OTTAWA -- With vaccinations for COVID-19 potentially starting next week, how will governments be keeping track of who has received their first doses, and ensuring they come back on time for their second?

It’s largely going to be left up to the provinces to sort out, according to Chief Public Health Officer Dr. Theresa Tam. However, there are calls to have a streamlined process in place across the country, before shots start being administered.

“The provinces or the local administrators of the vaccine have to actually record—of course—who got vaccinated, and provide them with their own way of recalling them… for the second dose,” said Tam on Tuesday.

She added that part of that tracking will be making sure that once there is more than one vaccine option, people get the right second shot.

Almost all provinces and territories have their own immunization registries and systems of recording that will be leaned on for this immunization program, according to Tam.

On Tuesday, Ontario Health Minister Christine Elliott said that Ontario will issue government documentation so that people can prove they have received the vaccine. While the vaccine is not mandatory, Elliott suggested that Ontarians who refuse to get the vaccine when it's available could face restrictions when it comes to travel and access to communal spaces like movie theatres.

"That will be up to the individual person to decide whether they want to receive the vaccine to be able to do these things or not,” she said.

In addition to the provincial data, more top-line information will be fed back regularly to the federal government about the coverage rates in each region.

Tam said that nationally, work is underway—though with a very short runway—to develop some form of an IT platform that can track the delivery and implementation of the vaccine program across the country.

This comes as discussions are ongoing with the provinces and territories about having some form of uniform tracking system that is consistent from province to province.

Intergovernmental Affairs Minister Dominic LeBlanc said Monday that Health Minister Patty Hajdu is speaking with her provincial counterparts about it.

“It was a comment that [Newfoundland and Labrador] Premier [Andrew] Furey—who as you know is a medical doctor himself—made in the last call with first ministers and Prime Minister Trudeau. Dr. Furey said that he believed it was very important that we have access to this common platform across the country, so that the safety and efficacy can be tracked,” said LeBlanc.

Asked for more details about this national IT system, Innovation Minister Navdeep Bains couldn’t say what information that database might hold, but said any vaccine tracking will be done with privacy and accuracy in mind.

“We're going to focus on end-to-end logistics, we're going to focus on the distribution aspect of it, and as you indicated, the tracking aspect of it as well with the provinces and territories. And we're confident that our plan will make sure that Canadians get access not only to one, but two doses if required,” Bains said in an interview on CTV’s Power Play on Tuesday.

A ‘LIVE’ ISSUE IN OTTAWA

On Monday, in an interview on CTV’s Power Play, Procurement Minister Anita Anand said that the topic of establishing adequate record keeping systems is a “very live” issue that is currently being discussed between the provinces and territories, and the federal government.

“The need to have a system in place to record doses, and doses of which vaccine, and where the doses were given, and those are all issues that are on the table that need to be sorted out prior to the inoculations occurring,” Anand said.

This could come up Tuesday, at a scheduled meeting between Trudeau and the premiers.

While the initial databases will hold the names of thousands of vaccine recipients, over the next several months as the federal government aims to vaccinate the majority of the population, they will grow into the millions.

Over time, the complexity of the process could become less, as not all vaccines currently being tested require two doses, or extreme cold storage. Though questions do remain around whether, or how often Canadians may have to receive booster shots to ensure they maintain immunity.

For now, Pfizer’s vaccine candidate is set to be the first approved vaccine in Canada, with the first 249,000 doses expected to land in this country this month. The initial doses will arrive in a series of shipments and altogether would be enough to fully vaccinate approximately 124,500 Canadians, as the vaccine requires two needles, weeks apart.

Prime Minister Justin Trudeau has said he anticipates the “vast majority” of the initial doses will go towards both the first and second shots for the first batch of recipients, but the government is anticipating a steady stream of additional doses in the weeks and months ahead.

MONITORING FOR SIDE EFFECTS

Tam said that in addition to keeping track of who has been vaccinated against COVID-19, the cross-country tracking can play a role in monitoring the vaccines’ safety.

While there have not yet been reports of any serious side effects among the thousands of people involved in the various vaccine trials, Tam said that “when you actually begin to roll it out to millions of people, even rare side effects need to be detected.”

“For that we have a foundation of several layers of surveillance and monitoring,” she said.

This includes:

  • Health Canada’s “Canada Vigilance Program” which collects and assesses reports of suspected adverse reactions to health products marketed in Canada from pharmaceutical companies; 
  • The Public Health Agency of Canada's (PHAC) “Canadian Adverse Events Following Immunization Surveillance System” which is a post-market vaccine safety surveillance system that keeps track of reports from the provinces and territories as well as conducts active surveillance of vaccine safety;  and
  • Networks of hospitals and research facilities that can detect serious adverse events that may occur.

PHAC is also planning surveys in collaboration with Statistics Canada, to go into more depth in terms of who got vaccinated, and their experience.

“There's going to be quite a few different streams that will be at play,” said Tam.

With files from CTV Toronto