Lack of transparency about Manitoba's vaccine eligibility plan erodes public trust: health experts

As Manitoba's vaccine rollout continues to run near the back of the pack among the provinces, most Manitobans remain in the dark about where they fit into the overall immunization plan.

Some other provinces, including Saskatchewan, British Columbia, Ontario and Quebec, have outlined the order in which they intend to vaccinate various groups within their populations, with rough timelines extending months into the future. 

Six weeks into Manitoba's vaccination campaign, however, the provincial government has yet to announce how it plans to expand access to COVID-19 vaccines beyond the first-phase priority groups — information health experts say is key to getting public buy-in on the strategy.

"What you want to do is tell people what you do know, tell people what you don't know, and tell them when you're going to tell them more about the things you don't know," said Heidi Tworek, a University of British Columbia professor and an expert in health communication.

"That kind of transparency can be very helpful in building that trust."

Manitoba has started making progress on vaccinating three of the four priority groups identified by the National Advisory Committee on Immunization — front-line health workers, residents and staff in long-term care facilities, and First Nations seniors — but it has given no indication of when seniors living in the wider community will become eligible. 

Both Saskatchewan and Ontario, meanwhile, plan to begin making the vaccine available to the general population as early as April. 

Unpredictable supply

Members of Manitoba's vaccine implementation task force said earlier this week they had planned to release more information on the eligibility list. However, they were forced to change direction after supply chain disruptions caused by vaccine manufacturer Pfizer's decision to temporarily shut down a plant in Belgium, in order to expand its long-term production.

The province's two major vaccination centres in Winnipeg and Brandon have stopped taking new appointments.

"With the changes in the Pfizer supply, all of the attention and work of the team was really focused on making sure that we had a plan in place that would still meet the needs of our health-care workers who already had appointments booked," Dr. Joss  Reimer, medical officer of health for Manitoba Health and a task force member, said on Wednesday.

Governments have known for months that the vaccine supply chain could be unpredictable, said James Blanchard, professor of community health sciences at University of Manitoba. 

While the implementation process could also be unpredictable, planning for the remainder of the rollout could have gone ahead, Blanchard said. 

"You can move things on dual tracks. I don't really understand the strategic need to do things sequentially."

Transparency is key

Transparency around who will become eligible and when would affect more than just the public's trust in the vaccination plan, Blanchard said. It could also help people get on board with public health restrictions meant to limit the spread of the coronavirus. 

"They're asking the public for feedback about decisions around continued constraints on social interactions and other kinds of things," he said.

"But it's very difficult for the public … to respond and to understand some of the other actions that might be needed in the interim without really understanding how long this might be, and when the vaccine rollout is going to start having an impact on wider transmission."

So far, Manitoba ranks second-last among the provinces in terms of the percentage of doses it has given to people compared to supply received from the federal government.

As of Friday, Manitoba had administered 46 per cent of its supply. Neighbouring Saskatchewan had administered 96 per cent of its vaccine doses.

Manitoba Premier Brian Pallister has defended Manitoba's rollout, saying the need to consult with First Nations leaders, and ensuring a reserve supply to administer second doses to vulnerable front-line workers and seniors living in care homes, have slowed down the process.

"I think that if Manitobans understand that, and I hope you do, you'll understand that we're going to put safety first," he said during a news conference on Thursday.

Dr. Nazeem Muhajarine, a professor of community health and epidemiology at the University of Saskatchewan, acknowledged that Saskatchewan's goal of opening up the vaccine to the general population by April is aspirational, and it depends on getting through two phases of priority groups. 

But the need to move in stages and prioritize certain groups before others does not mean that governments can't be open about who is next in line. 

"There's still a long way to go to get vaccines into 40-year-old persons … living in the community without a pre-existing condition," he said. "But that doesn't mean that we should not have a plan in place."