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Quebec updating vaccine priority list to address younger, vulnerable people

 Université de Montréal medical student Olivia Vachon pulls out a needle with a dose of vaccine at the COVID-19 vaccination site at Decarie Square in Montreal Monday March 1, 2021.
Université de Montréal medical student Olivia Vachon pulls out a needle with a dose of vaccine at the COVID-19 vaccination site at Decarie Square in Montreal Monday March 1, 2021.

Quebec’s immunization committee is considering a recommendation to raise the priority for younger people with certain health conditions to get the COVID-19 vaccine as it updates its advisory on priority groups, the committee chairperson says.

“We said our recommendations were preliminary and could be adapted with the evolution of knowledge,” Nicholas Brousseau, a public health physician with the Institut national de santé publique du Québec, said on Monday. He was referring to the 10-category priority list his committee recommended to the government in November, which lays out the order in which Quebecers are now receiving their doses of the COVID-19 vaccine.

“We’re working on an update,” Brousseau said, when asked about countries that have sped up vaccination for people with health conditions and the recent decision by British Columbia to allow people aged 16 to 69 who are “clinically extremely vulnerable” to be vaccinated at the same time as people in their 70s.

“Within about two weeks, we should be proposing slightly modulated recommendations that will resemble a lot what you’re mentioning.”

Scientific knowledge about the safety and efficacy of vaccines and the risk factors for people with different illnesses if they get COVID-19 is rapidly evolving, he said.

“The principal risk factor remains age,” Brousseau said. “People who are 70 and older are about 100 times at greater risk of dying from COVID-19. But I think people with chronic illnesses should also be prioritized, even if age is the principal factor.”

Brousseau’s comments offer encouraging news for advocates of people with Down syndrome and others with severe health conditions, said Evelyn Lusthaus, a Montrealer whose 43-year-old daughter has Down syndrome.

“It’s a great step forward,” she said when told about the Quebec immunization committee’s plan to update its recommendations on priority groups. “I really hope a change is going to be forthcoming.”

Lusthaus and friend Rissa Mechaly, whose 40-year-old son has Down syndrome, launched a letter-writing campaign and a petition after studies out of the United Kingdom and the United States in October found that significantly younger people with Down syndrome are more susceptible than the general population to getting COVID-19, four times more likely to be hospitalized and 10 times more likely to die from the virus.

Their petition had over 9,000 signatures as of Monday.

In response to the international studies, countries such as France and the U.K. and some states in the U.S., have raised the vaccine priority for younger people with Down syndrome. They were or are being vaccinated alongside people in their 70s.

Last week, the president of the Quebec association of hematologists and oncologists (AMHOQ) wrote to the director of the province’s COVID-19 immunization program to demand higher priority be given to cancer patients, regardless of age, and their caregivers.

The Quebec Immunization Committee’s report in November, which offered preliminary recommendations on the order to vaccinate the population, advised the provincial government that “certain people with a particularly high risk could benefit from a higher priority depending on the data available on the extent of risk.”

“So we’re working on an update on this notice,” Brousseau said, adding that the committee anticipated it would do an update this spring.

People who are under 60 years old with a pre-existing health condition are in the eighth of the 10 categories, after people aged 60 to 69.

If Quebec doesn’t offer vaccinations to younger people with certain conditions and chronic illnesses that put them at severe risk of complications from COVID-19 earlier than the eighth category, it’s unclear how long they’ll have to wait.

Mass vaccination for people over the age of 80 who don’t live in seniors’ residences began on Monday, and the Quebec health ministry rapidly announced that people over 70 in Montreal and Laval can start booking appointments for their shot.

The blitz results from directing more vaccine doses to Montreal and Laval, higher than their portion of the Quebec population, at the end of February, the Quebec health ministry said on Monday.

More vaccines were delivered to Laval and Montreal because of higher hospitalizations, Brousseau said. But with time, the regions will progress to the same rhythm, he said. Quebec has also extended the delay between the first and second doses to 12 weeks, which has temporarily increased the capacity to give people the first dose, he said.

The progress in vaccinating CHSLD residents, health care workers, people in retirement homes, people in isolated communities and now people over 80 years old might seem rapid. However, those first five categories on the priority list together include an estimated 965,000 people. The sixth category, which is people in their 70s, has nearly that number — 768,000 people. Another 1.16 million people are in the next category of people in their 60s.

So the province has to provide a first dose to another two million people before it reaches the eighth category of people under 60 with pre-existing conditions.

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1 being least likely, and 10 being most likely

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