The independent committee charged with deciding who should be the first Canadians to be vaccinated against COVID-19 today released its final directive recommending that long-term care home residents and seniors over the age of 80 get priority access to shots.
The National Advisory Committee on Immunization (NACI) said the initial, limited quantity of vaccine doses should be reserved for people who are most at risk of contracting the virus and developing severe symptoms.
Canada’s long-term care homes have been hit hard by the novel coronavirus, with thousands of deaths reported since the onset of this pandemic.
NACI said that since the elderly residents of long-term care and assisted living facilities, retirement homes and chronic care hospitals face “severe outcomes” and a much greater chance of dying from the disease, they should be at the top of the list for the initial batch of roughly six million doses that will be made available in Canada in the first three months of 2021.
Pfizer’s vaccine, which is expected to be the first product approved by regulators for use in Canada, requires two doses — so roughly three million people should be inoculated in this first stage of the rollout.
NACI said it’s not just the residents who should go first — it’s also recommending that provinces and territories prioritize the staff who work at these sites for early vaccination.
After long-term care home residents and staff are immunized, NACI said the next priority group should be all Canadians over the age of 80.
“All adults of advanced age should be prioritized for initial doses of authorized COVID-19 vaccines, beginning with adults 80 years of age and older, then decreasing the age limit in 5-year increments to age 70 years as supply becomes available,” the final directive reads.
After the 80-plus cohort is vaccinated, front line health care workers should be next in the queue, said NACI.
The committee said that doctors, nurses and other staff at hospitals should get their shots early to maintain staffing levels in the health care system.
“Immunizing health care workers and other workers functioning in a health care capacity (e.g. personal support workers) minimizes the disproportionate burden of those taking on additional risks to protect the public, thereby upholding the ethical principle of reciprocity,” the directive reads.
NACI also expressed concern about Indigenous adults living in communities “where infection can have disproportionate consequences, such as those living in remote or isolated areas.”
Because health care options are limited at the best of times in rural and remote areas, Indigenous individuals can face an elevated risk of death and “societal disruption,” NACI said. For that reason, the committee said that some First Nations, Métis and Inuit communities should be in the first cohort to get vaccinated.
In the second stage of Canada’s vaccine rollout, which could begin in April 2021 as more supply comes online, other essential workers will have access.
The committee said first responders — such as police officers, firefighters and health care workers not included in the initial rollout — should be next in line.
The residents and staff in other “congregate settings” — such as migrant workers, prisoners in correctional facilities and people in homeless shelters — should be next in line, NACI recommended.
Canada has seen a number of outbreaks in correctional facilities and places like farms and meat production and packing facilities where maintaining physical distancing is challenging and infection prevention and control measures are limited.
NACI said it would prudent for provinces and territories to make shots available in these high-risk places early to stop further caseload spikes.
Other essential workers should be included in the second wave of vaccinations, NACI said. Ultimately, it will be up to the provinces and territories to more precisely define who qualifies as an “essential worker,” but the committee suggested grocery store staff could be on that list.
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