'Welcome news,' but vaccine won't mean immediate relief for strained Manitoba health-care system

Front-line health workers set to receive the first doses of the COVID-19 vaccine in Manitoba say not much will change in terms of the pressure on the health system — or the need for public health restrictions — until it becomes more widely available. 

"I think it would be a fairly modest impact," said Dr. Anand Kumar, an infectious disease expert and intensive care unit physician at Health Sciences Centre.

Earlier this week, the provincial government announced that around 900 critical-care workers would receive the province's initial doses of the Pfizer-BioNTech vaccine, the first to be approved in Canada. That rollout could start within the coming week.

That news came as a surprise to those health-care workers, said Kumar.

"I think we're all kind of disappointed that the first people that get it aren't going to be long-term care residents," he said.

The National Advisory Committee on Immunization had recommended residents and staff at long-term care facilities be first priority for the vaccines, followed by adults over 80 years old, front-line health-care workers, and people in remote Indigenous communities.

Some provinces, including Quebec and Prince Edward Island, have gone with the NACI recommendation and will immunize long-term care residents first. Others, such as Ontario and Alberta, are going in the same direction as Manitoba and vaccinating health-care workers. 

Ultra-cold challenges

Manitoba's decision has more to do with logistics than other considerations, the province's chief public health officer said Friday.

"One of the requirements of this initial [vaccine] shipment we're receiving ... is that it must be administered at the point of receipt," said Dr. Brent Roussin.

The Pfizer-BioNTech vaccine must be stored in freezers capable of maintaining temperatures as cold as –80 C. Few facilities outside of research-oriented hospitals have that capability, Kumar said.

"So there isn't an opportunity to take that to a personal care home," said Roussin, who added that long-term care residents will be high on the priority list as more doses become available. 

The president of the Manitoba Nurses Union says the vaccine approval is "welcome news," but many questions remain unanswered.

"The vaccine will provide some relief, and help ensure that these nurses are able to continue to provide the care that's so urgently needed," said Darlene Jackson in an email statement.

"It's still not clear which areas in critical care will be eligible, and what the criteria will be."

Government and senior health officials must provide clear communication and rationale to health-care professionals and the public as the rollout progresses, she said.

It will also be important for the government to consult with public health nurses, who have experience with past vaccination programs and knowledge of the community, said Dr. Cheryl Cusack, executive director of the Association of Regulated Nurses of Manitoba. 

"Right now, we are hearing some of the public health nurses feeling like their expertise could be better utilized," said Cusack.

Public health nurses want to be consulted

Public health nurses differ from other nursing specialties because they focus on the whole population, and work to reduce inequities in health-care access, she said. 

"Many have first-hand experience with vaccination clinics established during the H1N1 pandemic," said Jackson. 

"We're calling on government to consult with nurses, to ensure a smooth and efficient rollout for the benefit of all Manitobans."

As they begin vaccinating health workers, some might develop secondary symptoms indistinguishable from COVID-19, such as fever and muscle aches, Kumar said. Health officials must take care to avoid leaving the health system short-handed by staggering the rollout.

Until a wider swath of the population receives the vaccine, Manitobans must keep following public health orders, said Jackson.

"Stay home and don't socialize outside your household, even over Christmas," she said. "We all must stay vigilant to reduce the spread of COVID in our community."