Dr. Dec’s Recommendations on the COVID-19 Vaccinations (as of April 20, 2021)

Many of my patients have been calling asking questions about COVID-19 vaccinations. You may be aware that I have been asked to act as the Chair of the Niagara Region Community Coordination Task Force for COVID-19 Vaccination. Information from many sources is changing rapidly regarding COVID-19 Vaccination. I will attempt to present “bullet points” that cover many of the questions people are asking.

  1. The Province of Ontario released a province-wide central booking system on March 15, 2021. It allows you to book mainly based on age categories as they are prioritized.
  2. The Niagara Region Public Health Department has started running mass vaccination clinics at locations rotating all around the Niagara Region. Right now, when in Niagara Falls, the location is the McBain Centre. These are booked through the province-wide central booking system, either on-line or by telephone. https://covid-19.ontario.ca/ontarios-covid-19-vaccination-plan   or   1-888-999-6488
  3. Niagara is following Ontario’s Vaccine Distribution Implementation Plan Ontario’s COVID-19 vaccination program and our Community Coordination Task Force for COVID-19 Vaccination is using principles set out in the Ethical Framework for COVID-19 Vaccine Distributionhttps://www.ontario.ca/page/ethical-framework-covid-19-vaccine-distribution These 2 documents set out a basic prioritization for people to get vaccinated and may be influenced by unique local/regional factors.
  4. The main prioritization of people has been based on age, and age categories have been gradually moved through, usually in 5-year intervals.
  5. Other populations have been targeted according to the above documents, including healthcare workers, developmental sectors and migrant workers.
  6. Niagara Health has set up a clinic at the Seymour-Hannah Arena in St. Catharines & they are vaccinating the different groups & populations, such as those listed above, as well some posting spots on the province-wide central booking system.
  7. Up until now, the vaccines that have been received in Niagara have been mainly the Pfizer brand and some of the Moderna brand. These vaccines are very difficult to transport, which is why they have been used in the large vaccination sites. The vaccine supply to Niagara started slowly but is steadily increasing, especially now that the Astra-Zeneca vaccine is becoming more available in pharmacies and in family doctors’ offices. 
  8. Phase 2 of the provincial vaccination plan, Guidance for Prioritization of Phase 2 Populations for COVID-19covid 19 Vaccination (PDF) starts to target those essential workers and people with underlying conditions, and younger patients with specific chronic conditions, which put them more at risk. These people will likely get moved up in priority, as clinics get scheduled and the prioritization and timelines evolve.
  9. If you are in one of the following groups: Organ transplant recipients; Hematopoietic stem cell transplant recipients; Neurological diseases in which respiratory function may be compromised (e.g., motor neuron disease, myasthenia gravis, multiple sclerosis); Haematological malignancy diagnosed <1 year ago; Kidney disease with eGFR< 30, or an Essential Care Partner of the above, then you are eligible to get vaccinated. I will provide you with a letter to confirm your eligibility, as well as that of your (one) eligible primary caregiver, which I will Fax to the Niagara Health Vaccine Scheduling Office at: 289-398-0198. You and your eligible primary caregiver will also need to bring a copy of the eligibility letter to your vaccine appointment. The Niagara Health Vaccine Scheduling Office will call you to schedule your appointment, after your letter has been received.
  10. The interval between the 2 doses of vaccine (Astra-Zeneca/Pfizer/Moderna) has been extended to 16 weeks, except in certain populations where it should be given in a 21-28 day interval. Those are: Transplant recipients (including solid organ transplants and hematopoietic stem cell transplants) and Individuals with malignant hematologic disorders and non-hematologic malignant solid tumors receiving active treatment (chemotherapy, targeted therapies, immunotherapy) excluding individuals receiving solely hormonal therapy or radiation therapy. If you fall into the above categories, I will provide you with a letter to confirm your eligibility to receive your 2nd dose sooner, which I will Fax to the Niagara Health Vaccine Scheduling Office at: 289-398-0198. You will also need to bring a copy of the eligibility letter to your vaccine appointment. The Niagara Health Vaccine Scheduling Office will call you to re-schedule your 2nd dose appointment after your letter has been received.
  11. Pharmacies in Niagara have started receiving the Astra-Zeneca vaccine which targets those people who will turn the age of 40 in 2021. If you are age 40+, want a vaccine and have the opportunity to book an appointment at a pharmacy, I strongly encourage you to sign up.
  12. Many people have expressed concerns about the Astra-Zeneca vaccine, and are thinking they wish to wait to get either a Pfizer or Moderna vaccine. There are several risks with this approach. With the variants spreading rapidly, the chances that unvaccinated people will get infected in the coming weeks to months are much higher, so getting a vaccine ASAP is paramount and delaying for even a few weeks may be costly. With so many people wanting to get vaccinated and the available appointments at mass clinics being booked rapidly, the next slots available anywhere in the region is reaching into May. Public Health only has knowledge of the amount and type of vaccine a few weeks in advance. Thus, there is a chance that the only vaccine that will be available in May for those 40+ may be the Astra-Zeneca vaccine anyway. There have been reports about “blood clots” in younger patients in Europe (the Astra-Zeneca vaccine is not recommended for people < age 40), however the incidence is extremely rare and quite frankly, the chances are very much higher that if unvaccinated, you will catch COVID, possibly be hospitalized or even die compared to the very remote chance that you will have a major, significant side effect to the Astra-Zeneca vaccine. The odds dramatically favour getting the vaccine if you are age 40+.
  13. All 3 vaccines, the Astra-Zeneca vaccine, the Pfizer vaccine and the Moderna vaccine are safe, effective and are almost 100% in preventing hospitalization and death, which are the 2 outcomes we want to avoid. Please take the first one you are offered. The provincial government has guaranteed a vaccine to everyone who wants one by Canada Day BUT it does not guarantee you the vaccine of YOUR choice, only whichever one may be available.
  14. There are almost no reasons you should not get vaccinated. People have asked whether conditions such as diabetes, high blood pressure, heart disease, cancer, lung disease, previous blood clot, having minor allergic reactions or being on certain medications are reasons not to get vaccinated. The answer is: all these things have NO impact on your ability to get vaccinated. If you had a MAJOR allergic reaction to another vaccine, you may wish to discuss it with me further. If you have a condition, or are on a medication that reduces your immune system, you should probably discuss it either with your specialist or myself. If you are allergic to polyethylene glycol, then please discuss it with me as well. Otherwise, I strongly encourage you to get a vaccine.
  15. Our office is preparing to also offer the Astra-Zeneca vaccine first to our patients aged 55-59, and then likely to those 40-55. We are initially receiving a very limited supply very soon and we do not know what we will get after that. We are creating a list, and I am reviewing everyone’s risk to determine how we prioritize people. Again, if you have the opportunity to receive the Astra-Zeneca vaccine at a pharmacy, before we can give it to you, please capitalize.

Thank you for your patience as we navigate the challenges of vaccine coordination/distribution.

For additional information, I invite you to go to the Niagara Region website  https://www.niagararegion.ca/health/covid-19/vaccination.aspx &  https://www.niagararegion.ca/health/covid-19/default.aspx or the Niagara Health website https://www.niagarahealth.on.ca/

As soon as new additional information is available, it should be posted at the above locations and I will try to keep my website http://www.docdecfamilymd.ca current and up-to-date. If you still have unanswered questions, please contact the office and I will be happy to speak to you directly.

David Dec – B.Sc., M.D., C.C.F.P., F.C.F.P.

Chair – Niagara Region Community Coordination Task Force for COVID-19 Vaccination

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