VANCOUVER -- British Columbia is keeping up with vaccination supplies from the federal government, but an increasingly complex rollout program has slowed the process and cost standby appointment opportunities, with more pressure to come on the system.

While the health minister often repeats the claim that B.C.’s vaccination process is only slowed by the availability of vaccine, one of the province’s leading experts in operations and logistics characterizes it a little differently.

“Given the current supplies, we are OK for our throughput (or progress) and we will meet our target for June 30,” said UBC Sauder School of Business professor Mahesh Nagarajan. “We can do more, I know that, but there are a few complicating issues — it is not simply how many vaccinations can a vaccination centre do, how many appointments can we take in.”

Right now, B.C. has an increasingly complex vaccination program. The initial rollout saw health-care workers in the most dangerous settings, care home residents and workers all get their shots, which was then expanded by age with the oldest having top priority. At the same time, some vaccines were rationed for use in outbreak locations, which has continued along with special allowances for certain serious medical conditions.

Essential workers were briefly prioritized, but when AstraZeneca was restricted for use only in those 55-64 it got even more complicated. Add to that the reality a growing number of people will soon come due for their second shot, and the fact there’s a centralized website and phone number to book doesn’t come close to addressing the complexities of the vaccination rollout.

“We have a fairly heterogenous system of vaccination and that can cause some variability and that dampens some of the effect to vaccinate more,” said Nagarajan. “Even though though we can vaccinate 40,000 per day, when you have these different streams of people booking and different allotments that can be made, that causes some inefficiency. I fully anticipate that’s going to get smoothed out.”

But he also pointed out there will be “huge pressure” to get the second, booster shot into as many people as possible, with variants thriving and throwing the efficacy of a single shot into question; as the United States starts to reopen and their economy starts to pick up, Canadian provinces will be scrambling to avoid being left behind.

Strong words but few details

Late Thursday, the federal procurement minister acknowledged that Moderna vaccine supplies would be halved with questionable reliability going forward, but Friday morning the prime minister announced a deal to double the amount of Pfizer doses coming instead.

Pfizer has been the backbone of Canada’s vaccination plan, with the majority of doses coming from that company, but Adrian Dix was cool to the feds’ solution for the shortfall.

“We’ve been talking about deferral of vaccine right now for April, and getting more vaccine in June and that sounds good at press conferences and of course we’d like it in June and we’d like it in May, but we’d really like it now,” said the health minister “If we had a million more doses from the federal government, we’d distribute those into people’s arms. We have very significant capacity, what we don’t have yet is enough vaccine.”

Several observers have noted B.C. is keeping track or slightly ahead of other provinces in the amount of vaccine it's distributed from supplies provided by the federal government.

But Nagarajan also points out the province’s current technology and complex vaccination streams make it difficult to offer standby vaccinations for appointments that are never filled or use the appointment of a no-show; the province hasn’t disclosed the vacancy rate despite weeks of repeated requests from CTV News.

“When you have a very clunky front end — heterogeneous booking, plus you don’t have a robust appointment system that can point back and put other people in priority — this is going to happen,” he said. “We will have to smooth out our appointment systems and our booking systems — not even the wastage, just our regular appointment systems to be more robust before we can actually do some of these things (like standby lists).”

Pfizer seeks teen approval

These developments come as Pfizer makes an application to Health Canada for approval to administer their COVID-19 vaccine to children as young as 12 years old.

“The Department is currently reviewing this submission,” they tweeted earlier today.

Two weeks ago, the pharmaceutical company had announced its vaccine was effective and safe in children, raising the possibility that students could be vaccinated before returning to school. While children themselves have not been seriously ill with COVID-19 and few require hospitalization, many experts point out they can carry and transmit the virus to others, including their parents, who can become seriously ill.

The prospect of vaccinating teens before they head back to school in the fall adds yet another layer of complexity onto the province’s rollout plan,

Following in Ontario’s footsteps?

Like Ontario, British Columbia has sought to keep as many businesses open as possible through the pandemic in the name of the provinces’ economic health.

But on Friday, Premier Doug Ford acknowledged their strategy of vaccinating their way out of the third wave won’t work, admitting: “We're losing the battle between the variants and vaccines.”

And while he blamed the federal government for not acquiring enough vaccines to do that, Ford’s government also downplayed or ignored the advice of experts and doctors urging him to take proactive measures to limit opportunities to spread the virus.

Calls are growing to not just extend, but expand the restrictions that have so far seen a modest reduction in case rates that may or may not indicate a plateau or bending of the epidemic curve in B.C.

In the meantime, help is unlikely to come from other parts of the country, though the suggestion has been made that vaccine supplies can be diverted from provinces where COVID case counts are low in favour of cities where infections are soaring.

“If we were to redirect a proportion of our vaccines, that would be a drop in the bucket for a province the size of Ontario or others,” said Nova Scotia Premier Iain Rankin, insisting he expected their fair share. “There is a myriad of different tools that provinces can use, the tools that we used very early on to suppress the spread of COVID-19, so we would expect other provinces to do that as well.” ​