Confused about chronic conditions and vaccine access in Quebec? Here are answers
MONTREAL -- It's been a confusing few days for Quebecers, and especially Montrealers, who live with chronic health conditions.
But after a series of contradictory statements, the province's health ministry clarified Friday what the progression will be.
The government also asked those who don't yet qualify to stop calling their pharmacists to try to book appointments -- a problem, apparently, and perhaps an unsurprising one after all the twists and turns this week.
WHAT WAS FIRST ANNOUNCED?
Last week, the province announced that as of Monday, April 12, a relatively small group of people in Montreal with extremely serious conditions, who are getting frequently treated in hospital, will begin getting their vaccinations -- in hospital, from their treating doctors.
It later expanded that to include all Quebecers with the same conditions. Those outside of Montreal will qualify as of Wednesday, April 14.
Here are the Quebecers who now qualify:
- People getting frequent hospital treatment for cancer
- People getting hospital-based dialysis
- People with certain transplants
- Anyone currently hospitalized with a condition that puts them at extra risk for COVID-19
- Anyone who needs to get their dose under the supervision of a hospital allergist.
These patients do not need to make appointments. Their treating doctors will arrange the shots.
The province clarified on Friday that this remains the only group of people with serious illness who have currently been given a timeline for getting a shot.
WHAT WAS THE CONFUSION?
However, on Wednesday and Thursday, contradictory information was released, including in comments by Public Health Director Dr. Horacio Arruda in a Thursday evening press conference.
First, the government, on Wednesday and again on Thursday morning, published a longer list of pre-existing conditions that will qualify people for priority access for vaccines, including diabetes, hypertension, anemia, heart and lung disease and obesity.
On Thursday evening, when asked about it, Arruda seemed to say the bigger group would also also eligible now, but they needed to book their shots through their pharmacist instead of doing it at the hospital or through the Clic-Santé website.
"I would say that's probably the place, if you have a chronic disease -- you go to your pharmacy and then they're going to be evaluating [your eligibility]," said Arruda.
"The very, very high-level, critical chronic diseases, [those] are going to be [done] in hospitals because they need to get care in hospitals. But for the other ones, the people who had a blood pressure, diabetes, and everything, that's going to be in pharmacies."
When asked if those people can book their shots "at the same time," he again said yes and urged them to call their pharmacists.
However, the entire exchange was in English, not Arruda's first language, which may have led to some miscommunication. While he was first asked if the bigger group would only get shots "alongside" the general public, he appeared to understand that to mean physically alongside, rather than at the same time.
In any case, on Friday, the province confirmed what it earlier announced: only the small group has access for now.
After that, Quebecers will get more news about which other people with health conditions will be eligible and when.
WHAT CAN THE OTHER GROUPS EXPECT?
First of all, for now, no one with any health conditions may book an appointment through Clic-Santé.
There is a second tier of health conditions that will soon be considered priority, but the patients with these conditions will hear they're eligible through their pharmacists, the health ministry told CTV.
"Soon, people followed on an outpatient basis for the following conditions will be able to obtain a vaccine against COVID-19 in their pharmacy," wrote spokesperson Marie-Claude Lacasse.
The key phrase is "on an outpatient basis" -- many of these conditions are the same or similar to those in the first list, but the patients are generally not being treated frequently in hospital.
Here's the list:
- Patients on dialysis for renal failure;
- Solid organ transplant (especially cardiac or pulmonary);
- Hematopoietic or bone marrow transplant according to the evaluation of the transplant doctor;
- People waiting for a short-term transplant (under the advice of the treatment team)
- Patients under active treatment for the following cancers:
- Hematologic cancers except CLL;
- Lung cancers, especially if radical radiotherapy;
- Cancers whose treatment induces severe immunosuppression according to clinical judgment (e.g. certain forms of chemotherapy);
- Advanced neurodegenerative problems or other condition causing significant difficulty in managing respiratory secretions.
"Pharmacists know these clienteles and will be able to directly offer them an appointment for vaccination when they renew their prescription, or by contacting them directly," said Lacasse.
The province hasn't yet responded to a request to clarify what kind of timeline it has in mind for this group.
As for the much bigger group affected by more common, and less serious ailments -- diabetes, hypertension, heart disease, et cetera -- they'll wait longer still, with no word yet on what the timeline might be.
When those on the second list above have gotten their shots at their pharmacies, "we will assess with pharmacists the possibility that they can vaccinate their customers who suffer from chronic diseases such as hypertension, diabetes, etc.," wrote Lacasse.
"These people are currently being asked not to contact their pharmacy to try to get an appointment."