Canada's vaccine task force co-chair says following front-line service staff should be next in line for immunization following the current priority groups of seniors and health care workers, as well as those in remote and Indigenous communities.
"The next bite I think that's going to happen has to be with some of the front-line workers who are in essential services and functions, that's going to include individuals who are firefighters, emergency care providers," Dr. David Naylor said in an interview. "There are a lot of people who are on the front lines, everything from retail, grocery stores to all those essential services who are all exposed to some extent."
For seniors, the national advisory committee on vaccines recommends vaccinations by five-year increments.
In the spring when the Ontario government was using a multi-phase approach to economic reopening, it listed certain sectors as essential.
Like health services and retail workers above, other employees included construction, animal services, media industries and vehicle dealerships and retailers.
But Naylor believes there should also be a neighbourhood strategy where people in high-density and racialized neighbourhoods that have been especially hit should be given priority.
"We've seen it strongly in Toronto in terms of some neighbourhoods getting hit hard," he said, such as northwest and northeast parts of the city which have seen positivity rates well above the average.
In updated models released last week, the Public Health Agency of Canada released new immunization goals, including enough vaccine for eight per cent of the population by end of March, half by the summer and all by the end of September.
Ontario's associate chief medical officer of health, Dr. Barbara Yaffe, gave the provincial goal for herd immunity.
“Usually for infectious diseases, we're looking 70, 80 per cent of the population has to be vaccinated,” she said. “We're not going to get there with this vaccine until probably the summer.”
But Naylor describes what he sees as a “wrinkle” when it comes to COVID-19 transmission, since it’s so heavily concentrated in certain parts of certain provinces.
“This has been lumpy epidemic, there's been a lot of clustering, it's not be uniformly distributed," he said. "When that happens, there's some reason to believe that you actually have a lower percentage that you have to cover, so we may be surprised, we may get a break here and things could slow down meaningfully as we get 30 to 40 per cent of the population immunized.”
"The yield is better in the zones where you have a lot of virus and root out that unepidemiological community spread, that is important to do.”
But at the same time he says we must err on the side of caution and inoculate as many people as possible, as soon as possible, without letting our guard down.
Both he and Yaffe reiterate there’s a difference between the vaccine preventing disease and preventing infection, which has to be studied more.
“Even if somebody gets vaccinated, they may, they may have an asymptomatic infection, they could still be infectious to others,” she said. “We're still going to learn and it may be that that is not the case, but currently we don't have the evidence, so even when somebody’s vaccinated, they need to protect themselves and others from spreading.”
Naylor says while it’s crucial to study how safe and effective various vaccines are over the short and long-term, he calls what he’s seen a stunning triumph for science, as well as remarkable collaboration between academia and industry to get them out.
“Follow the rules, as maddening as they are and grit it out,” he said. “We're at the start of the third period and the end of the game is in sight.”