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A container of COVID-19 vaccine is seen on a table at a vaccination centre at Winnipeg's Convention Centre on Jan. 1, 2021.

JOHN WOODS/The Canadian Press

Adults from racialized communities disproportionately affected by the COVID-19 pandemic should be prioritized for shots in the second stage of the vaccination campaign, says new guidance from Canada’s national advisory committee on immunization.

The advice also would see all essential workers who can’t do their jobs from home moved into the second stage, instead of focusing on health workers with lower-risk jobs.

The second stage is expected to start this spring after provinces get COVID-19 vaccines into the arms of all the staff and residents of long-term care homes, adults aged 70 or older, front-line health workers and adults in Indigenous communities.

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The committee added a third stage to its immunization recommendations that includes people between 16 and 59 years old with underlying conditions, those who are between 50 and 59 years old with no underlying conditions, and health workers and essential workers who didn’t receive shots in previous rounds.

The new recommendations prioritize racialized adults from groups disproportionately affected by the pandemic ahead of some older non-racialized people.

“This is a big move in the right direction,” says Akwatu Khenti, who teaches at the University of Toronto’s Dalla Lana School of Public Health and is a special adviser to the City of Toronto Targeted COVID Equity Action Plan. He says he was “as surprised as everyone else” to see the news, but says it is “very welcome, and very appreciated.”

There is “no ambiguity” in the data: this virus is hitting racialized communities hardest, Mr. Khenti says, noting that in Toronto, 79 per cent of hospitalizations are of racialized persons. Torontonians of African and Caribbean descent currently experience the highest COVID rates in the city, comprising 26 per cent of total cases.

Another reason to prioritize racialized communities is that they have been falling behind during the vaccine rollout in both Britain and the U.S., says Ananya Tina Banerjee, who teaches public health at both the University of Toronto and at McGill University in Montreal.

Ms. Banerjee notes that white Britons are twice as likely to have received the vaccine as their Black, Asian and bi-racial counterparts. White Americans are meanwhile being vaccinated at rates of up to three times higher than Black Americans, early data from the 23 states that are reporting racial and ethnic data on vaccinations show. “We don’t need to wait for these communities to fall behind, we can act now to ensure equity,” Ms. Banerjee says.

Both Ms. Banerjee and Mr. Khenti are concerned about the backlash this announcement may engender. Mr. Khenti has already, in the hours since it was made, begun receiving hate mail. He cautions that this does not mean that racialized people are going to be jumping the queue. “Your vulnerability is what really moves you to the front.”

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Ms. Banerjee adds that those who are most vulnerable, who are required to work outside the home, who live in crowded houses need to be vaccinated first. “That’s just the reality,” she says. “Those who are able to work from home can afford to wait a little longer.”

The experience of the U.S. and Britain has also shown that public health officials should consider setting up “pop-up vaccine clinics” in “trusted access points,” such as temples, mosques and workplaces, Ms. Banerjee adds. This can help ensure that the most vulnerable and isolated members – those who may lack English or digital literacy skills – are being reached.

To Ms. Banerjee, Monday’s announcement highlights the “power” of collecting race-based data and how it can lead to solutions. “There was so much backlash to doing this in Ontario, but it’s really shown that by doing this we can avoid pitfalls and ensure that those who need the vaccine most are prioritized.”

The new federal vaccination guidance comes as COVID-19 vaccination efforts are expected to get a big boost this week.

The Public Health Agency of Canada says it expects Pfizer and BioNTech to deliver more than 400,000 doses of their COVID-19 vaccine this week and about 450,000 doses each week until April.

This story was produced with the financial assistance of the Facebook and Canadian Press News Fellowship.

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– with files from Nancy MacDonald

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