2021-04-01 BC

Vaccine Clinics

My sources tell me that the clinic at the Vancouver Convention Centre has about 20 vaccinators, with about 6 greeters and 6 check-in people.


The Province announced that workers must be given time off to take the vaccine.

Supply

An article about supply says:

  • 300 kilodoses of the vax which Canada withdrew from COVAX are due to arrive next week.
  • At least one person in the government expects that we’ll get our shipment of 1M Serum Institute of India doses only a little delayed from the mid-April schedule.
  • They thought they were probably going to get J&J at the end of April, but a manufacturing snafu meant J&J had to trash 15M doses, so now maybe it’ll be later.

Press Briefing

Dr. Henry, like last week, spent a lot of time answering questions that her office gets a lot. Here is a very rough translation of the questions she asked herself, and the answers she gave herself:

Q: Why do I have to wear a mask after I get vaccinated? A: Because it takes time to generate antibodies. We see good protection after 21 days. NOTE: three weeks, not two. There are two important parts to the adaptive immune systems: antibodies and cells. The antibodies are easy to measure, but the T-cells and B-cells are also really important, but take a while to get trained (and harder to measure).

Q: I had an allergic reaction to the flu shot, will I get an allergic reaction to the mRNA COVID shots? A: Probably not, the flu shots and the mRNA COVID-19 vaxxes are made in really different ways, with different ingredients. The mRNA vaxxes actually have a much shorter ingredients list. Editor’s note: I believe that flu shot allergies are usually to egg, and there’s no egg in these vaxxes. They believe that the thing people react to in the mRNA vaxxes is PEG. If you know you are allergic to PEG, go for the AZ or J&J vaxxes.

Q: Is the long interval between doses really okay? A: Yes. The interval was so short in the trials because we wanted to get results fast. But real-world data suggests that it’s better to have a longer delay between the two shots.

Q: Why aren’t you immunizing family members who take care of vulnerable people? A: Because we’ve got limited doses. Those people are only taking care of one person, not like e.g. care home workers who are taking care of many people. Editor’s note: I think at one point she was trying to say, “and the vulnerable person’s vaccination will protect them”, but it was really oblique.

Q: Why can’t people under 55 get AZ? A: People under 55 almost never die from COVID-19, but you can die from the side effects, so we want to make sure we really firmly understand the risk-to-reward equation. We’ve asked AZ for more data, we’re waiting on it, I expect we’ll greenlight AZ soon. But the good news is we have alternatives, we’re getting LOTS of Pfizer.

Q: If I got AZ before and now I can’t get a second shot of AZ, then what? A: We have a few months to figure that out AND there is a “mix and match” study going on in the UK right now to figure out what works best with various combinations of vax1 first and vax2 second, vax2 first and vax1 second, etc. We will know more soon.

Q: With AZ on pause, what are you doing with the occupation-based track? A: Pausing it, sorry. Please be patient.

Q: When is J&J going to come? A: We don’t know, but hopefully at the end of April.

Dix: Q: How many people have gotten vaxxed by age group? A:

Age# vaxxedcohort size
90+44913~50K
85+62430~72K
80+88555~107K
75+79808~160K

Q: We’ve been stuck on 73 years-old being the cutoff for bookings for several days, why are we stuck? A: Partly because we folded in the ~150K of extremely clinically vulnerable, but understand the problems we have with vaccine supply. For example, we expected 112,500 Moderna doses last week, but only got ~34K. We expect the rest of it this week, but they say they are going to deliver it on Saturday. Our vax team has to keep scrambling and adjusting to handle the unpredictability of the shipments and they are awesome.

Q: Why did you do such a sloppy job of rolling out the AZ-for-55-to-65-year-olds? A: We have 18K doses of AZ which are going to expire tomorrow, we had to get those in arms. We found out we couldn’t use the AZ on people under 55 on Monday, we changed on Tuesday, we vaccinated people yesterday, and we are not going to throw away our shots. (Okay, he didn’t actually say that last clause, but I couldn’t resist.)

