NWT speeds up vaccinations for long-term care homes

The Northwest Territories will now move to vaccinate long-term care home occupants and staff against Covid-19 in the next two weeks, ahead of its initial vaccine rollout schedule.

While vaccination for most high-priority groups will begin in the week of January 11, NWT care homes can expect vaccinations to take place in the coming days, officials said on Wednesday.

Yellowknife’s Avens facility and Hay River’s Woodland Manor are among seven long-term care homes to be prioritized.

“Some of our most vulnerable populations are long-term care residents and staff,” said Dr AnneMarie Pegg, the territorial medical director.

Pegg said staff were now discussing the vaccine with long-term care residents and their families to ensure informed consent can be provided.

“The actual administration of the vaccine is probably the least complicated part, but the communication component is incredibly important – potentially consenting to having a loved one vaccinated,” she said.

Dr Kami Kandola, the territory’s chief public health officer, stressed the NWT could not rush people into making decisions about vaccination.

“The NWT is in a better situation than most jurisdictions. We have no active cases, we have no community transmission, we’ve run close to 10,000 tests. Of all the people who can take the time to do a job well and allow family members to read the material and understand, we are the best-situated,” Kandola told reporters.

“If a family member felt rushed and they regret it, that would be on me and the system. They’ll get the vaccine but let’s please just take a day or two and talk to the family members so they know what the vaccine’s about.”

Language needs

Once vaccination is complete in care homes, other priority groups will be next: Elders, those with pre-existing medical conditions, essential workers, and residents of remote Indigenous communities.

There is no specific schedule for those vaccinations to take place, though many members of those groups will be vaccinated by the end of March.

The NWT has so far received 7,200 doses of Moderna’s Covid-19 vaccine – enough to vaccinate 3,600 people as two doses are required, four weeks apart.

A second shipment of doses is expected at the end of January.

Defending the territorial government against accusations it was moving too slowly with the vaccine now in its possession, Pegg said many factors had to be considered.

For example, she said, many members of priority groups speak a traditional language that isn’t English and need to be given information they can understand before vaccination goes ahead – but the exact information about this vaccine wasn’t finalized until last week.

Where possible, interpretation services will be provided so Elders who speak a specific language can have their questions answered prior to receiving the vaccine.

“Yes, we’ve known about the vaccine arrival for months. While some aspects of planning can be done well in advance, others required us to have a clear idea of which vaccine we were receiving and the quantities,” Pegg said.

“We need to ensure communities and individuals have the information they need to make an informed decision. We need to ensure people trust not only the vaccine but the process by which it will be administered.”

Vaccine hesitancy

Kandola spent time appealing for residents to consider the scientific evidence that has declared the vaccine safe and effective. She said anyone with concerns should approach her office directly.

“Health Canada has independently reviewed the evidence and felt the vaccine is safe. What we need is for people to be able to communicate their concerns, provide them the information we have, and have an ongoing dialogue,” said the chief public health officer.

“We know the vaccine will save lives, especially in priority populations.”

Ultimately, Kandola said, the NWT hopes to immunize 70 percent of its eligible population in a bid to create herd immunity from the virus. Among the most vulnerable residents, she said, the aim was to immunize “every single one of them.”

“I get where people are coming from,” she said, referring to residents who have expressed doubt about the vaccine, “but it has gone through all the required clinical trials and independent review. I’m pretty confident this vaccine is going to work and most of all, we want to protect people from the severe consequences of Covid-19.”

Kandola said she herself did not fall into any of the priority groups and would be “waiting in March just like the rest of the general population.” Residents without any priority will be waiting for at least three more months to receive the vaccine.

She said politicians in the NWT would have the same test applied: if they fell into a priority group they would receive the vaccine soon, but otherwise there would be no preferential treatment.

Sending the right quantity

Publication of the NWT’s vaccine rollout plan, initially expected in December, is now due to take place next week.

Pegg said the biggest challenge was establishing exactly how much vaccine must be sent to each community to allow for vaccination of high-priority residents.

The vaccine must be kept at a temperature between -15C and -25C throughout its journey to its final destination. Once defrosted, it can be stored at 2C to 8C for up to 30 days but can’t be refrozen.

At room temperature, the vaccine can remain in a vial for 12 hours. Once the vial is opened, it must be used within six hours.

If at any point in its journey the vaccine ends up at the wrong temperature, it has to be thrown away.

So far, the NWT’s health authority has hired or redeployed 18 logistics workers and 43 nurses to help administer the vaccine and ensure the so-called “cold chain” is not broken, Pegg told reporters.

“We need to ensure we send the right amount of vaccine into each community: not too much, not too little,” she said.

Each time staff head to a community with the vaccine, she added, they must “send the right amount of vaccine and clearly communicate who, where, and when people will be vaccinated,” factoring in the logistics of travel to remote communities.

Staff had worked through the holiday season to figure out the fine detail of that operation, she said. At a meeting immediately before speaking with journalists, Pegg had been working on dates to reach each community.

“We are working really closely with communities to look at what will work for them and how we can get the vaccine out, particularly for priority populations … in a timely manner,” she said.

“Prioritization is based on likelihood of severe outcomes and also geographic risk factors.”

Exact vaccination dates are not yet available.

“This is not a regular vaccine rollout. The logistics are more complex. We have been working on the logistics for months and are close to providing the general plan to the public,” said Pegg.