Snowbirds complicate vaccine rollout
Despite a raging second wave of COVID-19 and travel restrictions to contain its spread, many older Canadians have made their annual winter migration south. While it is hard to begrudge anyone the chance to escape a Canadian winter, the estimated 375,000 snowbirds who travel annually to the U.S. and Mexico will likely complicate Canada’s response to the coronavirus, including the rollout of vaccines.
While two vaccines – one from Pfizer and the other from Moderna – have been approved in Canada and enough doses have been ordered to ensure every Canadian can be vaccinated, delivery will take time. Priority will largely go to those most at risk, including older Canadians in long-term care homes and frontline health workers. But the U.S., which provided massive funding for development through its “Operation Warp Speed,” has been among the first in line to receive vaccines.
As a result, Canadian snowbirds in the U.S. are now receiving these vaccines sooner than they would have had they stayed in Canada and before Canadians with similar or greater risks to COVID-19 infection. Putting aside the question of fairness to Americans who are also queueing up for these vaccines and the massive strains on their health system, there are good reasons to be concerned at the prospect of Canadian snowbirds seeking to become vaccinated as quickly as they can.
The first issue is that both of the vaccines approved thus far in Canada and the U.S. require two doses about four weeks apart. This raises the prospect of Canadian snowbirds receiving a first dose in the U.S. and then needing a second upon returning home. If they are unable to receive this second dose on time, they may have to re-start the vaccination process, potentially wasting one of the precious doses at a time when they are most needed. On the other hand, giving snowbirds priority for a second vaccine dose upon returning home raises the question of fairness for Canadians who did not travel abroad.
Second, Canadian snowbirds receiving vaccines abroad will further complicate the already difficult issue of creating a dynamic vaccine registry to track who gets what vaccine and when. This registry is needed to ensure that Canadians get their second dose on time, track vaccine uptake and herd immunity and identify any issues with side effects or loss of efficacy over time. All of this is already hard enough but if large numbers of Canadians are getting one or both vaccine doses abroad, completing a registry becomes considerably more difficult.
Finally, vaccines aren’t free or free from complications. While COVID-19 vaccine side effects have been rare, there have been issues with severe allergic reactions to the Pfizer vaccine in particular, in some cases requiring hospitalization. Moreover, while these vaccines have been promised to be free for Americans, it is possible that non-Americans will be charged and that even Americans will face administrative costs for receiving the vaccine. If Canadian snowbirds lack adequate travel insurance or savings to meet these needs, they will need to seek help from their provincial governments and Canadian taxpayers, especially in the case of emergency hospitalization and medevac back home.
In general, these issues aren’t new. Travel abroad by Canadians, especially seasonal stays by older Canadians, has always raised issues like ensuring that medical records are complete and fairness in paying for care. Many of these practical and ethical issues arising from the coming vaccine rush are entirely foreseeable. What is needed is for Canadian health authorities, provincial governments and our federal leaders to plan for these complications now. This will require reaching out to snowbird communities and associations to provide guidance on if and how they should seek vaccination and what will be required of them upon returning home.
New vaccine approvals are giving us hope this winter but now is the time to prepare for a still-challenging spring that includes the return of Canadian snowbirds from the U.S.
Jeremy Snyder is a bioethicist, professor in the Faculty of Health Sciences at Simon Fraser University and author, most recently, of Exploiting Hope.