The largest mass immunization effort in Canadian history began Dec. 14 in Ontario and Quebec after the country received its first COVID-19 vaccine shipment.
Prime Minister Justin Trudeau said Canada has signed a contract to receive up to 168,000 doses of Moderna's COVID-19 vaccine by the end of December, ahead of their planned January arrival and part of 40 million Moderna doses Ottawa has secured for delivery by the end of 2021.
The Moderna vaccine has not yet been approved by Health Canada, but Trudeau said deliveries could begin within 48 hours of it getting the green light.
Canada is also set to receive about 200,000 of its total early shipment of Pfizer-BioNTech doses this week, on top of 30,000 last week. They are bound for 70 distribution sites across the country — up from 14 now — where the vaccine can be administered.
A vaccine maker said vials may yield more doses than expected.
Pfizer Canada spokeswoman Christina Antoniou said in an email that the amount of any excess vaccine left in the vial can vary based on provider technique and ancillary supplies.
"There may be excess vaccine in the vial after withdrawal of five doses, which in some cases may leave enough volume for an additional dose."
Health Canada said in a statement that it's aware vials may contain more than the five doses of 0.3 millilitres indicated on the label.
It said there are safeguards against potential losses in volume that can happen during storage, preparation and administration of the vaccine, and that can result in an extra dose or two.
Alberta's chief medical officer Dr. Deena Hinshaw said extra vaccine in vials would be given when possible.
The Canadian military is assisting a massive effort to distribute 249,000 doses developed by pharmaceutical giant Pfizer and German partner BioNTech.
Here's a look at what the various provinces have said about their rollout plans:
Newfoundland and Labrador
A public health nurse in St. John's, N.L., received the province's first dose of the Pfizer-BioNTech vaccine at Memorial University on Dec. 16.
Newfoundland and Labrador's chief medical officer of health, Dr. Janice Fitzgerald, administered the symbolic first vaccine.
Premier Andrew Furey said he anticipated receiving 1,950 doses of the COVID-19 vaccine at the St. John's receiving site last week.
Furey also said the province expects another shipment of the vaccine later in the month.
Prince Edward Island
In Charlottetown, a physician, a resident-care worker and a registered nurse were among the first people vaccinated on Prince Edward Island on Dec. 16.
Dr. Heather Morrison, the province's chief medical officer of health, said a few hundred people would be vaccinated each day until Dec. 19.
P.E.I. received 1,950 doses of the vaccine in its first shipment.
The owner of a bluefin tuna exporting company in the eastern part of P.E.I. has offered up two freezers to the provincial government to aid in the effort to store the vaccine.
The province held its first COVID-19 vaccination clinic at the Miramichi Regional Hospital on Saturday (Dec. 19).
Pauline Gauvin, an 84-year-old resident of Shannex Losier Hall in Miramichi, was the province's first recipient of the vaccine.
New Brunswick's health minister had said a shipment of 1,950 doses of the Pfizer vaccine would be used to inoculate long-term care residents and staff, staff from rapid COVID-19 response teams, ambulance workers, health-care workers involved in COVID units, seniors 85 and older and First Nations nurses.
Dorothy Shephard said the vaccine plan was being carried out by the provincial Emergency Measures Organization.
The first round of vaccinations were being done at the Miramichi Regional Hospital, starting on Dec. 19 and continuing the following day. The hospital has an ultralow-temperature freezer to store the vaccine.
A nurse who works in a COVID unit at the Halifax Infirmary, was the first recipient in her province of the Pfizer-BioNTech vaccine on Dec. 16.
The province's chief medical officer of health said 1,950 doses of Pfizer's vaccine were received on Dec. 15.
Dr. Robert Strang said the first shots in Nova Scotia were destined for 350 front-line health workers in Halifax and would be administered at a clinic close to the Dalhousie University campus, where the province's first shipment of the vaccine is being stored.
Strang said because the vaccine has specific handling requirements, Pfizer has stipulated that the initial round of immunizations take place near where the doses are stored.
Nova Scotia has one ultralow-temperature freezer to store the vaccine at the tertiary care teaching complex at the Queen Elizabeth II Health Sciences Centre.
Strang said the province is getting another freezer through Ottawa that will operate out of a central depot for vaccines at the public health office in Halifax. The province is also looking at securing freezers from the private sector.
The first doses of Pfizer's COVID-19 vaccine were administered in the province on Dec. 14.
Residents of long-term care homes and health-care workers are being given first priority.
The groups next in line are people living in private seniors residences, followed by residents of isolated communities and then anyone aged 80 and over.
Ontario received 6,000 doses of Pfizer's COVID-19 vaccine last weekend and began giving them out on Dec. 14.
