Administering the Moderna Covid-19 vaccine to Elders in long-term care facilities and their support staff will begin within the next week, said senior health officials on Wednesday.
“When it comes to the highest of the highest risk (groups), especially Elders in long-term facilities or congregate settings, we will not wait until Jan. 11. We’re doing everything possible to get them vaccinated ahead of time,” said chief public health officer Dr. Kami Kandola in a video conference with reporters.
Kandola spoke just two days after the first shipment of the Moderna vaccine arrived in Yellowknife, of which 7,200 doses are being stored at Stanton Territorial Hospital.
Territorial medical director Dr. AnneMarie Pegg, who also spoke in the conference said the prioritization of Elders will be done to protect the most vulnerable residents from Covid-19.
Among the four groups prioritized to receive the vaccine in January and February, Elders will come first, individuals with high-risk health conditions will come second, front line health-care workers third and members of remote Indigenous communities will come fourth, Kandola explained.
During the week of Jan. 11, vaccination will proceed with other priority groups.
“We’ll have enough to vaccinate the priority populations in January (and) February and the remainder would be in middle of March for the first dose. The second dose will likely be will be followed 28 days later in April,” Kandola said.
Vaccine roll out complexities
Pegg responded to concerns expressed by members of the public as to why the GNWT didn’t have a plan to begin vaccinations immediately.
“This isn’t a regular vaccine roll out,” she said. “The logistics were more complex, they require more planning and thought and we’ve been working on the logistics for months.”
While some of the logistics were planned out already, health authorities only learned of the exact arrival date and quantities of the vaccine about one week ago.
One challenge is the transportation of the vaccine, as it is required to be stored at a temperature between -15 C and -25 C, or maintaining a “cold chain.” Once it’s defrosted it can be stored in temperatures of between 2 C and 8 C for 30 days but it can’t be refrozen.
After the vaccine vial is opened it must be used in six hours or it spoils.
“There is a limited supply of the vaccine and we need to ensure that we send the right amount of vaccine into each community. Not too much, not too little,” Pegg said.
“We have a plan to use it all to avoid waste. This may be the biggest challenge currently. In a normal vaccine campaign, we have enough vaccine to give it to anyone who wants it and qualifies for a shot. This vaccine is different. We’ll receive our Moderna allotment piece by piece, we will not have enough vaccines for all eligible persons to be vaccinated at the same time.”
Health-care providers must also receive training specific to the Moderna vaccine, such as learning how to maintain the correct temperature, appropriate documentation when delivering the vaccine and educating patients.
“We only received this information specific to the vaccine several days ago,” Pegg said. “And so training has now begun to ensure that vaccination staff are able not only to safely administer the vaccine, but to answer questions from Northerners about it.”
Pegg said the Northwest Territories Health and Social Services Authority has hired or redeployed 18 logistics staff and 43 nurses to ensure the cold chain is maintained.
Staffing has been scaled up as well and all health-care providers giving vaccinations need certification in the Education Program for Immunization Competency (EPIC), which many staff already have and others hired on must still receive it.
Another key aspect of the vaccination campaign is communication with residents to allow for informed consent on the vaccine.
“We can’t just show up and start vaccinating people without the proper information,” Kandola said, who gave the example of people who aren’t able to give informed consent due to certain conditions like Alzheimer’s.
“Then it’s the next of kin who need to be able to make that decision. All those conversations actually have to take place before we just start vaccinating high-risk Elders.”
Pegg said that process has already begun with residents of long-term care facilities, such as Aven’s Manor in Yellowknife, so that health-care providers can answer peoples’ questions on the vaccine, or provide information to families of residents who aren’t able to consent by themselves.
“The communication component is incredibly important. And we want to make sure that people feel that they’re getting the information before potentially consenting to have one of their loved ones vaccinated.”
Pegg provided a hypothetical scenario for visits by vaccination teams to communities in the territory.
A first visit would involve answering questions from community members and checking on the number of people to be vaccinated. A second visit would be to vaccinate high-priority members. Third visits would be for the second dose of the vaccine and to begin the first doses for others.
The process would be repeated until everyone is vaccinated.
Dedicated health-care teams that will go into communities will tally the number of people in need of vaccination so that the right amount of the vaccine is taken to the communities to ensure nothing is wasted.
Details such as whether residents would have to book appointments for their vaccinations or if they have go to a specific place for the vaccine are yet to determined.
Pegg said it’s likely that places such as school gyms or community centres would be designated as vaccination sites, such as how flu clinics were set up in the fall.