Canada

Vaughn Palmer: B.C. defends decision to extend second-dose timeline

Analysis: Some 100,000 people who have already received their first doses will have to wait as long as another month to receive a second

File photo: Provincial health officer Dr. Bonnie Henry responds to questions while B.C. Premier John Horgan, back left, and Health Minister Adrian Dix listen during a news conference about the provincial response to the coronavirus.

VICTORIA — On the eve of this week’s rollout of the revised B.C. vaccination strategy, Dr. Bonnie Henry and the provincial health team made a bold and controversial decision.

With COVID-19 transmission still continuing at a disturbing level, the province would make the most of limited vaccine supplies by delivering as many first doses as early as possible.

B.C. would do this by extending the interval between first and second doses of the approved vaccines to four months, up from the earlier three.

First doses were proving to be 90-per-cent effective or better, said Dr. Henry, and there was “no evidence” to suggest that a person needs “that small bit of extra protection” from a second dose.

“We do better by spreading those doses to other high-risk people,” she said, explaining a “pivot” in the vaccination strategy.

The immediate effect of the decision taken Sunday and announced Monday was that some 100,000 people who had already received first doses would have to wait as long as another month to receive a second.

The doses that had been destined for them would now be used to deliver an equivalent number of first-time immunizations.

The extension of dose-two would affect the entire vaccination strategy, as Dr. Penny Ballem, coordinator for the province’s immunization team, explained at Monday’s media conference.

“When we modelled it last night, it will likely result in, by mid- to late-July, that we will have been able to give a first dose to everybody in our population, which is a significant shift from our earlier plan coming into September.”

B.C. was not going too far out on a limb in making the switch. Weeks earlier, Quebec established a three-month interval for second doses. Dr. Henry hinted Monday that the National Advisory Committee on Immunization (NACI) was on the verge of approving the longer interval.

Still, B.C. was the first to go to a four-month delay for second doses, and would thus bear the brunt of controversy.

Barely was the rollout completed Monday when the federal government’s science adviser, Mona Nemer, delivered a scathing assessment on CBC News Network.

In the absence of proper clinical trials, Nemer told interviewer Vassy Kapelos, B.C.’s adoption of the four-month interval “amounts right now to a basically population-level experiment.”

Premier John Horgan and his ministers had repeatedly passed on opportunities to publicly criticize Ottawa’s botched vaccine rollout.

But now the prime minister’s science adviser was accusing Dr. Henry of treating British Columbians as guinea pigs?

Provincial Health Minister Adrian Dix was first out of the gate in responding. He challenged the Justin Trudeau government for picking on B.C. when it hadn’t levelled similar accusations over the extended interval in Quebec.

Quebec had been holding off delivering second doses for weeks, Dix told host Carolina de Ryk on CBC Daybreak North on Tuesday, adding with undisguised sarcasm: “I may have missed the federal government’s interest in that question.”

Dr. Henry delivered her own response to Nemer later Tuesday, using language that was pretty strong by her kindness-first standards.

It was a “little bit unfortunate that the national science adviser” had spoken out, when “obviously (she) was not involved in some of these discussions and decision-making, and perhaps didn’t understand the context.”

The provincial health officer then repeated that the national advisory committee “will be coming out with a statement shortly.”

NACI did so Wednesday. It echoed Dr. Henry’s view that “in the context of limited COVID-19 vaccine supply, jurisdictions should maximize the number of individuals benefitting from the first dose of vaccine by extending the interval for the second dose of vaccine to four months.”

In the course of a media conference Tuesday, Dr. Henry highlighted other factors that shaped the decision here in B.C.

Clinical trials by the manufacturers were an initial guide to the province’s vaccination strategy. But the makers had limited the timeframe of those trials to three or four weeks in order to expedite delivery of vaccines that were sought all over the world.

B.C. was now able to draw on the “real world” experience regarding the delivery of vaccines here and elsewhere. They pointed to greater effectiveness than identified in the trials, justifying the longer interval between doses.

“That is why I am so confident that the decision we made over this past weekend to extend the interval is the best one, based on all the science and data that we have,” she said.

But had not Dr. Anthony Fauci, America’s leading COVID-19 fighter, spoken just last month against extending the interval between doses?

“He did not recommend the extension of doses in the United States because he felt they had sufficient vaccine,” she replied. “We’re in a position that is quite different from the U.S. in terms of our vaccine availability in the short-term.”

And the vaccine gap is increasing. U.S. President Joe Biden suggested this week that everyone in the U.S. could be vaccinated — first and second doses — by the end of May.

For those who will be waiting a little longer for their second dose here in B.C., Dr. Henry says she will be waiting with you.

She received her first dose back in December to demonstrate her belief that the vaccines are safe. Her four months are up in late April, but she now says she may decide to wait “even longer” if the science indicates that is the better course to strengthen one’s immune-system response.

vpalmer@postmedia.com

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