People with certain cancers and on immunosuppressants can book ahead of their age cohort

People deemed clinically extremely vulnerable will be able to register for a COVID-19 vaccine appointment starting on March 29.
In a Tuesday (March 23) news release, the province said that about 200,000 people with conditions that compromise their immunity will get a letter from the health ministry starting this week and might also be contacted by their treatment clinic or local health authority. That letter will let them begin to book appointments at noon on March 29.
The province said the conditions were determined by looking at people who have ended up in hospital, ICU or died due to COVID-19. Data from B.C. was used to determine which risk factors were most linked to serious illness or death from COVID and experts in cancer care, kidney disease, transplant, rheumatology, diabetes and developmental concerns, came together to review all the data and give clinical advice.
Ethics experts were consulted to make sure the list was fair to the rest of B.C.’s population.
READ MORE: Health officials give timetable for vaccinating all B.C. adults by July
B.C.’s aged based vaccination schedule was also moved up by one day. The timetable for seniors between the ages of 74 and 76 is:

  • Wednesday, March 24 at noon for people born in 1945 (age 76)
  • Thursday, March 25 at noon for people born in 1946 (aged 75)
  • Friday, March 26 at noon for people born in 1947 (aged 74)

The list of eligible clinically extremely vulnerable conditions includes:
People who have undergone a transplant:

  • People who have received a solid organ transplant at any time in their life

People with specific cancers:

  • People who have had systemic therapy for cancer now or have had it in the past 12 months, this includes chemotherapy, molecular therapy, immunotherapy, monoclonal antibodies and hormonal therapy for cancer.
  • People who are receiving radiation therapy for cancer now or in the past six months
  • People having or who have had targeted cancer treatments that can affect the immune system, such as CAR-T cell treatments in the past six months
  • People who have blood or bone marrow cancer (such as leukemia, lymphoma, myeloma and myelodysplastic disorders)
  • People who have had a bone marrow or stem cell transplant in the past six months, or are still taking immunosuppressant medicine related to the transplant

People with severe respiratory conditions: cystic fibrosis, severe chronic obstructive pulmonary disease (COPD), severe asthma:

  • cystic fibrosis: anyone with this condition (aged 16 and older)
  • people who have been hospitalized because of COPD at least one time since April 2018
  • People who have been hospitalized because of asthma at least one time since April 2018

People with rare blood diseases

  • including homozygous sickle cell disease, highest-risk thalassemia, meaning thalassemia and two of the following: transfusion dependent, receiving iron chelation therapy, pre-transfusion hemoglobin level of less than 70 in the last two to three years
  • people who have iron overload
  • people who have had their spleen taken out as treatment for thalassemia or have other significant health conditions
  • people who are over the age of 50
  • adults with atypical hemolytic uremia syndrome (aHUS) or paroxysmal nocturnal hemoglobinuria (PNH)

Other rare diseases:

  • people who have a condition for which they see a metabolic (biochemical diseases) specialist and who are known to have a metabolically unstable inborn error of metabolism
  • people who have severe primary immunodeficiency, meaning these people have combined immune deficiencies affecting T-cells; familial hemophagocytic lymphohistiocytosis or have Type 1 interferon defects
  • received a splenectomy at any time in their life or have been told they have a spleen that does not function (functional asplenia)
  • People with diabetes who take insulin:
  • People currently using insulin for diabetes (pump or injection)

People with a significant developmental disability:

  • such as Down syndrome and other conditions, that is significant enough the person requires support for activities of daily living and therefore use or receive support from: Community Supports for Independent Living, Community Living British Columbia, Nursing Support Services program for youth aged 16 to 19

People on dialysis or with Stage 5 chronic kidney disease:

  • dialysis (hemo and peritoneal)
  • glomerulonephritis receiving steroids
  • chronic kidney disease stage 5 (eGFR <15 ml/min)

People who are pregnant and have heart disease:

  • people who are pregnant and have a serious heart condition, congenital or acquired, that requires the person to see a cardiac specialist during their pregnancy

People with neuromuscular/neurologic or muscle conditions who require respiratory support:

  • people with significant muscle weakness around their lungs, such that they need to use a ventilator or use bi-level positive airway pressure (BiPAP) continuously
  • These include many patients with spinal muscular atrophy, Pompe disease and Duchenne muscular dystrophy, as well as a range of other conditions that lead to muscle weakness around lungs and where the individual is using home ventilation or BiPAP on a continuous basis.

People whose immune system is affected by immunosuppression therapies they take, including people taking high dose steroids or other medicines known to suppress the immune system:

  • people taking the following biologics since Dec. 15, 2020: Abatacept, Adalimumab, Anakinra, Certolizumab, Etanercept, Golimumab, Infliximab, Ixekizumab, Ocrelizumab, Sarilumab, Secukinumab, Tocilizumab, or Ustekinumab
  • people taking the following oral drugs since Dec. 15, 2020: Azathioprine, Baricitinib, Cyclophosphamide, Cyclosporine, Leflunomide, Mycophenolate, Sirolimus, Tacrolimus, Tofacitinib, Upadacitinib, Methotrexate, Dexamethasone, Hydrocortisone, Prednisone, or Methylprednisolone
  • people taking the following oral or injectable steroid products since Dec. 15, 2020: Dexamethasone, Hydrocortisone, Methylprednisolone or Prednisone
  • people 16 to 18 years of age, taking Canikinumab or Vedolizumab since Dec.15, 2020
  • people taking Rituximab since Feb. 15, 2020

@katslepian
katya.slepian@bpdigital.ca
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