Some vulnerable Manitobans are being added to the third COVID-19 vaccine eligibility list.

First Nations people living on a reserve in Manitoba will be eligible for a third COVID-19 vaccine. A centre working with First Nations leaders and the federal government, the Integrated Vaccine Operations Centre, is being reactivated to oversee this. Third doses can only be given if the second dose was given at least six months earlier.  This will affect approximately 7,200 people as of Monday morning, with the province expecting that number to climb higher as the days go on.

Dr. Marcia Anderson, the First Nations Pandemic Coordination Team public health lead, says there have been many breakthrough COVID-19 cases

"In a small community where there may be only two or three nurses providing 24/7 care, those two or three nurses can really be working 24 to manage the COVDI-19 response and that is the type of strain that we are talking about," Anderson says.

Out of Manitoba's 1241 breakthrough cases, 384 of those cases come from a First Nations reserve. The doctor says they are not sure if this has to do with underlying risks people on reserve face, such as overcrowded housing and classes and food insecurity. Children aged 11 and younger make up roughly 30 per cent of all COVID-19 cases on reserves.

How a community responds to an outbreak is also different than a more metropolitan region. She says a large part of healthcare is coordination, figuring out who is responsible for what. Anderson says responses can also include instances like in Norway House where three health agencies, federal, community, Manitoba's public health workers, and a University of Manitoba physician program called Ongomiizwin work together at the hospital.

"In remote communities, in most cases, there would be a nursing station, which is nurse-managed primary care with itinerant physicians services and then back up," Anderson says.

Third dose rollouts will be similar to how they were done previously with the first and second doses. Currently, this eligibility does not apply to people living off of the reserve.