MONTREAL -- Quebec is broadening vaccine eligibility to include more people with chronic illnesses, gradually ramping up the vaccine campaign to being open to the general population.

At a press conference in Quebec City Thursday, Health Minister Christian Dubé said eligibility has been expanded to people under 60 with certain serious chronic illnesses who aren't followed in hospital.

The province provided a specific list of conditions that now qualify, including diabetes and severe heart disease.

People who fall into this category can begin booking appointments to visit vaccination sites or pharmacies starting Friday at 8 a.m., Dubé said -- though in past such moments, the online booking system has often been changed late at night on the previous night.

Appointments can be made by visiting the Clic Sante website or by calling 1-877-644-4545. 

The new group includes approximately 300,000 Quebecers.

The province also announced that as of April 28, it will open up vaccination to people with motor, intellectual, speech, language, visual and auditory disabilities, including autism.

The province said this will allow 250,000 more people to be eligible to get their first shot and that appointments will open up to one caregiver per person at the same time. 

"Since we have new vaccines, particularly the Pfizer vaccine, with additions in May and June, we can now... broaden to more vulnerable groups before going to the general population," Dubé said.

He said no proof will be required for these priority groups, and while it's unavoidable that some people might try to cheat the system, the province has decided not to make the process more complicated.

"We’re really relying on the good faith of people," Dubé said. 

Here is a full list of conditions that allow vaccine eligibility at a pharmacy or mass vaccination clinic as of Friday:

  • Kidney failure requiring dialysis
  • Severe immunosuppression
  • Chemotherapy or radiation therapy for cancer
  • Severe heart disease
  • Severe lung disease
  • Obesity (person with a body mass index of 35 or greater)
  • Diabetes
  • Sickle cell anemia
  • Trisomy 21 (Down's syndrome)
  • Medical condition causing a problem with clearing respiratory secretions or a risk of aspiration of secretions
  • Cognitive disorder (dementia, Alzheimer's and Parkinson's disease)
  • Spinal cord injury (hemiplegia and quadriplegia)
  • Neuromuscular disorders
  • Intellectual disability or spectrum disorder

Conspicuously missing from the list, in some people's opinions, is pregnant women. Toronto has seen a sharp increase in pregnant patients with COVID-19 landing in intensive care, and some Quebec obstetricians have called for pregnant people to be given high priority in vaccinations.

But Quebec Public Health Director Dr. Horacio Arruda said Thursday that the province doesn't consider pregnancy as high-risk as the other conditions it picked for the new group.

"I'm not telling you pregnant women are not at risk at all -- they are more at risk than a non-pregnant person -- but they are not as at risk as all the other ones we [are vaccinatinge] first," Arruda said.

PREVIOUSLY ELIGIBLE MEDICAL CONDITIONS

As before, others with serious illnesses who receive frequent hospital treatment are still eligible to get their vaccines in their treating hospitals. That includes people with these conditions:

  • Kidney failure requiring dialysis
  • Solid organ transplant (especially cardiac or pulmonary)
  • Hematopoietic or bone marrow transplants as assessed by the transplant physician
  • When relevant according to the treatment team, vaccination of individuals prior to a transplant, when the transplant will be performed in the short term
  • Oncology (patients undergoing active treatment) :
  • Hematologic cancers (applies to chronic lymphocytic leukemia in certain circumstances)
  • Lung cancers, especially if radical radiotherapy
  • Cancers where treatment induces severe immunosuppression according to clinical judgment (e.g., certain forms of chemotherapy)
  • Need to vaccinate a patient undergoing cancer treatment at a specific time in their treatment cycle due to anticipated fluctuations in immune function
  • Cognitive impairment (dementia, Alzheimer's and Parkinson's diseases)
  • Spinal cord injury (hemiplegia and quadriplegia)
  • Neuromuscular disorders

Patients currently hospitalized for certain chronic diseases were, and continue to be, eligible to get vaccines in hospital as well. The chronic diseases covered in that category are:

  • Cardiac diseases
  • Pulmonary disease
  • Renal disease
  • Obesity
  • Hypertension
  • Diabetes
  • Severe immunosuppression (according to the list of immunosuppression conditions established by the National Institute of Excellence in Health and Human Services)
  • Includes individuals undergoing active treatment for cancer
  • Sickle cell anemia
  • Trisomy 21 (Down’s syndrome)
  • Cognitive disorder (dementia, Alzheimer's and Parkinson's diseases)
  • Spinal cord injury (hemiplegia and quadriplegia)
  • Neuromuscular disorders
  • Presence of more than one chronic disease

WHEN WILL THE GENERAL POPULATION BE VACCINATED?

With the month of April almost over, Quebec is weeks away from its target to open up mass vaccination for the general public at the end of May.

Dubé was asked Thursday how that will work, and particularly if it will be done by age brackets as it was in the early vaccination campaign.

The minister didn’t provide any details, but he said discussions are ongoing with public health to deal with the idea of millions of Quebecers wanting to book an appointment at the same time.

"We've worked on different scenarios and we will want to make sure that it's done in the proper order and that things are going well for the time being," Dube said.

“We’ll come back to you with detailed answers.”

The province is still aiming to have everyone receive their first dose by June 24.

LOW SUPPLY OF ASTRAZENECA VACCINES

Just before the age limit for AstraZeneca was reduced to 45, there were just under 200,000 doses available in Quebec and they're going fast. Vaccination appointment slots in the Greater Montreal Area appear booked for the next seven days.

A severe COVID-19 crisis overseas is expected to hamper supply, as well. India recorded a record-breaking 314,000 new cases recently. The Serum Institute of India manufactures COVIDSHIELD vaccine, and Canadian officials confirmed Thursday that 1.5 million doses of that vaccine won’t be coming here as scheduled.

Dubé told reporters the remaining supply of AstraZeneca doses in the province will likely dry up in the next four to five days.

However, that will not affect the expanded eligibility announced Thursday, since people in those two priority groups will be getting the Pfizer vaccine, Dubé said.

"So there's no impact on everything that we've announced for May and for our objectives to vaccinate everybody by the 24th of June," he said.

Just over 30 per cent of Quebecers have gotten their first shot of a COVID-19 vaccine after the province reached a record high of nearly 85,000 vaccinations on Wednesday.