Q: But there are way more 55-to-65 year-olds in the Lower Mainland, WTF? A: Yeah, we know, there are about 385K people 55 to 65 years old in the Lower Mainland, but we’re going to get 189 kilodoses from the US like, right now, and we expect more next week. Dr. Ballem will say where that goes, but a lot will go to pharmacies.

Q: Are we doing a lot of surgeries right now? A: Yes, a shitton. Editor’s note: I told you that this was a VERY loose retelling of the press conference.

Q: When is the online booking system going online? A: April 6. There will still be a call centre backing it up, so people can still phone in if they want. You should register a few days before your booking-open date, then book, then you’ll get your vax.

Q: What percentage of BC adults have been vaxxed? A: 16.3%. We had said we wanted to get 10% by 1 April, and we beat that. I’m very proud of that. Did I mention that we’ve vaxxed 16.3%? That’s good. Let me tell you again: 16.3%. 16.3% is more than 10%. Everybody rocks, to be able to get 16.3% vaxxed.

Then they went on to reporter’s questions:

Q: Did you get an assurance from the pharmacies that they wouldn’t give preferential treatment to their own customers? Someone said they were denied because she was not a regular customer. A: We love pharmacists, did we mention what a kickass job they did during the flu campaign? We are grateful that they stepped up this week with the big change of plans. Have I mentioned that reliable supply is a problem? By the way, we vaxxed 9000 people in Prince Rupert, and 67 got COVID yesterday, that’s because it takes time for the immunity to build. Everybody wear your mask!

Q: Where are VOCs happening, and why aren’t you doing more specifically to counter VOCs? A: The P.1 cluster was in VCH; it hasn’t been superspreader events but a lot of little chains. The P.1 cases are mostly 19-39 year/olds.

Q: People 65-75 are mad that they have to wait soooooo long when the people just older and just younger are going first, wtf??? A: That cohort is bigger than the others we’ve done so far, plus we folded in the 150K clinically extremely vulnerable, so it’s taking a little longer to go through the age-based track. For the AZ, we wanted to give it to people who weren’t just about to get vaxxed through the age-based clinics. It was not to slight the 65-to-75 year-olds.

Q: Alberta is quarantining VOC patients for 24 days, how are we making sure that people here are quarantining for the 14 days the are supposed to? A: That’s not quite right. If someone has a VOC and lives with other people, then the first person is infectious for ten days and then the quarantine period starts for the household members for 14 days, 10+14=24. In Alberta, they are supporting some people by putting them in a hotel so they don’t infect their household, and we do that too sometimes. For example, in Whistler, there were people in group accommodations, and while we were able to do some vax, we put some people in hotels. We also did that some at Big White and on the DTES, but for some families that’s unacceptable, so they elect to stay together for the full 24 days. As to what measures we use for people with VOC, the same things as we do for everyone, test, trace, track.

Q: Today there were fewer VOCs, is that good news or a blip? A: We hope it’s good news.

Q: With more VOCs, is it time to expand testing? A: I don’t know where we would expand the testing. Editor’s note: Dr. H has talked about this in the past: anyone who wants a test can get one, and she thinks it is a waste of resources to test people off the street at random.

Q: Are young people being hospitalized more? A: We aren’t seeing the proportion of young people going up, but as the case count goes up, the number of young people has gone up, and they stay longer in hospital because they don’t die. We are seeing the % of young people in ICU going up. It used to be that about 19% of hospitalizations would go to ICU, but for VOCs, it’s more like a third.

Q: What should BCers expect from the circuit breaker? A: The incubation period is up to 14 days and generally we see most transmission between day 5 and day 7. Right now, there are 11K people in isolation, and some of those are going to get sick, can’t avoid that. I also hear from my contact tracers that the number of contacts has been going up, that’s why we took Measures.

Statistics

Today: +832 cases, +5 deaths, +31,526 first doses, +43 second doses.

VOCs: +80 of B.1.1.7, 1 of B.1.351, 9 of P.1. NB: I had the impression that they didn’t get any WGS yesterday, like someone accidentally knocked the power out of the sequencer or something like that. Not sure.

Currently 296 in hospital / 79 in ICU, 7,571 active cases, 11,608 under monitoring, 91,732 recovered.

Charts

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