COVID-19 vaccination in Quebec

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COVID-19 vaccination in Quebec
DateDecember 14, 2020 (2020-12-14) – present
LocationQuebec
Also known asCampagne de vaccination contre la COVID-19 au Québec (French)
CauseCOVID-19 pandemic in Quebec
Organized by- Health Canada
- Public Health Agency of Canada
- Quebec government
- Municipal government in Canada
ParticipantsAs of June 21, 2021:
7,386,401 doses administered [1]
1,439,014 second doses administered [2]
OutcomeAs of June 21, 2021:
70.3% of the population has received at least one dose of a vaccine[1]
80.3% of the population aged 12 and up has received at least one dose of a vaccine[1]
WebsiteGovernment of Quebec

The COVID-19 vaccination programme in Quebec (French: Campagne de vaccination contre la Covid-19 au Québec) is an ongoing provincial effort to distribute and administer the vaccine against COVID-19.

Timeline[edit]

2020[edit]

Total number of people receiving vaccinations in Quebec as of June 21, 2021

  Unvaccinated population: ~2,546,647 people (29.7%)
  Population who has received only one dose of a vaccine: 4,588,909 people (53.5%)
  Population who has been fully vaccinated (both doses): 1,439,014 people (16.8%)

In autumn of 2020, logistical preparations for the rollout of the vaccine began to be developed. Since Quebec would be receiving vaccine doses from the federal government, the Quebec government began to study several scenarios based on the quantity and type of vaccine received.[3] The city of Montreal, in particular, set to work on creating its own plan and administrative structures for the vaccination campaign in late November 2020.[4]

At the end of November 2020, the director of the Quebec vaccination campaign against COVID-19 was chosen: Jérôme Gagnon, an assistant deputy minister.[5] After undergoing health problems, he was replaced two weeks later by Daniel Paré, CEO of the Chaudière-Appalaches Centre intégré de santé et de services sociaux.[6]

In early December, in addition to health professionals who are already authorized to administer vaccines, the Quebec government added new categories of people who are authorized to administer the vaccine:[7]

  1. Students in programs that lead to a diploma in which they would be authorized to administer vaccines;
  2. Ambulance technicians and students training to be ambulance technicians;
  3. Holders of a medical degree from outside Canada;
  4. Professionals in physical health, once they have undergone some training, including acupuncturists, audiologists, chiropractors, etc.

On December 10, Premier François Legault indicated that by January 4, 2021, Quebec would receive 55,000 doses of the Pfizer-BioNTech vaccine.[8]

On December 13, not even a week after its approval by Health Canada,[9] the first shipment of Pfizer-BioNTech vaccines arrived in Canada at Mirabel airport.[10] Vaccination in Quebec started the next day, on December 14, with Gisèle Levesque, an 89-year-old resident of a long-term care home in Quebec City, being the first in the province and country to receive a vaccine.[11][12] The vaccination campaign was slow to start, with around 1,400 doses being given per day in the first two weeks for a total of less than 20,000 people vaccinated.[13]

On December 23, Health Canada approved the Moderna COVID-19 vaccine[14] and on December 30, Quebec received their first shipment. Due to its lower maintenance requirements in comparison with the Pfizer vaccine, the Moderna vaccine will be prioritized for use in remote regions.[15]

2021[edit]

In the last week of January 2021, Quebec did not receive any vaccine doses, as Pfizer had temporarily stopped deliveries to Canada while its factory was being retooled.[16][17]

On February 23, Premier Legault announced that vaccine reservations would become available on February 25 by phone or online for Quebecers aged 85 and older.[18][19]

On March 1, vaccination of the general population began, starting with people 80 years of age or older in Montreal.[20] The next day, Minister Christian Dubé confirmed that 350 pharmacies in Montreal would begin taking appointments for vaccinations on March 15. The Director of the Vaccination Campaign Against COVID-19 in Quebec (French: directeur de la campagne de vaccination contre la COVID-19 au Québec), Daniel Paré, revealed that since February 25, there had been over 350,000 vaccination reservations made online.[21]

