Quebec pushing to get long-term care residents second dose, vaccine switch allowed

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MONTREAL — Quebec has instructed health authorities to prioritize giving long-term care residents their second dose of COVID-19 vaccine and to substitute the Pfizer-BioNTech vaccine for Moderna, if necessary.

A directive issued by the province's Health Department on Thursday instructs regional health authorities to give all long-term care residents their second dose by May 8 — even if that is less than the 112-day window between the two shots established by the provincial government.

In cases when residents are at or near the end of the 112-day period, health boards are instructed to vaccinate people as soon as possible — a phrase that is underlined and in bold in the document signed by public health director Dr. Horacio Arruda.

Dr. Sophie Zhang, who oversees 15 long-term care centres in Montreal, said the new directive will help provide maximum protection for patients who remain vulnerable despite having received one dose.

"I am pleased to see that the government has been swift in responding to our request that the second dose be given immediately to long-term care residents," she said in an email. Ideally, people would receive the same vaccine for both shots, but with supply shortages and "the fact that most vaccine experts are fairly confident a mixed-dose regime will be safe and effective, I think this is the right thing to do," she added.

Four new cases of COVID-19 were reported in Quebec's long-term care system on Friday, bringing the total number of reported active cases to 118.

Residents at the long-term care centres that Zhang oversees will start receiving a second dose — of the Pfizer vaccine — on Monday, she said. Those residents, who originally received the Moderna vaccine, had been scheduled to get their second shot on April 16, but the inoculations were cancelled due to supply shortages.

The government directive also instructs health authorities in Quebec City, Chaudiere-Appalaches and Outaouais, currently the province's three most affected regions, to begin offering long-term care residents who have received a first dose of the Moderna vaccine a second dose of the Pfizer immediately and not to wait for a delivery of Moderna scheduled for April 26.

The health authority in Quebec City said Friday it was beginning to give residents of 20 long-term care centres their second dose — using the Pfizer vaccine — and would begin giving residents of the other long-term care centres in the region their second dose within the coming days.

The new directives are based on a report from Quebec's immunization committee.

The report, dated April 12 but made public on Friday, said the committee was concerned about the percentage of unvaccinated health-care workers in the long-term care network. It said it feared the workers could carry the virus into facilities and infect vulnerable residents who haven't been fully vaccinated.

The committee said more work needs to be done to encourage workers to get vaccinated. The Health Department said Friday that 64 per cent of health-care workers in long-term care centres have been vaccinated.

In an interview earlier this week, Zhang said that after four workers in a long-term care centre she oversees were infected with COVID-19, two residents who had received their first shots also tested positive.

Marjaurie Cote-Boileau, a spokeswoman for Health Minister Christian Dube, said interest in being vaccinated has grown among health-care workers since the vaccination campaign began in December, adding that health-care workers who aren't vaccinated now have to be tested for COVID-19 three times a week.

So far, Quebec has given 45,260 people their second dose, according to data from the provincial government. More than half of those recipients are health-care workers. Fewer than 3,000 long-term care residents — about eight per cent of the total — have received a second dose.

Quebec administered 88,000 COVID-19 vaccinations on Thursday, a daily record, surpassing the 85,000 vaccinations from a day earlier.

Health Minister Christian Dube said Friday on Twitter the province has given 2.6 million first doses — 50 per cent of the goal of getting 5.3 million adults their first shot by the Fete nationale holiday on June 24.

As of Wednesday, anyone in Quebec 45 and over has been eligible for the Oxford-AstraZeneca vaccine via appointment or at mass vaccination sites without an appointment. However late Friday afternoon, officials said that all doses of the AstraZeneca vaccine reserved for walk-in vaccinations in Montreal have been used.

The province reported 1,043 new cases of COVID-19 Friday — the lowest number of new daily cases since March 30 — and 15 more deaths attributed to the novel coronavirus, including six in the previous 24 hours.

Health officials said hospitalizations dropped by 27, to 684, and 172 people were in intensive care, a drop of two.

This report by The Canadian Press was first published April 23, 2021.

— With files from Sidhartha Banerjee


This story was produced with the financial assistance of the Facebook and Canadian Press News Fellowship.

Jacob Serebrin, The Canadian Press