Summary
Canadian provinces and territories have been taking different approaches to vaccine allocation and distribution. Some of those plans have been simple, such as mass vaccinations, others complex, with workplaces, health conditions, and risk and severity of transmission considered.
All provinces and territories prioritized vaccinating select vulnerable populations within their first phase, including residents of long-term care facilities, seniors in congregate living settings, front-line health care workers, and adults in remote communities.
Canada can learn valuable lessons from both local and global effective vaccine delivery strategies that improve population uptake.
- The United Kingdom delivered the highest number of COVID-19 vaccine doses per capita earlier than other nations comparable in size. This was, in part, the result of distribution strategies such as utilizing primary care, pharmacies, general practices, and training volunteers to deliver vaccinations.
- Israel, commonly cited as the global leader in vaccine distribution, led the way by repackaging vaccines for smaller quantities, setting optimistic targets, operating clinics with extended hours, and leveraging a vast range of both health and human resources. Israel also allowed leftover vaccines to be given to the next priority group and the general population to reduce vaccine wastage and improve vaccine uptake.
When considering vaccination allocation and distribution, evidence suggests after those at high risk of severe outcomes have been vaccinated, efforts should target vaccinating those who live and work in areas where transmission is high. Other considerations include the risk of acquisition (occupational, geographic, economic, other), the risk of severe disease/poor outcomes, and equity concerns.
It is noted that steps to improving accessibility among various populations include
- Increasing overall accessibility of vaccines;
- Increasing the types of health care workers able to administer vaccines;
- Taking an overall flexible vaccination campaign approach;
- Continually adapting to challenges; and
- Reassessing vaccine supply and priority groups.
CoVaRR-Net Recommendations
At the national level
- In preparing for future pandemics, develop a pan-Canadian vaccine delivery evaluation network. The network may allow for provincial/territorial public health collaboration on Canadian emergency planning and preparedness, vaccine rollouts, information/knowledge sharing, and collecting standardized data on rollout effectiveness.
At the provincial level
- All jurisdictions should consider prioritizing the populations recommended by the National Advisory Committee on Immunization, including racialized minorities, individuals experiencing homelessness and migrant workers.
- Communication of vaccination allocation and distribution from government officials to the general public should be clear and transparent to improve public trust.
At the local and regional level
- Researchers should fill knowledge gaps through researching the effectiveness and equity of vaccine distribution and allocation approaches in relation to vaccine coverage rates.