By March 10, all Quebecers 70 years of age and older were able to book a vaccination appointment.[22]

On March 16, Premier Legault promised that by June 24 (Quebec's national holiday) all Quebecers who wish to be vaccinated would have at least their first dose.[23]

By March 18, over 10% of the Quebec population had received at least one dose.[24]

On March 22, pharmacies began administering shots.[25]

On March 26, Premier Legault received a dose of the Pfizer vaccine.[26]

On March 29, Canada's National Advisory Committee on Immunization (NACI) recommended that use of the Oxford-AstraZeneca vaccine be suspended for patients below the age of 55, as the risk of blood clots seemed to be higher in younger people.[27] As a precautionary measure, the Quebec government modified their strategy to comply with the new recommendations.[28]

Vaccination centre at Montreal's Olympic Stadium

By April 8, all Quebecers 60 years of age and older were able to book a vaccination appointment.[29]

By April 14, 25% of Quebecers had received at least one dose.[24]

On April 21, the minimum age for the AstraZeneca vaccine was lowered to 45 years old.[30] Despite concerns of vaccine hesistancy stemming from reports of rare blood clots linked to the AstraZeneca vaccine, which has led to slowed demand for the AstraZeneca vaccine in some other provinces,[31][32] long line-ups started to form before dawn at drop-in vaccation sites.[33] In Montreal, all available AstraZeneca doses were exhausted within two days, forcing the drop-in vaccination clinics to close.[34][35]

In the last week of April, two more priority groups became able to get vaccinated: people with a chronic illness or underlying health condition that increases their risk of COVID-19 complications,[36] and people with physical or intellectual disabilities, including those on the autism spectrum. This would allow for around 550,000 more people to get vaccinated.[37][38]

On April 27, businesses with enough capacity began opening up their facilities for mass vaccination, with Montreal-based CAE Inc. being the first to do so.[39] The same day, Quebec reported its first death from an adverse event following immunization — a 54-year-old woman from Montérégie who died of a thrombosis after receiving the AstraZeneca vaccine.[40]

On April 28, pregnant women became able to get vaccinated with one of the approved mRNA vaccines (Pfizer-BioNTech or Moderna).[41][42]

On April 29, the Quebec government announced its vaccine schedule for adults under 60 years old, who will be divided into seven groups spanning about five years, with vaccination of the final group beginning on May 14.[43]

On May 4, Quebec announced its first drive-thru vaccination clinic, located at the Pierre Elliot Trudeau International Airport in Montreal. It is slated for opening on May 17 and will be able to administer 4,000 doses per day once operational.[44]

On May 10, Marguerite Blais, the Minister Responsible for Seniors, announced that all CHSLD residents who had received a first dose of the vaccine have now been fully vaccinated with both doses.[45]

On May 13, the Quebec government announced the suspension of the AstraZeneca vaccine for first doses, citing the risk of post-vaccination embolic and thrombotic events in the current context of readily available mRNA vaccines (Pfizer and Moderna), which do not seem to pose the same risk. The move came after several other provinces, including Ontario and Alberta, announced similar suspensions. Consequently, the 148,000 doses of AstraZeneca arriving in the next week will be used as second doses for those over the age of 45 who have received the AstraZeneca vaccine as their first dose. However, for those under the age of 45, the CIQ recommends giving an mRNA vaccine as the second dose.[46][47]

By May 14, the vaccination campaign had expanded to all adults in Quebec.[43]

By May 19, 50% of Quebecers had received at least one dose.[24] The same day, Minister Dubé and Mayor Valérie Plante announced the opening of a vaccination clinic at the Circuit Gilles Villeneuve that will welcome both vehicles and cyclists, in light of the cancellation of the 2021 Canadian Grand Prix.[48]

On May 21, the vaccination campaign was expanded to children aged 12 to 17 years old.[49]

