Targets, timeline and strategy: What we know about B.C.'s vaccination program

If you're a British Columbian in good health between 20 and 60, when can you expect to receive the COVID-19 vaccine? 

How long will you have to wait for your second dose? 

And when might things return to "normal"?

The answers to those questions aren't known yet, won't be until February or March at the earliest, and weren't announced on Wednesday when the province said Dr. Penny Ballem, the chair of Vancouver Coastal Health, was their new lead on vaccination efforts. While the federal government announced Tuesday the order of another 20 million doses of the Pfizer-BioNTech COVID-19 vaccine, those won't start arriving until April or May.  

But here's what we can say at the moment. 

Timeline until March clear

By day's end on Jan. 11, B.C. had given vaccinations to 62,294 people, representing 88 per cent of the doses received by the province. It then slowed its pace slightly to await more doses.    

The federal government has released its allocation forecast until the end of February for both the Pfizer-BioNTech and Moderna vaccines, showing B.C. will receive an estimated 433,875 in shots by then. 

By the end of March, B.C. expects to receive 792,000 vaccinations in total — and approximately 243,000 people will have received two doses. 

That's because B.C. has decided to delay the second dose to 35 days after the first one, rather than the 21 to 28 days recommended by Pfizer and Moderna.

The gap has been approved by the World Health Organization and federal government, and B.C.'s Provincial Health Officer Dr. Bonnie Henry said it's designed to get a first dose of the vaccine to enough vulnerable people while transmission is still high. 

It means that the province is on target to give a vaccination shot to every resident and staff member of a long-term care or assisted living home by the end of February. The province may reduce the gap between vaccinations once supply increases. 

Vaccinations are also being given to essential visitors in long-term care homes, other health care workers, and people in remote First Nation communities, but a more detailed plan for the broader population is expected to be released later this month.  

The province hopes to be vaccinating nearly half a million people per week by July and achieving herd immunity by September, but both of those goals will require a supply of vaccines which is not yet guaranteed.  

Lower deaths first, then overall transmission

Dr. Caroline Colijn, an infectious diseases specialist at Simon Fraser University in Burnaby, said the province's strategy is designed to reduce deaths first, and reduce community transmission later. 

"The optimal strategy depends on what you're optimizing for," she said.

"If you want to reopen the soonest, then you need to find the transmitters: the people who can't distance, the people who are working and at risk of both exposure and transmission. But if you want to focus on preventing severe outcomes and you think you can keep transmission at bay through other means, then you want to identify everyone really vulnerable to hospitalization and death."  

Colijn said given the fact nearly two-thirds of the province's deaths have been in long-term care homes, it's reasonable to believe deaths could fall by around the same amount over the next two months.

But she said that assumes the vaccine will be efficient in the very elderly, or in preventing transmission from people who aren't showing symptoms, something that was not tested in trials. 

"I totally trust the trial data that I've seen. It's more about what you can measure in a trial and what you can't," she said.

What comes next?

Over the next two months, Colijn says a number of aspects of B.C.'s vaccination timeline will become clearer. 

Much of that will have to do with whether the AstraZeneca and Janssen vaccines — currently under review by Health Canada — are approved, hypothetically allowing for the majority of people to be vaccinated in the spring or early summer. 

Another part will be whether active cases continue to decrease, or whether an increase in transmission — whether from the B117 strain first detected in the United Kingdom or another factor — requires a change in strategy. 

And perhaps most importantly for British Columbians, the province is expected to release a more detailed timeline for when and how residents can expect to receive a vaccination, something the opposition B.C. Liberal Party has made a priority. 

"People want to know when is it going to be their turn? Who contacts me or do I keep calling a number? That level of detail should be readily available and will really help to quell a lot of anxiety," said Liberal health critic Renee Merrifield.

"People want to know when are we going to have our sacrifices mean something and our lives resume? And the vaccine plan gives people a goal, gives people an idea of when that's going to happen. And I think that's the least the government can do at this point."