Extending second COVID vaccine dose by four months means enough for single-shot for all by June: Sask.

A nurse draws a dose from a vaccine vial in Prince Albert. Photo courtesy SHA.

The Saskatchewan government is applauding a national decision to recommend spacing out first and second doses of COVID-19 vaccines by four months.

The recommendation allows more residents to receive the first dose of any of the three available vaccines in Canada, giving more people more protection from the virus, before second doses are distributed.

The recommendation comes as evidence from other jurisdictions shows immunity from a single dose extending into four months. Saskatchewan had hinted early this week they would move to a 16-week gap between doses. On Thursday, they announced they would be adopting that recommendation, which would allow every resident over the age of 18 who wants a vaccine to receive one by June, three months ahead of what was originally anticipated.

While there may be some residual risk with extending the second dose, the benefits are anomalous,” said Chief Medical Health Officer Dr. Saqib Shahab.

“The fact that we can provide population-level protection within three to four months is huge. A vaccine in the arm is better than no vaccine.”

Shahab said he and his colleagues from across Canada will monitor the longer gap in vaccine dosages to ensure that no difficulties arise. If any do, the plan will be adjusted again. Early results from BC, the UK, Quebec and Israel show few downsides to delaying the second dose.

“While studies have not yet collected four months of data on vaccine effectiveness after the first dose, the first two months of real word effectiveness are showing sustained high levels of protection,” wrote Canada’s National Advisory Committee on Immunization (NACI), which provides advice on immunization to jurisdictions across Canada.

“Extending the dose interval to four months allows NACI to create opportunities for protection of the entire adult population within a short timeframe. This will not only achieve protection of the adult population, but will also contribute to health equity.”

Saskatchewan Health Authority (SHA) CEO Scott Livingstone said that in jurisdictions around the world further along than Saskatchewan in their vaccination campaigns, cases have plummeted “dramatically” since inoculation began.

He said that phase one should be “substantially” complete by April. That includes the vaccination of frontline health care workers, residents over the age of 70 and long-term care home residents and staff.

Phase two, which will be the vaccinations for the rest of the province, will then begin with an age-based priority sequence. The province said Thursday that all residents over the age of 50 who want a vaccine should be able to get one by May, with the rest of the adult population eligible by June. The initial estimation didn’t have the entire population receiving the first dose of a vaccine until September.

‘The next three months are really important,” Shahab said, “that we all maintain public health measures … and all step forward to be vaccinated.”

He said that if vaccination uptake remains high — 91 per cent of long-term care residents opted to receive a vaccine — the majority of the population should be somewhat protected from COVID-19 in time for summer, meaning more restrictions can be lifted.

It’s too early to tell, though what that looks like.

“We would like to think we emerge from the pandemic in the fall or even late summer,” Shahab said, though that’s reliant on lots of vaccinations and few COVID-19 cases.

“Twelve months ago we did knot know when the pandemic would end. We are looking at 12 weeks and we can start coming out.”

Shahab said some experts last year estimated it would take 24 months for Saskatchewan to emerge on the other side of COVID.

What that emergence looks like, though, is anyone’s guess.

It will rely on the length of immunity from vaccines, the presence and spread of variants and whether COVID-19 will disappear off the map, or continue in little pockets going forward.

“Over the long run, these questions will have to be looked at,” Shahab said. “It’s really important to accept the vaccine that’s offered.”

While the ability to offer the vast majority of the population a first dose before completing second doses is being welcomed by health officials, they’re warning that the new direction will cause a few short-term delays. The booking system, Livingstone explained, was designed for the previous four-week vaccine interval and will have to be updated. He also said the news that the province will receive 15,000 doses of the AstraZeneca vaccine is also a wrinkle. That vaccine has not been recommended for use in adults aged 65 and over. Instead, it will be offered to frontline health care workers and residents in the 60-64 age group ahead of when they would have originally been able to get vaccinated under the Pfizer and Moderna vaccine sequencing.

Livingstone, though, said those disruptions will be minimal. He said the online booking and phone booking systems are about ready to go and have been set up separate from the 811 health information and testing line.

Meanwhile, health officials have begun calling older adults who live independently. Over 4,000 Pfizer doses arrived in Prince Albert, with clinics starting yesterday.

Saskatchewan announced Tuesday that all long-term care homes had received a first dose of vaccine.

While most residents will now have to wait four months to get their second shot, long-term and personal residents and staff and people who have already booked a second shot will be exempt from the new timetable.

The AstraZeneca vaccine will be distributed starting March 22, starting with six major hubs throughout the province. All doses are expected to be delivered within one week on a by-appointment basis. Health care workers will receive notifications directly from the SHA, while Eligible members of the public will be able to book by phone.

Details on how to book an appointment through the phone and online booking system will be announced early next week.

The province also expects the supply of vaccines to keep picking up as currently approved products arrive in greater numbers and pending vaccines complete testing and are approved.

‘Vaccines will be coming through fast and furious,” Shahab said.

Livingstone emphasized that it’s still important to follow health restrictions while vaccinations roll out.

“It’s a race against time. The vaccine has given us a definitive tool in our toolbox that will get us out of this.”

Residents shouldn’t be picky about what vaccine they receive, he said, or when they receive it.

“The real-world evidence is speaking to us,” Livingstone said.

“The right vaccine is the vaccine that’s in front of you.”