Retired gen. Rick Hiller, who is leading Ontario's vaccine task force, said half the shots would be administered last week, and the other half would be intentionally held back to give the same workers a required second dose 21 days later.
"Given the sort of information flow of what we know about the supply, which is very little at this time ... we decided it was better to err on the side of caution," he said.
An additional 90,000 doses of the Pfizer vaccine are expected to arrive later this month and are to be provided to 14 hospitals in COVID-19 hot spots.
Hillier has said the province also expects to receive between 30,000 and 85,000 doses of the Moderna vaccine by the new year, pending its approval by Health Canada.
Ontario's Solicitor General Sylvia Jones said hospitals receiving the first shots have made security arrangements to ensure the vaccine is safe from theft.
A doctor who works in an intensive care unit became the first person in Manitoba to get the COVID-19 vaccine on Dec 16.
Premier Brian Pallister said some 900 health-care workers in critical care units would be the first to receive the vaccine.
As more shipments come in, priority will be given to other health-care workers, seniors and Indigenous people.
The province plans to vaccinate more than 100,000 people by March -- that's roughly seven per cent of Manitoba's population.
Officials say they've been setting up a large-scale "supersite" to deliver the vaccine. The first freezer able to store the Pfizer vaccine at low temperatures has been delivered and installed, with another four on the way.
The province says the vaccine will become more widely available at a larger number of sites, similar to a conventional vaccination campaign, such as the annual flu shot.
Saskatchewan began its vaccination program on Dec. 15 as two health-care workers got the first shots.
Premier Scott Moe says the province received 1,950 doses of Pfizer’s vaccine.
The first official stage of Saskatchewan’s vaccination program will be in late December when the province receives more doses.
It will target more health-care workers, staff and residents in long-term care, seniors over 80 and people in remote areas who are at least 50.
Some 202,052 doses of the Pfizer vaccine are expected to arrive within the first quarter of next year, and there are to be 10,725 weekly allocations.
Moe says vaccinations for the general population is expected to begin in April.
The first vaccinations in Calgary and Edmonton were given Tuesday to health-care workers.
Alberta Premier Jason Kenney announced in a video released on Dec. 14 and recorded next to a cargo plane at Calgary International Airport that the province's first 3,900 vaccine doses had arrived.
Alberta Health Minister Tyler Shandro said another 25,000 Pfizer doses would be coming this week and would be given to health workers.
Doses of the Moderna vaccine are expected by the end of the month.
The province says it eventually plans to roll out the vaccine from 30 different locations.
The first COVID-19 vaccination was administered on Dec. 15 in British Columbia. Those working in long-term care facilities and intensive care units were the first people to take part in the province's immunization program.
Provincial health officer Dr. Bonnie Henry said an initial shipment of 4,000 doses of the Pfizer-BioNTech vaccine would be available at two clinics in the regions covered by the Vancouver Coastal and Fraser health authorities, before immunization is eventually expanded to 30 sites.
Workers in long-term care facilities are at the top of the list to get the vaccine.
A joint statement from Henry and Health Minister Adrian Dix said nearly 2,600 doses of the Pfizer-BioNTech vaccine had been administered to front-line health-care workers as of Dec. 18.
Henry expects about 400,000 people to be vaccinated by March.
The province said it is developing a system so people can register to get the vaccine and receive a formal record of immunization.
Nunavut's premier says the territory will get the vaccine made by Moderna in the first quarter of 2021.
Joe Savikataaq says Prime Minister Justin Trudeau has told him Nunavut will get enough doses to vaccinate 75 per cent of the population.
Chief public health officer Dr. Michael Patterson says Nunavut will prioritize elders and health-care workers first for the vaccine.
Savikataaq says his government is still working on its plan to roll out the vaccine once it arrives in the territory.
The premier of the Northwest Territories says N.W.T. will receive 51,000 doses of the Moderna vaccine in the new year.
Caroline Cochrane says that's enough to vaccinate 75 per cent of the population ages 18 and up.
The territory is creating a vaccine team made up of nurses and support staff to travel to smaller communities.
Health Minister Julie Green says two specialized freezers for storing the vaccines are on their way from the federal government and will be placed in Yellowknife and Inuvik.
Smaller, portable freezers are also on the way and will be placed in smaller communities.
Yukon says it will get enough of the Moderna vaccine by spring to vaccinate 75 per cent of its residents.
A statement from the Yukon government says the territory's allocation is in recognition of its large Indigenous populations and remote communities.
Premier Sandy Silver says getting vaccinated is the best thing residents can do to protect themselves and their loved ones.
"Over time, widespread immunization will allow us to return to a life without COVID-19 restrictions."
This report by The Canadian Press was first published Dec. 20, 2020.
The Canadian Press