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A health-care worker prepares a dose of the Pfizer-BioNTech COVID-19 vaccine at a vaccine clinic in Toronto on Jan. 7, 2021.Nathan Denette/The Canadian Press

Canada is scaling back its COVID-19 vaccination efforts because of a looming shortage of shots, with some provinces ordering a halt to nearly all first-dose appointments outside of the country’s hard-hit seniors’ facilities.

Provincial governments, hospital executives and local public-health officials spent the weekend scrambling to ration doses after vaccine-maker Pfizer-BioNTech announced on Friday that it would halve shipments to Canada in late January and the first three weeks of February while the company expands a manufacturing plant in Belgium.

The news threw a wrench into vaccination plans across the country.

In Ontario, hospitals that had already begun vaccinating staff cancelled first-dose appointments, while hospitals that had not yet received a single dose braced for an even longer wait. The City of Toronto announced that a mass immunization clinic that had just opened Monday would have to pause operations on Friday because of limited shots.

Alberta Premier Jason Kenney said on Monday that his province would stop scheduling new first-dose appointments “until further notice.” Plans to start inoculating First Nations people over the age of 65 and other Albertans over 75 would have to be put on hold as well, Mr. Kenney added.

“The shipments we’ve received do not match the pace at which we’re able to vaccinate Albertans,” he said. “I’m deeply disappointed at the situation that we are now facing.”

Manitoba temporarily stopped booking new vaccination appointments over the weekend because of the pending shortage, but officials said on Monday that they had enough supply to honour existing appointments and start taking new ones on Tuesday. Manitoba is postponing the opening of a mass vaccination centre in Thompson because Pfizer is cutting back on deliveries.

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After a slow start over the holidays, Canada’s vaccination campaign picked up speed in the early weeks of January. Glimmers of hope emerged as teams of doctors and nurses conducted vaccination blitzes inside nursing homes, and as health care workers who had toiled for months in overburdened hospitals queued up for their COVID-19 shots.

Provincial governments reported 570,742 shots injected as of Sunday night, according to the COVID-19 Canada Open Data Working Group, about two-thirds of the at least 761,500 doses distributed so far by the federal government.

Now the pace of vaccinations in Canada – already well behind peer jurisdictions such as the United States, Britain and parts of Europe – is poised to slow down with about 327,000 Canadians getting their two-dose vaccinations later than originally planned.

Pfizer said it still expects to deliver four million doses to Canada by the end of March as planned.

However, The Globe and Mail reported on the weekend that Canada is facing a longer slowdown in Pfizer-BioNTech vaccine deliveries than European Union member countries also supplied by the Belgian plant.

The office of Procurement Minister Anita Anand said in a statement on Sunday that the government is in contact with the company “to reiterate firmly the importance for Canada to return to our regular delivery schedule as soon as possible.”

“Pfizer assured us that it is deploying all efforts to do just that. This is an evolving situation. As soon as updated information on the delivery of Pfizer doses for Canada is available, we will share it with Canadians,” Ms. Anand said.

In a statement Monday, a spokesperson for Pfizer Canada said the manufacturing slowdown is affecting countries beyond Canada and Europe.

“While the precise percentage allocation may fluctuate, we anticipate that it will balance out by the end of Q1 2021,” spokeswoman Christina Antoniou said.

According to a federal delivery schedule that was removed from the Public Health Agency of Canada’s website over the weekend, Ontario was supposed to receive 509,925 doses between Jan. 25 and Feb. 21. (PHAC said the schedule would be reposted once Pfizer’s revised delivery schedule is finalized.)

After learning it would receive half that number, the Ontario government said it would reserve most of its available doses for second shots – which could be delayed by a few weeks for hospital workers – and to meet its goal of offering first doses to everyone who lives, works and provides essential care inside nursing and high-risk retirement homes by the middle of February.

As a result, major hospitals, including Hamilton Health Sciences, University Health Network and Sunnybrook Health Sciences sent notes to their staff on Monday saying first-dose appointments would be paused immediately.

In Waterloo, west of Toronto, the immunization clinic at Grand River Hospital will shut down until at least Jan. 24 because of lack of supplies, according to Shirley Hilton, deputy chief of the Waterloo Regional Police Service and chair of the area’s vaccine task force.

“You’ve got to triage. It’s a crisis,” said Isaac Bogoch, an infectious-diseases doctor at Toronto’s University Health Network and a member of Ontario’s vaccine task force. “The long-term care facilities are on fire and you’ve got to put out the fire.”

Lynn Mikula, the chief of staff of Peterborough Regional Health Centre, east of Toronto, agreed that scarce shots should go to nursing homes first. But she and her staff found it demoralizing to hear that, until recently, some Greater Toronto Area hospitals were offering shots to employees who don’t interact with patients. Peterborough, meanwhile, has yet to receive a single dose, Dr. Mikula said.

Her hospital, which is now accepting transfers from Toronto hospitals overwhelmed by COVID-19 patients, planned to start vaccinating high-risk staff, such as ICU nurses, the first week of February. The Pfizer shortfall has scuttled those plans.

“For us, it truly is a morale issue in the sense of, is [the vaccine] ever going to come here? And by the time it comes here, how many COVID patients will we have taken from the GTA? That’s tough for people,” Dr. Mikula said.

In British Columbia, Provincial Health Officer Bonnie Henry tried to allay concerns about the Pfizer shortfall.

“It is a bit of a setback,” she said Monday, “but only a delay.”

Dr. Henry told a briefing Monday that B.C. is expecting 60,000 fewer doses of vaccine over four weeks. “But we are expecting and have been told that amount will be made up in March,” she said.

With reports from Oliver Moore, Carrie Tait and The Canadian Press

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