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A COVID-19 vaccine shot is prepared in Halifax on Feb. 22, 2021.Andrew Vaughan/The Canadian Press

The first batch of Oxford-AstraZeneca’s COVID-19 vaccine, containing 60,000 doses, is expected to arrive in British Columbia this week. It isn’t clear who is going to be offered these shots.

Back in January, Premier John Horgan said British Columbia would provide vaccines based on a straightforward, age-based formula. “The science is very clear. The single biggest factor for death or severe illness is age,” he said then, sweeping aside intense lobbying efforts by different interest groups that wanted priority vaccines.

That plan was based on the two vaccines that were available in Canada at the time, from Pfizer and Moderna.

Canada vaccine tracker: How many COVID-19 doses have been administered so far?

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Moderna, Pfizer, AstraZeneca or Johnson & Johnson: Which COVID-19 vaccine will I get in Canada?

Canada pre-purchased millions of doses of seven different vaccine types, and Health Canada has approved four so far for the various provincial and territorial rollouts. All the drugs are fully effective in preventing serious illness and death, though some may do more than others to stop any symptomatic illness at all (which is where the efficacy rates cited below come in).

PFIZER-BIONTECH

  • Also known as: Comirnaty
  • Approved on: Dec. 9, 2020
  • Efficacy rate: 95 per cent with both doses in patients 16 and older, and 100 per cent in 12- to 15-year-olds
  • Traits: Must be stored at -70 C, requiring specialized ultracold freezers. It is a new type of mRNA-based vaccine that gives the body a sample of the virus’s DNA to teach immune systems how to fight it. Health Canada has authorized it for use in people as young as 12.

MODERNA

  • Also known as: SpikeVax
  • Approved on: Dec. 23, 2020
  • Efficacy rate: 94 per cent with both doses in patients 18 and older, and 100 per cent in 12- to 17-year-olds
  • Traits: Like Pfizer’s vaccine, this one is mRNA-based, but it can be stored at -20 C. It’s approved for use in Canada for ages 12 and up.

OXFORD-ASTRAZENECA

  • Also known as: Vaxzevria
  • Approved on: Feb. 26, 2021
  • Efficacy rate: 62 per cent two weeks after the second dose
  • Traits: This comes in two versions approved for Canadian use, the kind made in Europe and the same drug made by a different process in India (where it is called Covishield). The National Advisory Committee on Immunization’s latest guidance is that its okay for people 30 and older to get it if they can’t or don’t want to wait for an mRNA vaccine, but to guard against the risk of a rare blood-clotting disorder, all provinces have stopped giving first doses of AstraZeneca.

JOHNSON & JOHNSON

  • Also known as: Janssen
  • Approved on: March 5, 2021
  • Efficacy rate: 66 per cent two weeks after the single dose
  • Traits: Unlike the other vaccines, this one comes in a single injection. NACI says it should be offered to Canadians 30 and older, but Health Canada paused distribution of the drug for now as it investigates inspection concerns at a Maryland facility where the active ingredient was made.

How many vaccine doses do I get?

All vaccines except Johnson & Johnson’s require two doses, though even for double-dose drugs, research suggests the first shots may give fairly strong protection. This has led health agencies to focus on getting first shots to as many people as possible, then delaying boosters by up to four months. To see how many doses your province or territory has administered so far, check our vaccine tracker for the latest numbers.

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This new supply from AstraZeneca is not being added into the general pool. It is being managed as a parallel track, meant to give public-health officials more flexibility to tailor vaccine distribution as needed. But it has reignited unseemly competition in regards for who should get priority.

B.C.’s pandemic response, held up in the early months as a shining example of leadership, now revolves around holding the reins tight on a public eager to slip loose of restrictions that have been in place since November.

Those measures – a ban on gatherings and events, as well as limits on travel and other activities – have plateaued in their effect. About 500 people in B.C. every day are testing positive for the virus.

Rather than changing the restrictions, public-health officials are focused on vaccine distribution, which is why B.C. was willing to stick its neck out last week and adopt a four-month delay for booster shots. Everything rides on getting the vaccine out into the community as quickly as possible.

A public-health committee will make recommendations in the next two weeks about priorities for what the province regards as a “bonus” supply, but generally the AstraZeneca doses are earmarked for first responders and other essential workers. While those decisions are made, the vaccine will be offered to people in the midst of COVID-19 outbreaks to “stop that cycle of workplace-to-community transmission,” Provincial Health Officer Bonnie Henry told a news conference last week.

Mr. Horgan has heard from a lot of people who have their own ideas of who should come next. More than 20 groups have contacted him to make the case for priority vaccinations for their members, and dozens of individuals have made their own personal pleas.

Representatives for egg farmers, police, bus drivers, dentists, couriers, flight attendants, airport workers, railway suppliers, waste handlers and others have lobbied the Premier. Unicef Canada has used its voice for teachers and education workers.

Dr. Henry noted that the AstraZeneca trials had few people over the age of 65, giving B.C. a reason to look for a different approach. The priority list of essential workers who cannot work from home, and first responders, is coming soon, Dr. Henry said. “And the AstraZeneca will be the one that we will focus on, because it is fridge stable, which means we can be much more agile in how we are able to get it to people’s workplaces and things like that.”

This is not just about protecting the delivery of essential services, she said. It’s figuring out who is likely to spread the coronavirus.

“We need to address those people who have not been able to work away from others at home. They are also, we know from the data on cases, people who are more likely to be transmitting.”

The age-based criteria outlined in January remains in place, because it is based on protecting those most likely to get seriously ill or to die. But the majority of new cases are among younger British Columbians and this parallel program seems designed to curb community spread, rather than protecting the most vulnerable.

So AstraZeneca will be directed to younger age groups while B.C. continues to deliver Pfizer and Moderna to the older populations over the next few months. “We know that if we can target younger people who have more social interactions, who would have to wait much longer for the Moderna/Pfizer vaccines, that we can make a greater impact and protect more people in that sector,” Dr. Henry said.

The province expects 660,000 doses of AstraZeneca in March, and it will have to be distributed quickly as some will likely expire in late March or early April. Now with the expectation that B.C. will also soon get the newly approved, single-shot Johnson & Johnson vaccine, it means everyone should get vaccinated sooner.

But in the short term, some groups are going to win and others are not.

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