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B.C. stays the course as first-dose vaccinations plateau and COVID-19 cases creep up

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British Columbia’s health minister is staying the course as public health enters the most difficult phase of the vaccination effort, focussing efforts on ensuring everyone in the province has access to the vaccine, but not changing strategy as first doses plateau and new cases slowly creep back up

In a one-on-one interview with CTV News, Adrian Dix acknowledged that dose-one appointments have slowed down, but pointed out many communities are already nearing 90 per cent first-dose vaccination rates, while others have barely surpassed half the population with a first shot. He said he is focussed on raising vaccination rates in communities lagging behind, particularly in Interior Health, where cases are growing daily. 

"I don't want anyone in the province to feel like they haven't had access to the vaccine," said Dix, describing a slew of new mobile and pop-up clinic options outside Metro Vancouver but acknowledging many of those who remain unvaccinated will be tough to reach.

“It'll just be a grind,” he said. “It'll take us ‘til September to get from 82 to 85 (per cent)." 

The latest available data from the B.C. Centre for Disease Control shows that in June, 76 per cent of lab-confirmed COVID-19 cases were in unvaccinated people (predominantly in their 20s, with 10-19 and 30-39 close behind), while 22 per cent were among those who’d had just one dose of the vaccine. Only two per cent were in fully vaccinated people.

One of the province’s top infectious disease modellers is urging people to get vaccinated and encourage those in their lives to do the same. Sally Otto, a UBC biomathematics professor and an analyst for the BC COVID-19 Modelling Group, says the ultra-contagious Delta variant means 90 per cent vaccination is required for herd immunity to keep the virus from spreading.

"Right now, Delta is spreading so fast, and it can spread even among people that have been vaccinated, because vaccinated mainly you're protected against a severe infection and hospitalization," Otto said. “Globally, the only way to prevent the next variant is to reduce the case numbers so much the virus doesn’t have this huge capacity to explore evolutionary space in so many individuals.”

MORE OPTIONS FOR GETTING TO THE FINISH LINE

Otto called incentives a “great idea” and suggested that pharmacists be re-involved in the vaccination effort alongside doctors – who’ve never been involved in COVID-19 vaccination in B.C. – since they are trusted medical contacts for many people and could overcome barriers for those with distrust or fear or the medical system in general.

Family physicians, in particular, are keen to participate with the right tools and support from the province.

"It's always a compliment when someone comes to us as a trusted source of information,” said Dr. Eric Cadesky, a former president of the Doctors of BC.

“We always want to leverage the trusted relationships we have with our patients to give them the best information so they can make the best choices, and in this case the best choice for almost everyone is to get vaccinated." 

Several doctors have taken to social media to normalize discussions around vaccine hesitancy and make it be clear their offices are a private, judgement-free zone.

“Today I spent ~45 mins (with) a (patient) who was nervous and had questions about the COVID vaccine. It was a respectful dialogue,” tweeted Dr. Anna Wolak. “In the end, (patient) agreed to get vaxxed. (Their kids too!)”

Cadesky pointed out it’s a good idea to take advantage of positive conversations.

“It's important that we have the vaccine ready to go for people so that if they do decide to do it that we're able to act on that in the moment," he said.

HEALTH MINISTER RESPONDS

The health minister addressed these issues in detail and explained why the government hasn’t made any major changes to vaccine delivery in the province.

Doctors have been kept out of the vaccination system largely because of logistics, Dix said. Right now, incoming vaccine supply from the federal government is sent to vaccination centres in large quantities, where they can distribute a large number of vaccines in a centralized location.

Dix said it would typically be hard to book the Vancouver Convention Centre or Cloverdale Recreation Centre, so the province is taking advantage of the fact that they’re empty right now, but he expects to use family doctors soon.

"I think once we get past this main vaccination there'll be people who still need to get vaccinated in September, October, people turning 12, people arriving in B.C., other circumstances," said Dix. “In later phases, absolutely, and we're looking at that. Obviously we have to prepare – should it be necessary, for a potential third dose – so there's a lot of planning going on."

With a significant proportion of new infections among British Columbians who are only partially vaccinated and Delta surging in countries with lower vaccination rates than Canada, CTV News asked why the province wasn’t shortening the interval between doses from eight weeks to four, as provinces like Quebec have already done. 

"The view is the effect of the vaccine will be better and longer with a longer delay," said Dix.

Otto agreed keeping the longer interval is a smart move, even if it leaves people more vulnerable for an extra month.

“We’ve got to try it all (to get people vaccinated) and we're trying it all because it's really important to all of us,” Dix added.

In that vein, CTV News asked the minister if he’d try offering incentives – such as lotteries for cash and prizes – to try to entice people who may be hesitating due to convenience or who aren’t in a hurry to get the jab. 

While other jurisdictions have adopted these measures, Dix revealed his team has considered and dismissed the idea.

"Here's what I would say: the vaccine's a gift," said Dix. “I'm not sure that kind of incentive system is the most effective. There's always coffee and donuts and that sort of thing, which we have on some of our sites and great, but I'm not sure they help, what message they send.”

“I think the message should be, ‘This is something you can do to help your family, yourself, your community, your loved ones. It allows us to get back to our lives." 

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