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Manitoba will begin delaying second-dose appointments for COVID-19 vaccinations, a decision that follows emerging real-world science on lasting immunity from one dose, and one that will speed up the vaccination campaign in the province, officials said Wednesday.

Speaking during a press conference, Dr. Joss Reimer, medical lead of the vaccination implementation task force, said the province is comfortable delaying second doses up to four months but will continue to follow the science and guidelines set forth by the National Advisory Committee on Immunizations (NACI).

“These vaccines are providing a significant level of protection, even after one dose,” Reimer said. “This means there is more of a clear advantage of getting more vaccine to more people, sooner.”

The change comes after a similar one was made in B.C. earlier this week, and decisions made in other jurisdictions across the world. How quickly the pivot in the vaccination campaign will speed up the process in Manitoba has yet to be calculated. Task force officials said they would have a clearer picture in the coming days.

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The current recommendations by Pfizer and Moderna suggest a three-to-four-week interval between first and second doses, but study data in the United Kingdom and in Israel has shown effectiveness levels between 70-80% after one dose, along with a decline in severe outcomes, including hospitalization and death.

“We feel very comfortable with the data we have in front of us,” Reimer said.

The province will honour all existing second-dose appointments, Reimer said. The province lowered the age eligibility for general population immunizations to 89 and up on Wednesday (69 and up for First Nations people).

The province will now prioritize health-care workers who declined to get a vaccine earlier after doing a self-assessment to determine the intent of the former eligibility requirements.

“I want to encourage health-care provides, homecare workers, lab staff, correctional officers, staff in congregate living facilities — all of the groups who are now eligible — to do that assessment and then pick up a phone and make an appointment,” she said. “We want you all to be immunized.”

The key variable on quick immunizations remains vaccine supply. So far, more than 80,000 doses have been given to Manitobans, including more than 50,000 first doses.

The province is expecting the recently-approved AstraZeneca (AZ) vaccine to arrive in the province in mid-March, although total numbers and an exact date of arrival remain unknown, task force members said during a technical briefing earlier on Wednesday.

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When it does arrive in the province — the first shipment of the vaccine arrived in Canada on Wednesday morning — AZ will be distributed to doctors and pharmacies and will first be used to vaccinate Manitobans aged 50 to 64, beginning with those who are at higher risk, including those with liver failure, people who are on dialysis, along with other factors the province is continuing to determine. The AZ vaccine is not currently recommended for those 65 and over.

The vaccine doesn’t require the same ultra-cold storage requirements as the Pfizer and Moderna vaccines. For the AZ vaccine, storage temperatures are recommended between 2 C and 8 C, which is more typical of other vaccines, including flu vaccines. The AZ vaccine also has a different timeframe between its first and second doses, with four weeks being the minimum and 12 weeks being the preferred gap between doses.

Meanwhile, Reimer said the best vaccine for Manitobans is the first vaccine that is offered to them.

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In an effort to quell concerns regarding the effectiveness of the AZ vaccine — a DNA vaccine, as opposed to the mRNA vaccines of Pfizer and Moderna — officials said while clinical trials of the latest approved vaccine showed moderate efficacy rates (around 60%), subsequent analysis has shown that the 12-week interval between the first and second doses resulted in effectiveness above 80%.

Dr. Tim Hilderman, Manitoba’s Medical Officer of Health, Vaccines, said the discrepancy between clinical trials and real-world effectiveness comes down to the way in which the trials were held. In some cases, Hilderman said, the AZ vaccine has been more effective in curbing hospitalizations and death than the Pfizer variant.

“What I’m trying to drive home here is it is less about the exact number and more about the overall effectiveness, which appears to be high and higher than expected for all of these,” he said.

An mRNA (messenger RNA) carries instructions that prompt the immune system to produce a spike protein, which then stimulates the immune system to provide protection.

A DNA (viral vector) works differently in that it’s an inactivated virus that can’t replicate inside a person, but can effectively attach and discharge the DNA into the cell, which then turns into mRNA and then stimulates the immune system.

All vaccines approved for use are effective in preventing you from getting COVID-19, and in reducing the seriousness of your symptoms, the task force said.

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“The bottom line is, all of these approved vaccines have exceeded the threshold for safety and effectiveness against COVID-19,” Hilderman said.

Furthermore, being immunized with one type of vaccine now will not prevent you from getting another type of COVID-19 vaccine in the future, when supplies are greater.

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FEWER DOES EXPECTED IN SECOND QUARTER

Health Minister Heather Stefanson said the province will be getting around 130,000 fewer doses of both the Pfizer and Moderna vaccine.

During a scrum at the Manitoba Legislature on Wednesday, Stefanson said the province believed it was getting Option 4 when it comes to the allotment in the second quarter of this year. The number, which is based on per capita adjusted for 85% Indigenous population and 60-79 years of age, meaning 960,959 doses would arrive during that span.

Instead, Stefanson said the province would be getting Option 1, which is only based on per capita and totals 832,820 doses, a reduction of 128,132 doses.

“We have some serious problems about how they went about doing this,” Stefanson said. “We really didn’t have an opportunity to have a say on that… we’ve been in contact with Ottawa to let them know that.”

Stefanson feels the province should be getting vaccines based on priority, which includes having a disproportionately higher Indigenous population.

This does not apply to the recently-approved AstraZeneca vaccine, Stefanson confirmed.

[email protected]

Twitter: @scottbilleck

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