vaccine effectiveness due to disease or treatment

Counselling by their healthcare provider is not a requirement but may be considered prior to vaccination.

Allergies:

  • It is recommended that individuals who have had a serious reaction to a previous dose of mRNA vaccine or any of the vaccine ingredients receive an urgent referral to an allergist/immunologist to assess the method required for vaccine administration if recommended. Individuals who have had an allergic reaction with 4 hours of a previous mRNA vaccine or any vaccine ingredient must be evaluated by an allergist-immunologist to determine if is safe to receive the vaccine.

Documentation of the consult with the allergist-immunologist must be provided to the clinic and include a vaccination plan. For more details on the requirements please refer to COVID-19 Vaccination Recommendations for Specific Populations

  • For individuals who have had an allergic reaction within 4 hours and/or anaphylaxis that occurred with a vaccine or injectable medication that does not contain components or cross-reacting components of the mRNA COVID-19 vaccine, the mRNA COVID-19 vaccine may be administered with a longer observation time of 30 minutes after immunization in the clinic.
  • Individuals with a history of serious allergic reactions and/or anaphylaxis to any food, drug, venom, latex or other allergens can receive the COVID-19 vaccine followed by a 30 minute observation period at the clinic. Individuals with allergy issues like allergic rhinitis, asthma and eczema can receive the vaccine with a longer observation time of 15-30 minutes in the clinic.

Resources

The Porcupine Health Unit wants to keep you informed about COVID-19 vaccines. Our website now includes a COVID-19 Vaccine page with more information on approved vaccines, vaccine safety and other general information.

Our COVID-19 phone lines remain open. Call us with any COVID-19 related questions you have at 1-800-461-1818.

Moving Forward

Widespread COVID-19 vaccination offers the best option to protect people from serious infection and death related to COVID-19 and, provides hope that in time, when enough of the population is immunized, the restrictions placed on communities to keep people safe and healthy will be relaxed. While everyone patiently waits for the opportunity to receive the COVID-19 vaccine, please stay safe and help prevent the spread. Correct and consistent use of public health measures work, even for new COVID-19 variants of concern:

  • Stay home as much as possible.
  • Limit close contacts to members of your household.
  • Follow provincial gathering limits.
  • Wash your hands frequently with soap and water or use alcohol-based hand sanitizer.
  • Wear a mask in all indoor public spaces.
  • Wear a mask indoors and outdoors when you are unable to maintain a physical distance of 2 metres from anyone you do not live with.
  • Frequently clean commonly touched surfaces.
  • Practice proper coughing and sneezing etiquette.

 

Dr. Lianne Catton, Medical Officer of Health

Additional Information: