Province forgot to include vaccination plans for vulnerable care-home residents who miss first round of shots

There’s a major flaw in Manitoba’s COVID-19 immunization plan for personal-care homes that has caught the province off guard.

Newly arrived seniors at care homes where residents have already been vaccinated may have to wait up to a month for their first shot, with no plan on when their second dose will be administered.

Under the province’s rollout, immunization teams visit long-term care homes and vaccinate eligible candidates, usually the same day. Teams will return several weeks later to administer booster shots.

However, seniors who miss the first round, including new or re-admitted residents (or those too ill to be vaccinated at the time), have to wait for the immunization team to return to get their first shot. That could take up to four weeks. In a pandemic, that could be life or death.

"Residents admitted between the two scheduled doses may be able to receive their first dose when the team arrives to administer the second dose," a provincial spokesperson said in an email.

What's more, there appears to be no plan in place to administer their second injections.

"It is preferred that the site arrange for the second dose to be administered," the spokesperson said.

This is a major oversight.

Dr. Joss Reimer, medical lead with the vaccine implementation task force, has emphasized repeatedly how important it is for everyone to get their second dose within the manufacturer’s timeline (21 days for the Pfizer-BioNTech vaccine and 28 days for the Moderna version).

The second dose is required for maximum protection and long-term efficacy. That’s especially important for seniors living in congregate settings such as personal-care homes, Reimer said.

"This population is our top priority," she said Wednesday. "It is critical that we offer them that second dose."

Yet the province has still not figured out how to avoid lengthy delays for first doses, or how to administer followup shots for many care-home residents. (There is a steady stream of residents arriving at care homes every week, including many from hospital who were awaiting placement).

When pressed further, provincial officials would say only that they’re still working on the problem.

"With vaccination now underway for Manitoba’s PCH residents, we are reviewing plans to ensure we include new admissions or re-admissions to PCH within our immunization schedules," the provincial spokesperson said.

In other words, there is no plan. If they had one, they would make it public.

The province continues to blame the recent Pfizer shipment delays for many of its vaccine-rollout troubles. However, this has nothing to do with delivery schedules. The oversight is another example of poor planning.

All jurisdictions were aware last summer that vaccines could be approved for emergency use as early as the end of 2020. A vaccine team, led by someone experienced in large-scale logistical planning, should have had detailed plans months ago.

Instead, the province is making decisions on the fly, without experienced leadership. (Doctors who specialize in public health and government bureaucrats whose jobs normally include drafting budgets do not necessarily have backgrounds in logistical planning).

"With vaccination now underway for Manitoba’s PCH residents, we are reviewing plans to ensure we include new admissions or re–admissions to PCH within our immunization schedules." –Provincial spokesperson

What Manitoba needs now are mobile vaccination teams that can do followup at long-term care homes to ensure all residents get timely first and second doses. Arranging for booster shots should not be left up to individual facilities, as the province has proposed. There is far too much room for error and neglect (given the track record of some nursing homes) to leave it in their hands.

Immunizing the most vulnerable as quickly as possible is the key to mitigating death and protecting hospital capacity. Nearly half of Manitobans who have died of COVID-19 were residents of care homes.

Premier Brian Pallister said last week he hopes the media doesn’t focus on every "hiccup" of his government’s immunization plan. This isn’t a hiccup; it’s a major blunder that could cost lives. It needs to be rectified immediately.

tom.brodbeck@freepress.mb.ca