May 28, 2021 Vulnerable Populations in Canada Need Earlier Access to Second Doses of COVID-19 Vaccines

In this third wave of COVID-19, the undersigned Canadian health charities urge provincial governments to shorten the interval between COVID-19 vaccine doses for residents who are living with pre-existing health conditions. Our organizations recognize the urgency of breaking chains of transmission by extending second doses and providing first doses to more individuals. However, the vaccine availability is due to ramp up in the coming weeks, such that Canada will be receiving a 19% increase of Pfizer-BioNTech vaccines from May 31^st onward (1). Additionally, Moderna is poised to increase their vaccine supply to Canada by early summer (2).

For the second time in less than a month, the National Advisory Committee on Immunization (NACI) has updated their recommendations on the second dose interval for vulnerable populations (3,4). Their most recent recommendations, published on May 28^th, state:

“With the increase of COVID-19 vaccine supply in Canada, second doses should be offered as soon as possible, with priority given to those at highest risk of severe illness and death from COVID-19 disease after or concurrent with first doses for all remaining eligible populations” (4).

Recently, Statistics Canada published mortality data for deaths due to COVID-19 in 2020 (5). This data indicates that Canadians with one or more pre-existing health conditions are at higher risk of severe outcomes if they contract COVID-19, including death:

• 89% of people who died from COVID-19 in 2020 had one other comorbidity;
• 65% had 2 comorbidities; and
• 46% had 3 or more comorbidities.

This report goes on to state,

“The Public Health Agency of Canada has advised that certain pre-existing conditions such as diabetes, chronic obstructive pulmonary disease, cancer and heart disease put individuals at higher risk of severe illness or death from COVID-19. In addition, the suggested Canadian vaccination rollout prioritizes vulnerable populations, including those with underlying conditions.”

The report rightly highlights “the elevated risk facing younger populations with underlying conditions.”

Looking to other countries who have responded to increased COVID-19 cases in the midst of vaccination plans, the UK has announced an acceleration of second doses for individuals with underlying health conditions (6). This is validated by recently published research on vaccine effectiveness against new variants warrants and supports an acceleration of second doses for vulnerable populations (7).

Based on this rapidly changing but convincing data, we request the acceleration of second-dose vaccine access for all high-risk and vulnerable populations, including those with pre-existing conditions to ensure their risk of death from COVID-19 is reduced.

References

1. Canada PHA of. Vaccines for COVID-19: Shipments and deliveries [Internet]. aem. 2020 [cited 2021 May 20]. Available from: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/covid-19-vaccine-treatment/vaccine-rollout.html
2. Aiello R. Feds say Canada poised to “ramp up” second COVID-19 doses starting in June [Internet]. Coronavirus. 2021 [cited 2021 May 27]. Available from: https://www.ctvnews.ca/health/coronavirus/feds-say-canada-poised-to-ramp-up-second-covid-19-doses-starting-in-june-1.5442086
3.  Public Health Agency of Canada. NACI rapid response: Extended dose intervals for COVID-19 vaccines to optimize early vaccine rollout and population protection in Canada [Internet]. Ottawa: Public Health Agency of Canada; 2021 Mar [cited 2021 Mar 15]. Available from: https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/rapid-response-extended-dose-intervals-covid-19-vaccines-early-rollout-population-protection.html
4. Canada PHA of. NACI updated COVID-19 vaccine statement, May 28, 2021: Summary [Internet]. 2021 [cited 2021 May 28]. Available from: https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/recommendations-use-covid-19-vaccines/summary-updated-statement-may-28-2021.html
5. Government of Canada SC. The Daily — Provisional death counts and excess mortality, January 2020 to February 2021 [Internet]. 2021 [cited 2021 May 17]. Available from: https://www150.statcan.gc.ca/n1/daily-quotidien/210514/dq210514c-eng.htm
6. UK Government. Most vulnerable offered second dose of COVID-19 vaccine earlier to help protect against variants [Internet]. GOV.UK. [cited 2021 May 20]. Available from: https://www.gov.uk/government/news/most-vulnerable-offered-second-dose-of-covid-19-vaccine-earlier-to-help-protect-against-variants
7. Lopez Bernal J, Andrews N, Gower C, Gallagher E, Simmons R, Thelwall S, et al. Effectiveness of COVID-19 vaccines against the B.1.617.2 variant [Internet]. Epidemiology; 2021 May [cited 2021 May 25]. Available from: http://medrxiv.org/lookup/doi/10.1101/2021.05.22.21257658