The vaccination campaign for COVID-19 in Quebec is a joint effort between the federal and provincial governments, which means it wouldn't be complete without at least a little public sniping.
After Premier François Legault blamed Ottawa for the slow pace of vaccination through the month of December at a news conference Wednesday, federal House Leader Pablo Rodriguez and provincial Health Minister Christian Dubé exchanged tetchy messages on social media.
Rodriguez pointed out "nearly 50,000 doses of vaccine are sleeping in freezers in Quebec," to which Dubé retorted "send us triple [the amount], we will use them all."
It turns out the facts are on Rodriguez's side. But Dubé would like those numbers to change and he's made his plan to achieve that public. The hope is to vaccinate vulnerable clientele in retirement homes, health workers and all Quebecers over the age of 70 by the first week of April.
An additional 13,971 people were vaccinated in the 24 hours ending Thursday at 4 p.m., a single-day high since the campaign began. With 59,800 doses of vaccine arriving this week and a further 80,400 expected next week, the vaccination effort is about to ramp up sharply.
"We've received less than one per cent of doses ... in the coming weeks and months we'll be adjusting our supply to be able to give more and more. But the numbers right now are so small, that's why we have keep a sense of perspective," Daniel Paré, the senior Quebec bureaucrat in charge of the vaccination effort, told Radio-Canada's Tout un Matin.
The plan is still to distribute 12 million doses between now and the autumn, and he said "the [vaccination] rate will adapt to the number of vaccines that comes in ... when we get to May or June, we're going to be hitting 300,000 or 400,000 per week."
According to the Health Ministry, the province plans to vaccinate 250,000 people on its priority list between now and Feb. 8, when the enhanced lockdown measures are expected to be lifted.
More specifically, the province plans to reach its target of vaccinating 75 per cent of CHSLD residents, or 30,000 people, by Jan. 25. About 2,600 doses have already been distributed.
Priority populations will be inoculated by spring
Nearly 245,000 health-care workers, who are next on the order of priorities, will have received their shot by March 1 (and about 160,000 of them should get it by Feb. 8.)
Syringes and serum kits will start arriving in private retirement homes the week of Jan. 25, and 102,000 residents will have been vaccinated by the end of February.
Deliveries have already started in remote communities in northern Quebec, and 35,000 people there will be vaccinated by the end of February.
The fifth and sixth priority groups, people aged 80 and over and those aged 70 to 79, will start receiving inoculations in the week of Feb. 15 and March 15 respectively. And in mid-March, booster doses will be offered to CHSLD residents and 50,000 health workers.
On Friday, public health officials indicated teachers and first responders will reach their turn on the priority list this spring.
One of the reasons the campaign is accelerating comes down to a policy decision announced on Dec. 31.
The province reversed course on its previous policy of withholding second doses of the Pfizer-BioNTech vaccine, which according to the clinical protocol should be given after 21 days. It also decided to distribute all of its supply of vaccine from Moderna, which also requires two doses — the second after 28 days.
The decision was made in order to vaccinate more widely and more quickly, on the basis of evidence that a single dose can confer a high level of immunity after two weeks (though the vaccine stops people from getting sick with COVID-19, it doesn't prevent someone from contracting and spreading the coronavirus).
"What we see from their data is the vaccine, 14 days after the first dose, we have 92 per cent protection," Dr. Gaston De Serres, an infectious disease expert at the Institut national de santé publique du Québec, told CBC's As It Happens. De Serres also co-authored the Comité sur l'immunisation du Québec's recommendation to the government on delaying second doses.
Delaying boosters results in better outcomes
The second dose can bump that number up to 95 per cent but in the context of a raging pandemic, a strong case can be made for offering slightly lower protection to a far larger group of people than better immunity to a smaller cohort, De Serres said.
That decision has prompted an outcry in medical circles, and is being challenged by some experts.
But according to Dr. Gary Kobinger, a microbiologist and vaccine specialist who directs Université Laval's infectious diseases research centre, it's perfectly consistent with the science.
"Even if you wait six months, that's often what gives the best results in terms of long-term protection," said Kobinger, who helped develop a vaccine for Ebola and is involved in Quebec City-based Medicago's COVID-19 vaccine effort.
That's because vaccines are calculated to stimulate an immune response, in effect teaching the body how to recognize and eradicate a particular virus. Boosters are like a refresher course. Another benefit: spacing out doses can also help reduce side effects.
Kobinger said there are multiple recent examples of dose-splitting, like the Yellow Fever epidemic in Africa in the last decade. In that case, doses were sometimes broken up into four smaller doses in order to reach more people.
"Studies afterward confirmed it was the right thing to do because the protection was still there," he said.