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Hold on to your hats: The next week is going to be a whirlwind of coronavirus vaccine news.

In the coming days, Health Canada will almost certainly approve the Pfizer vaccine. The pharmaceutical giant says that when it gets a green light, it can start deliveries within 24 hours.

Major-General Dany Fortin, who is leading the national rollout efforts, has told the provinces to be ready by Dec. 14, next Monday.

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Then the vaccinations will begin, starting with a few symbolic shots, with photos prominently displayed in media, political propaganda oblige.

But make no mistake, this will take time.

Between now and the end of March, Canada is expected to receive enough stock to vaccinate about three million people. It will be a trickle – hopefully a steady one – not a flood.

It’s pretty clear who will (or at least should) be first in line: Frail elders living in long-term care facilities and front-line health care workers. They are at highest risk.

After that, it gets murky. People with severe chronic illnesses, elders over 80 living in the community and essential workers are certainly groups that need to be vaccinated as soon as possible.

But thorny questions will arise, such as: Who is an essential worker?

Public Safety Canada actually has a list, but it’s as long as your arm. Grocery store workers? Teachers? Police officers? Truckers? Family caregivers? How do you choose among them?

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What about people living with homelessness? Indigenous peoples? COVID-19 has hit racialized and low-income populations hardest. How do we ensure that the inequities exposed by the pandemic are not perpetuated in the vaccine rollout?

We also need to be blunt about some harsh realities, such as the likelihood that kids will be among the last to be vaccinated.

This being Canada, provinces may have differing priority lists, and that may confuse the public.

One of the things we should worry about most in the coming months is the eruption of ugly internecine disputes. The last thing we need is teachers fighting with food workers about who is more important in society.

We already got an unpleasant taste of potential seeds of division when Manitoba Premier Brian Pallister complained that prioritizing vaccination in Indigenous communities “puts Manitobans at the back of the line.”

Triage is never easy. Choices have to be made, and they will be difficult. Race-baiting won’t help, and neither will selfishness.

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There’s been a lot of talk about logistics, and rightly so. But with so much attention focused on the grunt work, some of the big questions have not really been addressed.

What is the purpose of our vaccination effort: Is it to prevent people from getting sick and dying, or to get people back to work?

The simmering “health vs. economy” debate – even if it is largely a false dichotomy – will be brought into sharper focus by the vaccination campaign.

Of course, we can’t talk about vaccination without mentioning anti-vaxxers. Or can we?

The loud minority of people uttering all manner of unscientific nonsense gets altogether too much attention.

There isn’t near enough vaccine to go around so why don’t we do ourselves a favour and ignore them, at least for now?

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As more vaccine becomes available and we move from targeted vaccination to mass vaccination of the general public – likely beginning summer or fall – we will have to reach out to those who are hesitant.

It’s normal to have concerns about a new drug, especially one with so many unknowns. One of the best ways to assuage fears is to run a well-oiled vaccination campaign.

The biggest problem we’re going to have is demand for COVID-19 vaccines, not refusal. We don’t need to make the coronavirus vaccine mandatory for the general public. But it does need to be obligatory in some settings – such as nursing homes and hospitals. Some vaccines are already mandatory for health workers and this one should be too.

There will, without question, be problems, such as reports of people falling ill after being vaccinated. How we handle these will matter in building trust.

Trust is the most important currency we have in battling the pandemic in the months to come, especially given that we will have to redouble our public-health efforts while awaiting vaccines for all.

Winston Churchill said this about the Second World War, but it applies well to the vaccine rollout: “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”

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