On May 27, Minister Dubé announced that the interval between the first and second dose of the AstraZeneca vaccine will be shortened to 8 weeks, as opposed to 16 weeks, following new recommendations from the CIQ. Consequently, anyone who had gotten their first dose before April 3 can now get their second dose.[50] In the next few days, some drop-in vaccination centres were overwhelmed with people seeking their second dose of AstraZeneca, resulting in many people having to be turned away.[51] Soon after, the minimum interval between the first and second doses for all vaccines was reduced to 8 weeks. As such, those in the 80-year-old and older age group were able to move up their appointment for their second dose starting on June 7. Over the next few weeks, all other age groups gradually became able to advance their second dose appointments.[52]

By June 6, over 75% of Quebecers aged 12 and up had received at least one dose of a vaccine.[24]

Approval and deployment of COVID-19 vaccines in Canada[edit]

Vial of the Moderna vaccine (10 doses of 0.5 mL) administered in a Quebec pharmacy
COVID-19 vaccines on order in Canada ()
Vaccine Progress Doses ordered Approval Deployment
Pfizer–BioNTech phase III clinical trials 51-76 million[53][54][55] Green check.svg 9 December 2020[56] Green check.svg 14 December 2020
Moderna phase III clinical trials 44 million[57] Green check.svg 23 December 2020[58] Green check.svg 31 December 2020
Oxford–AstraZeneca phase III clinical trials 23.9 million[59] Green check.svg 26 February 2021[60] Green check.svg 10 March 2021[61]
Janssen (Johnson & Johnson) phase III clinical trials 10-38 million Green check.svg 5 March 2021[62] Pending
Novavax phase III clinical trials up to 76 million Pending Pending
Medicago phase III clinical trials[63] up to 76 million Pending Pending
Sanofi–GSK phase III clinical trials up to 72 million Pending Pending


Dose Schedule[edit]

Towards the end of December 2020, the Quebec government had set aside 27,000 doses of the Pfizer vaccine so as to be able to administer second doses without delay, with Minister Dubé saying that this was a requirement from Pfizer. However, he added that he was in discussion with Quebec's public health agency, as well as with other provinces, to determine whether it would be possible to "force the hand of Pfizer in order to free up these doses" and thereby be able to vaccinate more people.[64]

In January 2021, the province announced its intentions to switch to a first-dose priority system, which would allow for the greatest number of people to receive a first-dose but which would delay administration of a second-dose to months after the first, as opposed to the three weeks recommended by Pfizer.[65] The Quebec government initially received criticism for this, with Supriya Sharma, Canada's Chief Medical Advisor to the Deputy Minister, stating that Quebec's calculations were done in a superficial manner and that this decision could have an effect on the delivery schedule for Pfizer-BioNTech and Moderna vaccines.[66] Indeed, on January 11, 2021, Premier Legault suggested that Pfizer might stop delivering vaccines to Quebec if the province does not comply with the recommended schedule. However, he affirmed that if such a situation arose, Quebec would modify their strategy to adhere to the recommended schedule.[67]

In March, the National Advisory Committee on Immunization modified its recommendations, confirming that the second dose can be administered up to four months after the first,[68][69] prompting other provinces, including British Columbia and Ontario, to start following the same strategy as Quebec. Given the recommendations, long-term care centre (French: centre d'hébergement et de soins de longue durée) residents and staff, who had begun to receive vaccinations in December of 2020, started receiving their second doses in early March 2021.[70] However, due to shipment delays of the Moderna vaccine, some residents who had received the Moderna vaccine as their first dose were administered a different vaccine for their second dose.[71] While the Comité sur l’immunisation du Québec (CIQ), a branch of the Institut national de santé publique du Québec (INSPQ), has recommended that both doses be given using the same vaccine, as there is a lack of data regarding the efficacy of mixing vaccines, they allow for flexibility in the context of a vaccine supply shortage. The CIQ thus suggests that in order to not delay the administration of a second dose any longer than necessary, a vaccine of a similar type to the first can be administered as the second (for example, a Moderna vaccine can be replaced with a Pfizer vaccine, since they are both mRNA vaccines).[72]

