Everything you need to know about Nova Scotia’s Pfizer vaccine rollout

The Pfizer vaccine arrived in Nova Scotia on December 15, one day after it arrived in Canada from its production facility in Michigan, and the day before the first vaccine is set to be given in the province.

Gary O’Toole, senior director of population and public health with the NSHA told reporters that there’s already a person identified to be the first recipient of the vaccine in Nova Scotia.

“Our clinic that’s open for health care workers tomorrow will run from 8am until about 6:30pm. We plan to vaccinate approximately 350 people in that group,” he said. But, “of course that will depend on uptake and how many people wish to have the vaccine.” If the uptake is high, O’Toole says the initial 1,950 doses the province received could be gone in three to four days.

The first group of health care workers were all contacted through their employer to book their vaccine clinic appointments via an online booking app. The appointments will take place at Dalhousie University where the vaccine is being stored in an ultra-low-temperature freezer at minus 70 degrees Celsius.

O’Toole says the NSHA still isn’t sure whether the vaccine rollout for the general public will use the same booking apps or different methods, but that “we have several months to make that happen.”

Dr. Gaynor Watson-Creed, the Nova Scotian deputy chief medical officer of health, says about 5,800 doses are expected in the province by the end of December. By the end of March, that number should be 150,000. But beyond that, it’s clear as mud.

“We’re really not able to plan into the second quarter of 2021 until we get more information from the federal government and the manufacturers as to what those numbers are,” says Watson-Creed.

The first shipment of 1,950 doses will go to 1,950 different health-care workers, but the province says for all subsequent shipments they “will be holding back 50 percent of the vaccine received in order to administer the second dose when it’s time.”

Watson-Creed called this a “conservative approach” to ensure people get fully immunized. It’s also part of the lengthy manufacturer’s directions from Pfizer and BioNTech. She says it’s not a major worry that the promised vaccine doses will be limited or cut off.

“I don’t at this time see that it’s a high risk,” she says. “Just simply for the fact that we have some fairly reliable assurances from the federal government now on how the vaccine is being distributed for each of the provinces and territories.”
After health-care workers are mostly vaccinated, the general directive is to move on to the elderly, especially those in long-term care homes. But the NSHA is still figuring out how to make that happen due to the regulations from Pfizer about temperature and movement. “At the present time we are limited by manufacturer requirements, and so product will not be distributed past the point of delivery, at least for the time being,” explained O’Toole.

The NSHA and government are also working on how to acquire more ultra-low temperature freezers, something in high demand right now as the vaccine can only be brought up to room temperature six hours before being administered. “There are plans underway to install ultra-low temperature freezers across the province to make sure that that storage capacity is available regionally in every part of the province,” says O’Toole, although exactly how many is still unclear.

O’Toole told reporters that the NSHA would be looking to give Nova Scotians “documentation of having received their two doses” of the vaccine, but that it may not be the vaccine passport some people are speculating about. “The idea of a passport that certifies somebody as immune currently is not on the table,” he says. But like many other vaccine specifics, the method to be used is still being sorted out.

The NSHA’s chief of the division of infectious diseases and senior medical director of COVID-19 planning and implementation Dr. Shelley McNeil told reporters the province will have other ways of tracking vaccine implementation.

“We do know who’s coming into the province, we collect that information through the safe arrival check-in when they come, and so that may be a way that we can coordinate a vaccine as that time,” McNeil says.

But because there’s no national vaccine registry in Canada, McNeil says provinces and territories “certainly will be doing their best do to that tracking back and forth as people travel.”

But there are no plans to make the vaccine mandatory for Nova Scotians, something McNeil says is rarely done. Because of that, there’s likely no end in sight for social distancing, mask-wearing, and sanitizing.

“We will expect people both in the general public and among health care workers to continue to follow all of the preventive measures that are in place now,” she says. “And that’s largely because we don’t have information yet about whether the vaccine will prevent people from getting asymptomatic or infection without symptoms that and may be still able to transmit the virus “

There’s also the question of whether the vaccine provides long-term immunity. “We don’t yet know how long the effectiveness lasts, we know that the vaccine was highly effective up to a couple of months after the second dose,” says McNeil.

“We’ll be following the people in the clinical trials to see how long the protection lasts and continuing to vaccinate new groups as we go,” added Watson-Creed, but she said it would be unlikely a health care worker receives a new, third dose of the vaccine before someone else received their initial dose.

Despite the unknowns, McNeil says currently “Enthusiasm for the vaccine is very high, we’re excited, most health care workers are quite excited to have the vaccine.”
To achieve the much-anticipated herd immunity, Watson-Creed says about 70 percent of the public would have to receive the vaccine. “The higher we are in that percentage of course the better. The idea is that the vaccine loses the opportunity to find people that it can infect. If you can imagine an infected person surrounded by 10 people and seven of them or more are protected by the vaccine, then in fact, the virus basically has nowhere to go to find a new host,” she says.

Currently, Nova Scotians are pretty pro-vaccine. “I think if our flu shot example is any indication this year we’ve had quite a high uptake of our influenza vaccines in the province of Nova Scotia,” adds Watson-Creed, estimating that number around 50 percent.

There are some high-risk groups who won’t be vaccinated right away, like people who are pregnant, breast-feeding, or those with MS, lupus, or other autoimmune conditions. “That’s really because the clinical trials that were done with this vaccine to look at its safety and how well it worked didn’t include any of those groups of people,” says McNeil.

Other groups, like international students and temporary foreign workers may be placed higher in the queue because of their status, but again, the exact details are still being worked out.

“As we get further and further into the immunization campaign in 2021, we will be looking at, who are those priority groups, those kind of populations at high risk for a multitude of reasons that we need to pay attention to,” says Watson-Creed.

But for everyone else, Watson-Creed says they will eventually be placed in the queue in order. “We are intending to get as much vaccine as will be needed for any Nova Scotian who wants to receive it,” she says.

It was not clear if residents of Nova Scotia who may not have full documentation or citizenship will be guaranteed inclusion in the rollout.
Like any other vaccine, Nova Scotians should ensure they’re healthy on the day of their appointment. “We would ask that people be well when they show up to the clinic. If they are experiencing symptoms of Covid or another respiratory illness, that they wait until those symptoms are resolved before they come for a vaccine,” Watson-Creed says.

Once other vaccines, like the Moderna vaccine (which is still completing its trials in order to be up for approval from Health Canada—but Watson-Creed estimates it will be by early January) come into play, the schedule will likely get even more complex.

“It doesn’t have quite the same requirements as the Pfizer vaccine does,” Watson-Creed said. “We will definitely be adding it into the mix to see if we can use that to sort of extend out to the populations of interest. But the details are still being worked out.”

And as the vaccine becomes more accessible among people in our province, city and our bubbles, Watson-Creed expects even more Nova Scotians to sign up once it’s available to them.

“I think what we’re seeing both in Nova Scotia and across the country is that upwards of 60 percent of Canadians are already interested in getting the vaccine,” she says. “I think that number will grow as the vaccine becomes available and as more and more people know people who have been vaccinated and it becomes a very tangible reality for them.”