Quebec opts to delay 2nd dose of vaccine in order to immunize health-care workers faster

© Evan Mitsui/CBC The Quebec government issued a directive Dec. 31, calling on health officials to withhold a second dose of the Pfizer and Moderna vaccines until further notice, in order to vaccinate more people.

Many of those who have so far received a first dose of the Pfizer-BioNtech vaccine in Quebec won’t be getting a second dose in the coming weeks, as planned.

Instead, with cases and hospitalizations surging, the Quebec government has opted to distribute the vaccine as quickly and widely as possible. The priority moving forward will be to immunize front-line health-care workers.

But the change in the Ministry of Health’s strategy is discouraging to long-term care home residents whose hopes rested on the prospect of an immunity of more than 90 per cent, said to be provided by two doses of the Pfizer vaccine. 

“I feel it’s such a blow to us. It was such a hope, such a miracle and now it’s not,” said Beverly Spanier, a resident of the Maimonides Geriatric Centre in Côte Saint-Luc, one of the two first long-term care homes to receive a thousand or so doses of the vaccine in mid-December. 

The West Central Montreal health board overseeing Maimonides says it is simply following a Ministry of Health directive issued Dec. 31.

A spokesperson for the health board said newly available doses will go first to health-care workers in long-term care homes, then to hospital staff who come into contact with COVID-19 patients.

Dr. Cécile Tremblay, a microbiologist and infectious diseases specialist at the CHUM, says she understands the government’s desire to distribute the vaccine more widely in less time, but also says those who received the first dose of the Pfizer vaccine should get a second one sooner rather than later. 

Tremblay noted a number of factors indicate the pandemic is far from over in Quebec, including community transmission remaining high, the detection of the new COVID-19 variant first recognized in the United Kingdom, and the fact that it will take several months before most of the population will be vaccinated.

“It’s the deaths that really tire me. Everything we’ve done so far was to prevent that,” Tremblay told Radio-Canada Monday. 

“The worst is yet to come.”

Tremblay cited studies showing the Pfizer vaccine provides 52 per cent immunity within two weeks of the first shot, and the Moderna vaccine is 90 per cent effective within weeks of its first dose. 

The two-dose regime involves injections given 21 days apart for the Pfizer-BioNTech vaccine, and 28 days apart for the Moderna version. 

The Ministry of Health, on the other hand, says the efficiency of both Pfizer and Moderna vaccines 14 days after the first shot is 90 per cent. 

Christina Antoniou, a spokesperson for Pfizer, told CBC the pharmaceutical company is “aware aware of assessments done by some groups of the existing data.”

But she said she could only confirm the results of the third phase of Pfizer’s own vaccine study, which demonstrated “partial protection” beginning as early as 12 days after the first dose, and that “two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95 per cent.”

Antoniou added that “there are no data to demonstrate that protection after the first dose is sustained after 21 days.”

The decision by the Quebec government to use the vaccines it had stored away for second doses follows a growing consensus among health experts in Canada that offering the COVID-19 vaccine to as many people as possible may have more impact than holding back supplies to give recipients their second dose.

Ontario officials still plan to maintain the two-dose timeframe to ensure immunity.

Still, the prospect of not getting a second dose within 21 days is disappointing to family members of long-term care home residents. 

Joyce Shanks, whose father has been a resident at Maimonides for five years, says she feels a promise has been broken. 

“They were going to do this for us. Now, they’re going back on their word, and that’s really big. It’s angering,” Shanks said. 

The West Island health board is also skipping a second dose originally meant for veterans at Ste. Anne’s Hospital and giving it to front-line hospital workers instead.