Towards the beginning of June, the interval between the first and second dose was reduced to 8 weeks.[52][50]

Priority groups[edit]

Official government categories[edit]

Sign at a vaccination site entrance in Montreal

In November 2020, the CIQ was asked to come up with a preliminary evaluation of which groups should be prioritized for vaccination.[73][74] Given the limited availability of vaccines, the CIQ based their evaluation on five values:

  1. Beneficence
  2. Equity
  3. Justice
  4. Reciprocity
  5. Non-maleficence

Based on these values, they proposed the following priority groups, in order of highest priority to lowest:[74][a]

Priority vaccination groups in Quebec
Priority group Description Start date
1 Vulnerable people and people with a significant loss of autonomy who live in residential and long-term care centres (CHSLDs) or in intermediate and family-type resources (RI‑RTFs). December 14, 2020[75]
2 Workers in the health and social services network who have contact with users. December 14, 2020[76]
3 Autonomous or semi-autonomous people who live in private seniors' homes (RPAs) or in certain closed residential facilities for older adults. December 15, 2020[24]
4 Isolated and remote communities. January 6, 2021[77][78]
5 People 80 years of age or older. March 1, 2021[79]
6 People 70 to 79 years of age. March 1, 2021[79]
7 People 60 to 69 years of age. March 22, 2021[80]
8 Adults under 60 years of age who have a chronic disease or health problem that increases the risk of complications of COVID‑19:[81][82]
  • People who are currently hospitalized with a condition that puts them at risk for complications from COVID-19.
  • People who require dialysis for kidney failure, grafting, cancer treatment, or some types of organ transplants.
  • People who must receive a vaccine under the supervision of an allergy specialist in a hospital setting.
April 14, 2021
Adults under 60 years of age who have a chronic disease or health problem that increases the risk of complications of COVID‑19, including but not limited to:[83] April 23, 2021
Adults under 60 years of age who have a chronic disease or health problem that increases the risk of complications of COVID‑19, including but not limited to:
  • People with a mobility or physical disability.
  • People with an intellectual disability (including speech, visual, and auditory disabilities).
  • People on the autism spectrum.
April 26, 2021[37]
9 Adults under 60 years of age who provide essential services and have contact with users. April 14, 2021[81]
10 People 50 to 59 years of age. April 30, 2021[84]
People 45 to 49 years of age. May 3, 2021[84]
People 40 to 44 years of age. May 5, 2021[84]
People 35 to 39 years of age. May 7, 2021[84]
People 30 to 34 years of age. May 10, 2021[84]
People 25 to 29 years of age. May 12, 2021[84]
People 18 to 24 years of age. May 14, 2021[84]
People 12 to 17 years of age. May 21, 2021[49]

Further vaccine trial data is required before the Quebec government can decide whether or when to vaccinate children under the age of 12.

Vaccination against COVID-19 is not mandatory in Quebec and the vaccines are free of charge for those who choose to take it.[85]

Other categories[edit]

Initially, in accordance with the precautionary principle, Quebec did not allow for the vaccination of pregnant women. However, in April 2021, calls for the vaccination of pregnant women, including from the Society of Obstetricians and Gynaecologists of Canada, began to increase.[86] Many gynecologists argued that pregnant women should be prioritized, as they are more likely to experience severe health complications after contracting COVID-19. They pointed to the situation in Toronto, wherein more than half of patients in intensive care in some hospitals are pregnant women.[87] In light of these recommendations, the Quebec government modified its position on April 28, allowing pregnant women to be vaccinated.[88]

According to some experts, Indigenous Canadians and prisoners should be considered as priority groups.[89]

Graphs[edit]

Daily doses[edit]

Total doses[edit]

Percentage of the population having received at least one dose[edit]

See also[edit]

Notes[edit]

  1. ^ Categories are not mutually exclusive

References[edit]

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