Beating the stale date – The return of the AstraZeneca pharmacy pilot project

Jeff Green | May 26, 2021

It might seem like a long time ago, but it has been just over ten weeks since the commencement of pharmacy based AstraZeneca vaccine rollout, that was targeted at the narrow cohort of the 60-64 year olds.

Kingston, Frontenac, Lennox and Addington was one of three districts that was chosen for the pilot, along with the COVID hotspot regions of Toronto and Windsor. The parameters of the rollout were challenging for independent, rural pharmacies because each participating pharmacy received the same amount of vaccine, 550 doses. It did not matter if the pharmacy was a large Shoppers Drugmart or Walmart pharmacy in Toronto or a small pharmacy in Harrowsmith or Northbrook, they had to commit to using every dose by April 1, when the vaccine was no longer usable.

Among the dozen or so pharmacies in KFL&A, who participated in the pilot project, there were four in rural Frontenac and Lennox and Addington; Tobia Guardian in Northbrook, and the Sharbot Lake, Harrowsmith, and Inverary Pharmasave stores.

The impact of the pilot project on the vaccination statistics in the region, is graphically depicted on the vaccination dashboard at KFLAPH. Over 2,000 people were vaccinated in the region, in each of the 8 days, between March 12 and March 19, with a peak of 3725 on March 16.

There have only been 2 other days when 2,000 or more people in KFL&A have been vaccinated since then. 

Since the pilot program was open to 60 to 64 year olds, who live anywhere in Ontario, many of those who got their AstraZeneca shot, during that time period, were travelers from outside the region.

It does demonstrate the local capacity to vaccinate when pharmacies are engaged.

In a media call on Friday, May 21, Kieran Moore, the medical officer of health for KFL&A, said “we are committed to keeping our fridges empty in KFL&A. We are receiving 10,000 shots of Pfizer each week for the next two weeks and maybe more after that, and other vaccine as well. Without pharmacy and primary care partners, in addition to our mass vaccination clinics in Kingston and Napanee, we are prepared to deliver 20,000 vaccines per week.”

Moore also talked about the second dose of AstraZeneca for those who received their first dose during the pharmacy pilot project between March 10 and March 19.

Since March, new rules for inoculation, with AstraZeneca, have been introduced several time. Cases of cases of blood clotting, always described as “rare” by health science officials in Canada and around the world, have been experienced in some cases, mostly after their first inoculation.

AstraZeneca is only being administered as a second dose in Ontario at the present time, and in addition to that there is a supply, 55,000 doses in Ontario, that will be stale dated at the end of May.

On Thursday, May 20, the Ontario Ministry of Health said that people who received a first dose of AstraZeneca between March 10 and March 19 can shorten the gap between the first and second dose to 10 weeks, from the recommended 12.

In order to do this, however, those who received their dose during that time frame are required to provide an attestation confirming they are choosing to receive the vaccine early. The attestation is necessary because “recent studies show the optimum interval for the two doses of AstraZeneca is 12 weeks or longer (with 10 weeks showing reduced protection)” in the words used by one of the local pharmacies who are participating in the program.

Doctor Moore said Public Health will be handling the distribution of the soon to be stale dated AstraZeneca supply that is earmarked for independent pharmacies in the region, and that the supply  was expected on Saturday, May 22.

“We will get the vaccine delivered early next week,” said Moore on Friday

The four rural pharmacies have been asked how much vaccine they expect to be able to administer before the end of May.

“It is a hard question to answer,” said Eric Tobia of Northbrook Pharmasave, “we want to make sure that any vaccine that we receive ends up in someone's arm, but I can't book people in until I know for sure when the vaccine will arrive.”

The Victoria Day weekend complicates matters as well. Most, if not all, of the independent rural pharmacies who are participating in the program will be closed on Sunday and Monday this week, leaving only 7 days to contact everyone who is eligible, determine if they want the second dose, obtain an attestation, and secure an appointment.

Some of them will attempt to provide the service during regular pharmacy hours, while others may set up special clinics.

“I expect I will set up a clinic for the weekend, to keep it outside of our regular operation,” said Tobia.

The first dose vaccination rate in KFL&A, which was ahead of the provincial average, until a couple of weeks ago, has dropped down a bit as the result of a provincial focus on providing an extra share of the supply to COVID hotspots in Toronto and Peel region, but Dr. Moore indicated that will change in June.

The AstraZeneca pilot, version 2.0, will bump up the second dose statistics for KFL&A in the coming two weeks.