Alberta professor running COVID-19 study says ‘normal’ is far off, multiple steps ahead of vaccination

There are still multiple steps to go through before Canadians will be vaccinated against COVID-19, according to a researcher from the University of Alberta involved in a study on Canada’s rapid response to the virus, including potential vaccines and how they would be distributed.

Shannon MacDonald, an assistant professor in the Faculty of Nursing, is leading a team that will survey Canadians on who they think should get the COVID-19 vaccination first, such as health-care workers and people in long-term care homes. Before that survey is launched, Canada’s National Advisory Committee on Immunization (NACI) will release its own list of priority recipients that the survey will be based on.

“Our survey will ask people in the prioritized groups whether they even want to get the vaccine first,” MacDonald said. “If you plan to give it to X group first, but X group has no intention of getting it, then your plan is not going to unfold how you anticipate.“

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However, MacDonald says determining who would get the vaccination is just the first of many steps that need to happen in Canada for a large-scale program to successfully beat the COVID-19 pandemic.

She said it’s expected a vaccine could be available by next summer, but supply may be limited and it could take months before things go back to “normal.”

MacDonald says there are still at least five other steps ahead, the first of which is finding a vaccine that works.

According to the World Health Organization, there are at least 45 vaccine candidates in clinical evaluation stage and hundreds more in development.

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However, MacDonald says there are many other factors to consider when it comes to a vaccination once it moves from clinical to real world.

“Many factors can impact real-world effectiveness,” she said. “For example, if it ends up being a two-dose vaccine and you get only one, or you get them too close together or too far apart.”

Secondly, she says the government will need to guarantee supplies of the vaccine.

Canada has committed over $1 billion into purchasing deals with pharmaceutical companies, as well as $440 million to the COVAX initiative, an international program that aims to distribute the vaccine around the world no matter which country has the breakthrough.

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MacDonald also says that Canada needs to set national priorities that are released to the public for the vaccination distribution.

She says this is important in case the vaccine that comes out first is less effective for certain groups, such as seniors.

“We may pivot and instead protect everybody who makes contact with the elderly, such as long-term care workers and household contacts,” MacDonald said.

She added that health officials need to be clear in the priority list, so situations like when the Calgary Flames received H1N1 vaccinations ahead of priority groups in 2009 can be avoided.

U of A nursing professor Shannon MacDonald.
U of A nursing professor Shannon MacDonald. Courtesy / University of Alberta

MacDonald says the fourth thing that needs to happen for a successful vaccination program is for Canada to set up a safety system to monitor the vaccine. The hard part about that is that each province has its own health-care system.

“The fact that we don’t have a national immunization registry has been the bane of our existence for decades because we can’t easily link data from different provinces to look for issues with safety or effectiveness,” MacDonald said.

MacDonald will co-lead a team of researchers from the provinces through the Canadian Immunization Research Network.

“We are currently exploring ways to pool efforts and data to ensure a more unified approach to vaccine safety evaluation once COVID vaccines are released to the public,” MacDonald said. “It is a great opportunity to join forces to ensure optimal vaccine safety monitoring.”

Lastly, she says one major hurdle is convincing people to get the vaccination at all.

Recent test numbers from the Angus Reid Institute indicate only 39 per cent of Canadians would be willing to get the vaccine as soon as it is available. However, MacDonald said that data is hard to interpret when there’s no actual vaccination.

“With questions about COVID vaccine intention, you’re asking about something that doesn’t even exist yet, so what are you really measuring?

“It’s more about media coverage than anything concrete.”

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She said the Canadian government needs to look at informational campaigns around a vaccine once it is launched.

“Public health’s job is not to sell a vaccine but rather to support people in making the decision to get vaccinated—really communicating that this is a dangerous disease that has put our lives on hold and if we want to get back to our everyday lives and protect the vulnerable in our population, it’s the right thing to do.”

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