MONTREAL -- READ THE LATEST: Quebec says essential workers will be high vaccine priority, including teachers, daycare workers

Quebec appears to be on the cusp of rolling out the COVID-19 vaccine to more priority groups.

Health Minister Christian Dube said in a Twitter post that the province is adjusting operations, which he noted "is normal when changing priority group."

He also said people with chronic illnesses and essential workers will be vaccinated "soon," but did not provide further details.

His social media comments came ahead of a special 5 p.m. news conference Tuesday with Premier Francois Legault and public health director Horacio Arruda where tighter restrictions on the province's red zones were announced.

Although there are numerous medical conditions tied to higher rates of complications and death from COVID-19, the most important factor remains age, according Abinash Virk, a specialist in infectious diseases at the Mayo Clinic in Rochester, MN. 

"From all the data we've seen, age is a much higher risk factor than individual comorbidity," she said. "If you have somebody who is 25 and has leukemia, yes, they're going to be at a higher risk. But they also have... protection in some ways."

In late March, the Quebec government said people with health conditions would learn their vaccine priority level "shortly." But Public Health chief Horacio Arruda said distinctions would need to be made within that group, saying some health issues present higher risk than others.

But Virk warned of dangers in getting too specific when it comes to a vaccination plan.

"It becomes a much bigger balloon in terms of the number of people who have diabetes and comorbidities and obesity and other things," she said. "At that point, it's just a matter of, let's keep the queue moving. You can't get bogged down with the details.... It needs to be a little bit more simplistic, so that it's not making it hard for the people who are on the front-lines to try and decide who they should give the vaccine to."

The doctor noted that while data is still being evaluated, early evidence shows the vaccines may not be as effective in people with underlying conditions as those who are healthy, but "That's not unexpected at all."

"This is true for all other vaccines. In immune compromised patients, they just don't mount the same response," she said. "Will they have some benefits? For sure... but will it protect them from severe disease? Maybe, possibly. Will it prevent them from infection, period? Maybe not."

Virk also cautioned against requiring too much proof of underlying conditions. For the program to proceed at the rapid pace that's needed, some form of the honour system may be required. 

"If it was a small thing and you were just dealing with 100 people, you would be saying 'Okay, give me proof and a letter from your doctor.' But you really can't, it's not practical to have every patient go out there and get a letter from their doctor proving they have diabetes or x, y or z."

CALLS TO EXTEND PRIORITY GROUPS

The age limit for appointments for regions outside of Montreal was also lowered to 60 and older Tuesday. Those regions include the Outaouais, Monteregie. Abitibi-Témiscamingue and the North Shore. Montrealers in that age group can also book an appointment to get a shot. 

Elsewhere in Quebec, the age limit is capped at 65 and older. 

There have been calls to roll out the vaccination campaign to essential workers, including daycare providers who say they fear the effects of the third wave on their operations. 

Tuesday morning, Daniel Pare, the head of the vaccination campaign in Quebec, told radio station 98.5 FM that approximately 5,000 appointments went unfilled over the Easter weekend. 

However, Pare said none of the doses were wasted and were kept safe in freezers.