BY PAMELA FAYERMAN
Vancouver health authorities have completed their investigations into hospital-based physicians who jumped COVID-19 vaccination queues by not waiting for their second dose “invitations.”
“While we are unable to disclose the details of specific personnel cases, we can confirm that the medical staff who have had received their second dose before they were invited to do so was limited and each case has been formally investigated and appropriate action has been or will be taken,” said Vancouver Coastal Health spokeswoman Rachel Galligan.
I first reported on the controversy here after obtaining the internal memo circulated to the medical staff at hospitals like Vancouver General and St. Paul’s. The identity of the physicians is a closely guarded secret, but since the only doctors who’ve been able to access COVID vaccinations thus far are those providing care to COVID patients, they are likely critical care specialists, emergency department physicians or other specialists working on COVID units.
“The vast majority of our health-care workers and medical staff are adhering to public health guidance and are patiently awaiting their turn for vaccination,” Galligan continued. “VCH and Providence Health Care are committed to fully investigating and addressing any substantiated breaches of Public Health direction regarding vaccine sequencing and administration.”
Meanwhile, the vanishing and indeed near-extinct supply of COVID-19 vaccine means that many first priority physicians, nurses and other healthcare workers – those providing direct patient care to COVID-19 patients – will likely miss recommended timelines for their second shots. The two vaccines approved in Canada so far — PfizerBioNTech and Moderna’s — both require two separate doses in order to achieve 94-95% protection for the patient. Pfizer’s second dose is intended to be delivered 21 days after the first, while Moderna recommends 28 days after the first. But the World Health Organization and the National Advisory Committee on Immunization (NACI) have each given support for up to 42 days between doses because of extraordinary supply issues.
Provincial health officer Dr. Bonnie Henry was among the first doctors to get vaccinated last month when the first shipments arrived. It’s now been 38 days since Dr. Henry’s first dose, so I dared to ask the ministry of health whether she has had her second shot or when she intends to get it. Her office staff declined to divulge anything yesterday. Today, at the end of an hour-long press briefing, Henry said she has not received her second dose:
“I absolutely believe in the data that we have that shows extending the interval between dose one and dose two is not only safe but there’s a real probability it will provide more durable and longer-lasting protection. So I will be waiting until there’s sufficient vaccine available later on in the Spring.” The first day of Spring is March 20.
Undoubtedly, vaccinations are a sensitive and politically charged matter purely because of vaccine supply issues. Henry had a photographer take photos of her getting her first dose at an Island Health clinic in Victoria late last year. Although she doesn’t treat patients and wouldn’t be considered a frontline healthcare worker, it made sense for her to make this public display in order to show her confidence in the safety and effectiveness of the brand new vaccine. Indeed, the confidence in vaccines demonstrated by experts like Dr. Henry – coupled with public desperation – are factors contributing to public opinion polls that show vaccine hesitancy is rare in Canada.
But now that the fridges are essentially empty for second doses, it makes little sense, from a public relations standpoint, for Henry to be seen rolling up her sleeve for her second dose. Indeed, doing so might provoke or irritate front line healthcare workers who may not get second doses until March, given supply interruptions.
Returning to the matter of discipline against the physicians who jumped the queue, many readers are likely intrigued by their possible excuses, explanations or even legal defences. Typically, doctors who get into medical-legal trouble immediately seek advice from the Canadian Medical Protective Association, their legal defence organization. I asked the CMPA if the Vancouver physicians had sought advice on this matter. Said Dr. Todd Watkins, Associate Executive Director of the CMPA:
“CMPA’s assistance to physician members is discretion-based. This means that we carefully review the facts and circumstances of each particular case and determine if the circumstances are within our scope of assistance and the nature of the assistance we can provide. Discretion gives us the flexibility to assist members rather than deny assistance based on a set of policies.
We cannot comment on individual cases, but we will generally assist members with College matters relating to the professional practice of medicine, such as developing medical directives to support the COVID-19 vaccine rollout.”
Information about the CMPA’s assistance concerning the COVID-19 vaccination program states:
“The CMPA will not generally extend assistance with respect to administrative or logistical issues associated with the vaccination process, such as decisions about prioritization of individuals eligible to receive vaccines. Physicians involved in these issues should ensure that the organization that they are being asked to serve will provide them with full defence and full indemnification in the event of medical-legal difficulties that arise from this role.”