Quebec to allow 90-day delay before second vaccine dose, more than double the national panel’s advice

QUEBEC CITY – Quebec public health officials said Thursday that provincial advisors have recommended a 90-day-long COVID-19 vaccination program between the first and second doses – a national advisory committee recommended a day earlier, Is twice that.

“In our context, this is the best strategy,” Health Minister Cristian Dubey said in a press conference on Quebec’s vaccination progress on Thursday.

Quebec announced in late December that it would delay the second dose of vaccine or “booster shots”, but the province did not say until Thursday what kind of delay it was.

Provincial officials say the second dose should come between 42 and 90 after the first.

Health department officials said such a program would allow the province to give the vaccine to more people who would otherwise wait for their first dose.

The 90-day delay is much longer than the 42-day delay in its recommendation by Pfizer (21 days for its vaccine), Moderna (28 days, for its vaccine), and federal public health advisors on Wednesday (for both Up to 42 days) vaccines).

However, that national advisory panel, called NACI, said on Thursday that the provinces have some avenues to make their decisions and are not opposed to Quebec’s 90-day timeline.

Deputy Chief Public Health Officer of Canada, Drs. Howard Nzu said the “extraordinary circumstances” of some provinces may mean they need to withdraw from federal recommendations.

“It’s the difference between actual epidemiology, on the ground, the fact that there is a markedly increased rate of cases, hospitalization,” said Njoo, and vaccine guidelines.

Questions based on detail ‘experience’, not data

So why is the province talking about 90 days?

Advisor to the Ministry of Health, Dr. Richard Masse said Quebec experts believe it is likely that immunity will last longer than 42 days, as recommended by the NACI panel, but clinical trials have not carried the past forward.

What they are instead relying on is previous experience with other vaccines.

“The experience we have is the experience of working with many vaccines,” Massey said. “Immunity is not something that is ‘on’ or ‘off’.”

While Quebec’s Ministry of Health has stated that a single dose can provide about 90 percent efficacy against the virus, Pfizer says that one dose alone is only 52.4 percent effective.

Massey told reporters that the discrepancy comes from various and more specific analyzes of Pfizer’s test data.

He said that Pfizer, while studying the issue, was among those who received their first dose, but did not have time to build immunity.

Massey said, “It takes 12 to 14 days for immunity. If you count people who get the disease two, three, five days after being vaccinated, it’s not really a failure to vaccinate because immunity [hasn’t been built up]”

An expert told CTV News this week that there are large variations in efficacy estimates due to the small sample size of people who got only the first shot in the Pfizer test. That expert, Drs. Donald Vinh said that in his opinion the efficacy is somewhere between 60 and 69 percent.

In a statement to CTV News, Pfizer Canada spokeswoman Christina Antoniou reiterated earlier statements that Pfizer had not evaluated the efficacy of her vaccine on an alternative dosing program.

“There is no data to demonstrate that safety after the first dose continues after 21 days,” she said.

“We recognize that recommendations on alternative dosing intervals remain with health officials and may include the adoption of public health recommendations to develop conditions during an epidemic,” he wrote.

But for Pfizer, “As a biopharmaceutical company operating in a highly regulated industry, our position is supported by the label and indicated with Signal Health Canada and informed by data from our Phase 3 study.”

Minister Dubey said that the province is talking to Pfizer. On January 5, Pfizer told CTV News that Quebec had not informed the company before deciding to delay the second dose.

“We’ve had conversations with Pfizer,” Dubey said, “to inform them why we’re making those decisions.”

Earlier this week, Premier François Legault said that in discussions with the federal government, the province learned that there could be a danger of losing Quebec’s vaccine supply if Pfizer was not happy with its dosing regime.

On Thursday, Pfizer’s statement said the company “remains.”[s] We are committed to our ongoing data-sharing efforts with regulators, health officials and governments, and to help inform any public health decisions aimed at defeating this devastating epidemic. “

Both Massey and Dubey said they are expecting an increased supply, as they would favor a slight delay before the second dose if the province’s vaccine increases.

“Saving lives is a moral imperative,” Dubey said.

“The higher the dose we have, the more we will be able to reduce the time between the first and second doses.”

Next step for location of QUEBEC

About 65 percent of CHSLD residents had already given the first dose, with Dubey saying Quebec would begin vaccinating residents of private senior citizens (RPAs) on 25 January.

He said that with a longer schedule between the first and second doses, the province may also consider vaccinating the general senior population soon.

With new vaccine shipments arriving in the province this week, Dubey said 115,000 people have now been vaccinated.

In total, the province has received 162,000 doses so far. Dubé says Quebec is on track to raise that total to 250,000 in February.

List on CJAD 800 radio:

Is there a delay in working for 90 days in the second dose of vaccine? Dr. Caroline Quach is an epidemiologist and in charge of the infection prevention and control unit at the Saint-Justine Hospital of the National Advisory Committee on Immunization.

– Files from CTV’s Kelly Greig


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