In the immortal words of materialist philosopher Mike Tyson, “Everyone has a plan until they get punched in the mouth.”
Last fall, Canada entered the ring with what appeared to be a winning vaccination plan. The Trudeau government presented it as one of the world’s best. It involved buying vaccines from multiple companies, and hedging the nation’s bets by contracting for far more doses per capita than any other country. Canada expected to end the COVID-19 fight with arms raised, as a world vaccination champion.
That was the plan. It looked like a good plan.
But as soon as the bell rang, Canada got punched in the mouth – repeatedly. The country was hit with delayed deliveries, even as our peers saw production and shipments ramp up. The best-laid plans got clocked. Canada’s vaccination rate is near dead last in the developed world.
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This country started the week aiming to inoculate all adults by September; the United States, in contrast, was aiming to get the job done by July. On Tuesday, U.S. President Joe Biden said that coming increases in shipments from U.S. factories mean his country can get there in May.
As for Canada, we’ll cross the finish line, eventually. But the expected path of vaccine imports, combined with a lack of domestic production, puts us on a timetable for suppressing the virus and returning our economy to normal that is well behind the Americans, British and Europeans.
But what if Canada could nearly double its inoculation rate, without doubling the number of shots?
Quebec pointed the way in December. And British Columbia is now taking things even further.
On Monday, B.C. extended its gap between the first and second vaccine dose to four months. Dr. Bonnie Henry, the Provincial Health Officer, says this will allow the province to give all adults at least one shot by July, rather than the previous target of September.
Quebec began its inoculation campaign last year with a similar move, setting a three-month gap between the first and the second dose. And on Wednesday, the federal National Advisory Committee on Immunization recommended following B.C.’s lead, and moving to a four-month gap. By Wednesday evening, Newfoundland and Labrador and Alberta said they would do so, with other provinces expected to join them.
It means that Canada could get to herd immunity, and the end of the pandemic, two months faster than expected, even if vaccine doses arrive no faster than expected.
When Health Canada gave two vaccines the green light late last year, the recommended wait between the first and second jab was three weeks for the Pfizer vaccine, and four weeks for Moderna.
That was based on research trials by those companies, which were done on an accelerated basis, without time to test just how long first-dose protection lasts.
Since then, real-world evidence appears to show that the gap between first and second shots can be extended, with little or no loss of protection.
In a recent letter in The New England Journal of Medicine, Dr. Danuta Skowronski and Dr. Gaston De Serres – the former a researcher at the BC Centre for Disease Control and the latter at Quebec’s Institut national de santé publique – made the case.
“There may be uncertainty about the duration of protection with a single dose,” they wrote, “but the administration of a second dose within one month after the first, as recommended, provides little added benefit in the short term, while high-risk persons who could have received a first dose with that vaccine supply are left completely unprotected.
“Given the current vaccine shortage, postponement of the second dose is a matter of national security that, if ignored, will certainly result in thousands of Covid-19-related hospitalizations and deaths… hospitalizations and deaths that would have been prevented with a first dose of vaccine.”
Is this change in strategy one of expediency? Of course it is – and that’s not a criticism. As one of Mr. Tyson’s philosophical antecedents, the Prussian general Helmuth von Moltke, put it, “Strategy is a system of expedients.” Canada may not have all the doses it wants, right now, but if first-dose protection lasts longer than originally believed, then the vaccination timetable can still be sped up – allowing an earlier reopening of the economy, and saving lives.
When reality socks it to your plans, change plans.
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