On Friday morning, British Columbians began learning how, when and where they would be vaccinated against a virus that upended their lives and led to the isolation and deaths of seniors in their communities. 

Many of the details came in the measured tones of Dr. Penny Ballem, the former city manager for Vancouver and a veteran administrator at Vancouver Coastal Health, who’s now leading the province’s vaccination rollout after a surprise appointment on Jan. 14, two months after another VCH doctor and ex-military surgeon had been named to the role. 

CTV News Vancouver’s Penny Daflos had the opportunity to discuss several issues in-depth with Ballem over Zoom. The long-time doctor has been chair of the VCH board for two years, is called upon to advise governments across the country, and still has time to teach at UBC’s school of medicine. This interview has been edited for clarity and length. 

Penny Daflos: What has been the biggest challenge you’ve faced so far in planning for the vaccine?

Dr. Penny Ballem: It’s a very complex initiative. There’s many many moving parts: the vaccine supply, getting it to places at the right temperature and properly preserved, communications are going to be very challenging because we’re trying to reach the whole public at an individual level, organizing the clinics, making sure we have the right supplies and people there, the right people getting immunized, the clinics are big enough and safe because we’re still in COVID.

All of these different parts have to be built on because we’ve already started vaccinating, we’ve done 100,000 people, so we’ve got to scale it up. And then we’ve got the digital platform because we want people to be able to pre-register and do that online as much as possible, have a call centre where they can phone in and having that be robust and able to handle the volume – and being friendly. It has to be very, very public-friendly.

PD: Some people don’t think they need the COVID vaccine because they’re young and healthy. Other people avoid vaccines altogether. How will you address vaccine hesitancy?

DPB: My first problem is to address it for the people who want the vaccine, but I think vaccine hesitancy is on a continuum. What we’ve seen so far is there may be a little bit, but by and large people are realizing what a remarkable difference this makes to how you feel about your life and safety. I think this is going to be a really different setting from the annual flu vaccine and the, “Well, maybe I’ll get it, maybe I won’t.” I think that the pandemic has meant such a dramatic shift in people’s lives, a lot of people will want the vaccine and certainly that’s what we’ve been hearing.

For individuals who are nervous, we need to share with them the results of the vaccine we’ve already given. We’re going to see a significant shift in long-term care and the problems there start to resolve quite quickly and we need to use our whole community to help send the message that this is a safe vaccine, it’s effective, and it will really benefit every family, every business, everybody, to get vaccinated.

PD: Earlier, there had been plans to prioritize essential workers and now we’re seeing this shift to strictly age-based, except for a few people with specific medical conditions. What would you say to people disappointed they’re being told something different now?

DPB: Our essential workers – working our grocery stores, teaching our kids in schools, pharmacists, driving our buses, plumbers – are so important. But I think our community realizes the people who have really suffered from this illness are the older people. The evidence is very clear that if you’re over 60, you have five times the risk of having a bad course of COVID and ending up in the hospital and potentially the ICU. It’s really important we get that group and that population protected because first, we don’t want them unnecessarily waiting around and having adverse outcomes and death, and second, that’s how we protect our health-care system. We’ve seen across the world if you don’t protect the people mostly likely to end up in hospital, then your hospitals get filled up and then people who have a heart attack or an insulin coma, they can’t get in.

If suddenly the supply of vaccine doubled in Phase 3, then we can start looking at things that are quite different and think about those essential workers.

PD: When it comes to registering for an appointment, reminders for the booster shot, documenting which brand each person gets, we keep hearing about data issues the province has and they’ve had to correct something as simple as the number of positive tests. Is the province’s IT infrastructure ready for the vaccine rollout?

DPB: These are good questions and we all know these systems are complicated and they've often got some kinks you've got to work out, but there's been a lot of work done and I'm very shortly going to get an overview of where we are. There has been some very good work done across the country. Every province is looking at this and I think the most important thing is for us to recognize pre-registration, scheduling and the ability of people to schedule themselves and to get a reminder, those are probably three of the most critical things we need to have in place.

If you think about it, the ability to reserve and schedule going out to dinner, we've come such a long way in these systems in the world. Our digital technology economy is just a whole different place than even 10 years ago. I have a lot of confidence that we will have a system and I think it will probably evolve and we will have more options and modules and functions over time. But we have a very good database that is tracking every vaccination and we get a daily report that shows us day-by-day what's going on, how many people got their first dose, was it Moderna, was it Pfizer, and then I think the key thing will be, can an individual and the public go and get that information themselves? In the early days we will give them a piece of paper and as they get more comfortable with the system, they'll be able to go online and find their digital record – and we'll obviously be tapping the private sector for help and to get us prepared.

PD: Why did you replace Dr. Ross Brown and what role will he have now? 

DPB: Dr. Brown and I are colleagues, he has run our regional emergency operations centre at Vancouver Coastal Health and has remarkable skills at organization of these kinds of initiatives. So, I haven’t replaced Dr. Brown, but I think Minister Adrian Dix realized the scale of this is so big, we need Dr. Brown to be able to focus on those logistics issues and use the incredible experiences he’s had through his military deployments around bringing that big support mechanism to the broader issue.

Coordinating all the health authorities, notifying the public, finding people who are going to be eligible if they’re clinically very at risk, we need public communication, you need to communicate to the public in multiple channels. There’s just a lot of work to be done so we’re now into tier two of the process, so Dr. Brown isn’t going anywhere. We will work together as a team to get this thing done and then there will be other people we have to bring in to help.

We need to mobilize the public, we’ve got to get the faith community, non-profits, the business sector and local government. I’ve heard from so many people around the province who say “we want to help” and organizing all that and leveraging it is a really remarkable opportunity and there’s no one person who can do all that, so we need to build our team.