Manitoba’s public health officials could keep waiting for more data to decide if they should delay giving out second doses of the COVID-19 vaccine. Or, they could follow the lead of other provinces, which have decided there's enough evidence that shows delaying doses saves lives and reduces hospitalizations.
Dr. Joss Reimer, medical lead on the province's vaccine committee, said Wednesday Manitoba is still reviewing the scientific evidence to decide whether delaying second doses beyond the manufacturer's recommended 21 to 28 days would protect more Manitobans from the disease.
Manitoba has resisted the move, suggesting it would be unsafe to go "off-label." Provincial officials have said repeatedly they would not compromise "safety for speed," preferring instead to fully vaccinate as many people as possible with both doses.
Delaying second doses would allow more people to get vaccinated with one shot sooner.
At least five provincial governments have expedited vaccinations by delaying second doses.
Quebec led the way in December when it announced second-dose intervals would be extended up to 90 days. British Columbia has been delaying second doses since January, citing evidence from around the world (and more recently from Quebec) that first doses of the Pfizer-BioNTech and Moderna vaccines provide over 90 per cent protection after two weeks. Ontario, Saskatchewan and New Brunswick are also delaying second doses.
Reimer, for the first time this week, appeared open to making the shift.
"Right now, this is being reviewed in all provinces and territories and at the national level by the national advisory committee on immunization and the Public Health Agency of Canada," she said.
That’s a bit misleading. Other provinces may be reviewing new data as it becomes available, but most of the country is already extending second-dose intervals, particularly in the face of limited vaccine supply.
"As we’ve said all along, we will shift our approach if the evidence shows us that that’s the best direction to go," she said.
That's not quite what they've said in the past, but it does appear they're now open to the change.
In a perfect world, the province would have the luxury of taking all the time it needs to review mountains of data. But in the midst of a pandemic, in which people are dying and where more contagious variants are circulating, time is of the essence.
No one is asking the province to be reckless or compromise safety when it comes to immunizing people. Nor is anyone suggesting second doses be eliminated altogether.
Rather, there is convincing evidence from around the world (supported by the World Health Organization, the U.S. Centres for Disease Control and Prevention and Canada’s national advisory committee on immunization) that first doses provide high levels of protection, and second doses can be delayed.
Manitoba already has anecdotal evidence from personal care homes, where most residents have received at least one dose of the vaccine. It’s led to a drastic decline in outbreaks, said Reimer.
Part of that is because of lower cases overall in the province, but first doses of the vaccine are likely a factor, she said.
"What they’re telling us is that it seems that the residents are experiencing less severe symptoms than they had seen in previous outbreaks," said Reimer. "They feel that fewer of (them) are becoming very ill, fewer are dying and fewer are ending up in hospital."
As of Feb. 17, only 106 Manitobans had tested positive for COVID-19 after receiving one dose (among 35,009 immunized, or 0.3 per cent), Manitoba Health said.
This is not just about reducing severe illnesses and deaths (although it is the primary consideration). It’s also about doing everything possible to reopen more of the economy sooner. Many businesses and not-for-profits are on the brink of bankruptcy.
Stepping up the province's immunization strategy would help mitigate that.
Manitoba can’t wait much longer. It’s time to make a decision.
Tom has been covering Manitoba politics since the early 1990s and joined the Winnipeg Free Press news team in 2019.