The eligibility for third doses of a COVID-19 vaccine is being expanded to include First Nations people living on reserve in Manitoba, health officials announced Monday.
The third dose should be given at least six months after the second shot and it’s estimated that this change makes 7,200 more people immediately eligible for the third shot.
As time passes, more will become eligible as they pass that six-month second dose marker, said Dr. Marcia Anderson, the public health lead for the province’s First Nations pandemic co-ordination team.
The Integrated Vaccine Operations Centre, co-led by First Nations and the federal government, is being reactivated to oversee the third dose rollout and co-ordinate other supports that communities may need.
Manitoba first offered a third dose to immunocompromised people in mid-September.
That was expanded shortly after to all residents and staff of First Nations personal care homes.
The next expansion of third dose eligibility, in early October, was to thousands of health-care workers and anyone who received full courses of the AstraZeneca or Johnson & Johnson vaccine. That decision was made after evidence suggested waning immunity from those vaccines.
The current recommendations for third doses of COVID-19 vaccine and information about where they are being administered are available online.
Public health officials also urge First Nations people who still aren’t fully vaccinated to get their shots, as COVID-19 infections in some First Nations communities make up an increasing proportion of the province’s overall caseload.
“We have seen throughout this pandemic that First Nations people are disproportionately impacted by COVID-19,” Anderson said. “The fourth wave is no different. First Nations communities are seeing breakthrough cases of COVID-19 among people who are fully vaccinated.”
Although the risk of a severe outcomes remains much lower for vaccinated people than those who are unvaccinated, “we are seeing some severe outcomes in fully vaccinated people as well,” she said.
She also noted that, on average, 30 per cent of all new cases occurring on reserve are in children aged 11 and under, who are not yet eligible for a vaccine.
Vaccine uptake on First Nations is only slightly lower than Manitoba’s rate overall (81.7 per cent compared to 82.6) but only about 64.5 per cent of First Nations people living off-reserve have gotten both doses.
Vaccination rates vary widely among different First Nations, with some boasting a much higher percentage than the provincial average and others far below the average.
On top of outbreaks driving cases in a few northern First Nations, new COVID-19 infections are now spread out across 17 — or nearly one-third — of the communities in Manitoba, Anderson said.
The proportion of breakthrough cases among First Nations people has been increasing since August and approximately two-thirds of those cases are in people residing on reserve, Anderson said.
It’s not clear how much of that is due to waning immunity — as the majority of people received their second dose in May — versus underlying risk factors such as overcrowding in houses and schools, she added.
“Let’s get those third doses out there and hopefully start to reduce those numbers again,” Anderson said.
“Those first and second doses have been critical where we’ve seen them and reducing severe outcomes that we saw that definitively in the third wave. And now we believe this third dose — and getting it sooner rather than later — will again boost that immunity and further protect our communities.”
Anderson expects third doses to become available to First Nations people living off-reserve at some point before the end of the year.
Front-line staff vaccinations
New health mandates for front-line workers also started Monday.
Provincial employees in a long list of jobs either have to be fully vaccinated or submit to testing every 48 hours.
The orders apply to staff in Manitoba schools and licensed daycares and 42,000 health-care and personal care home workers, including support staff such as cleaners.
Any employee who refuses to participate will be placed on unpaid leave, Shared Health officials said.
Among the roughly 32,000 health-care workers who had revealed their status as of Friday, 1,801 workers were unvaccinated, Shared Health said. More than 10,000 had not yet reported their status.
Chief Provincial Public Health Officer Dr. Brent on Monday thanked all of those who have been vaccinated, saying it is the best defence against the virus.
“It protects us and the people around us. This becomes even more important when you’re working with vulnerable individuals, such as our health-care system,” he said.
“This has really changed our trajectory here in Manitoba.”
He did not have specific data on the number of people who remain unvaccinated past the deadline.
When asked how concerned he is that there are public health staff who do not want to be vaccinated, Roussin said “we really need the support of everyone who sees themselves as a health-care worker. Being a health-care worker is a privilege — to be there for people in some times of their greatest need.
“But with that it comes with many, many responsibilities and protecting them is one such thing.”
Seasonal flu vaccine
Manitobans can also make an appointment for their seasonal flu vaccine at provincial, regional or urban Indigenous sites as of Monday, Roussin said.
That can be done using the provincial call centre or online booking system originally put in place for the COVID-19 vaccine. Individuals can receive their seasonal flu, COVID-19 or both vaccines at these sites at the same time, if they choose.
The online vaccine finder shows locations where these vaccines are available, including where walk-ins are available.
Many medical clinics and pharmacies with seasonal flu and/or COVID-19 vaccines will continue to be listed, with information about how to book at these locations.