TORONTO -- Some provinces’ vaccine rollout plans have paramedics questioning whether their role in the COVID-19 pandemic is getting the recognition it deserves.

Paramedics working in Alberta and Saskatchewan aren’t included in the first round of Canadians eligible for COVID-19 vaccines, despite working on the front line of the health crisis.

Alberta paramedics will have to wait until the second phase of vaccinations, currently slated for April of 2021, which has left them feeling vulnerable.

“EMS members never know what they are about to encounter when responding to a call for help,” Mike Parker, president of the Health Sciences Association of Alberta, said in an emailed statement to CTV News.ca Monday.

“Paramedics are amongst the most at risk.”

Parker said he is urging the Alberta government to put EMS members, including paramedics, on the priority list for COVID-19 vaccines.

“What we have been told so far is decisions about the ‘second phase’ of the vaccine roll out will be made soon,” he said.

“Our paramedics are at constant risk. They must have access to supports and protections to ensure they can continue to be there for Albertans facing a medical emergency,” Parker said.

Tom McMillan, a spokesperson for Alberta Health Services, said the province recognizes “the important role” that EMS members play in the pandemic, but “right now, we’re receiving limited doses of the vaccine, so we’re starting in Phase 1 with those who are most vulnerable, and health care workers who serve them.”

Alberta’s Phase 1 vaccine rollout includes health-care workers in emergency departments and intensive care units, respiratory therapists and staff in long-term care homes, among others.

“The next phase will start in the spring. No decisions have been made on the specific priority populations or groups in this phase. A lot will depend on how much vaccine is available and how the virus is spreading, as well as the lessons learned from Phase 1,” McMillan said in an email to CTVNews.ca.

In Saskatchewan, only the immunization pilot scheme in Regina is set to include EMS – the rest of the province does not include paramedics in the first phase of vaccinations.

Meanwhile, six front-line paramedics in Saskatoon are currently in isolation after contracting COVID-19, and an outbreak was declared Dec. 22 at Medavie Health Services West, with 12 paramedics contracting COVID-19, according to local reports.

In a statement to CTVNews.ca, the Saskatchewan Ministry of Health said it is using recommendations  from the National Advisory Committee on Immunization, which suggests prioritizing those with advanced age or high-risk condition, before then moving into those likely to transmit the virus to the people most at risk, including personal care workers, and health-care workers.

“Saskatchewan's vaccine delivery plans for the first phase focus on immunizing priority populations who are at a higher risk of exposure to the virus or more at risk of serious illness – health-care workers, elderly residents in care homes, seniors over 80 and residents in northern remote communities,” the statement read.

British Columbia was among the provinces waiting to vaccinate paramedics, but the provincial government sent out an amended vaccination plan at the end of December that included paramedics in the first round of inoculations, which extend until February.

Prior to that, paramedic organizations were lobbying for the province to move them up from the second phase to the first phase in an effort to recognize just how front line their work really is.

“We’re in every environment. We’re in confined spaces, in the ambulances and in the aircrafts, we’re responding in every community,” said the president of the Ambulance and Paramedics of B.C., Troy Clifford, in a phone interview with CTVNews.ca last week.

Clifford said his organization felt that paramedics were “overlooked” in the initial phasing sequence of the vaccine administration in the province, and while they’re “obviously happy to be in the first group now” – they are “very low [priority]” in it.

“We need some more clarity [on] where we fit in, and making sure that we’re being assessed for the highest risk. How will the logistics of rolling out vaccines for the 4,500 paramedics across the province work? I don’t know,” Clifford said, adding that in some rural communities, paramedics are “the only medical support” available.

“There’s not a lot of time between now and February to figure out how we’re going to do that.”

Ontario also changed its tune after initially telling paramedics they would have to wait until the spring of 2021, or possibly later, for their vaccines, including them in the second phase of the inoculation program.

An announcement from Dr. Dirk Huyer, a member of Ontario’s vaccine task force, clarified in a briefing Dec.30 that paramedics would now be included in the first round of vaccinations, which has been extended into March.

Although meant as a corrective gesture, the move has left some paramedics feeling like they are still an afterthought despite the high-risk nature of their work.

“Dr. Huyer said basically the same thing [retired] Gen. Hillier did, but in a more friendly way. Whether we are the lowest priority group in phase one or the highest priority group in phase two, the timeline is still March/April,” Travis B., an advanced care paramedic working in Ontario, said in an email to CTV News.ca.

Some paramedics in Ontario have received the vaccine in recent days, but the timeline to get the shots to all EMS has not been solidified.

CTV News has agreed not to use Travis’ full name or name his employer due to his fear of professional reprisals.

“Pre-hospital care is an extremely intricate form of medicine that has changed a great deal. After SARS we learned that the nature of paramedic work and pre-hospital care can be a vector of transmission,” he said.

“We are making life-changing decisions in an uncontrolled environment. Much of the public policies surrounding paramedics and pre-hospital care haven’t been updated to reflect the work we do today.”

When Travis heard the amended announcement from the vaccine task force, he was unimpressed.

“I am happy to hear that additional considerations are being made, [but] I’m deeply concerned about the approach being taken by this government.”

Most other provinces have announced that paramedics will receive vaccinations in the first three months of 2021.

The Northwest Territories, Yukon and Nunavut announced that they hope to vaccinate 75 per cent of the adult population within the first three months of 2021, starting with elders and health-care workers.

While paramedics are not specified as health-care workers in the respective governments’ announcements, they do fall under the adult population.

‘EMOTIONAL BURNOUT’

Back in Ontario, Travis’ concerns are echoed by other paramedics.

“Prior to this pandemic, we were dealing with possible amalgamations…and a hiring freeze throughout the regions,” Jason V., another advanced care paramedic working in Ontario, said in a telephone interview with CTV News.ca last week.

CTV News has agreed not to use Jason’s full name or identify his employer due to his fear of professional reprisals.

Jason said the already thinly-stretched service was then slammed with a rapidly changing pandemic, with required PPE and protocols that added more stress to volatile environments.

“Even the most simple tasks like starting an IV and getting medication becomes that much more difficult [with PPE],” he said. “Especially communicating with people’s loved ones, you know, it’s so hard to be able to get that face-to-face interaction and you have to tell somebody their loved one has passed away.”

Every day brings new risks.

“Any day that you show up at work, you never know if that’s the day that you’re not carrying the virus,” he said. “We’re dealing with people who are not always honest about the symptoms and exposures…there have been reports of paramedics who have been spat on or their masks have been pulled down by patients deliberately.”

There’s a level across the board that I can sense a level of just emotional burnout.”

Jason said all of those factors came together in his reaction when the Ontario government first announced that paramedics would not be included in phase one of vaccinations.

“My original reaction was, ‘Here we go again.’ We have to fight to be recognized publicly as essential workers…so I wasn’t surprised at all,” he said, adding that like Travis, he was “really frustrated” with the “slight adjustment” to Ontario’s vaccine schedule.

“I can imagine this is an incredibly stressful situation for anybody who’s in government who has to make these difficult decisions, but the sense is that decisions are being made by people who are quite far removed from the front line and who don’t understand the frustrations and the risk of everyday patient interactions,” he said.

With files from Ben Cousins