The National Advisory Committee on Immunization had
recommended the pause for safety reasons and the Canadian provinces, which
administer health in the country, announced the suspension Monday.
“There is substantial uncertainty about the benefit of
providing AstraZeneca Covid-19 vaccines to adults under 55 given the potential
risks,” said Dr. Shelley Deeks, vice chair of the National Advisory Committee
on Immunization.
Deeks said the updated recommendations come amid new data
from Europe that suggests the risk of blood clots is now potentially as high as
one in 100,000, much higher than the one in one million risk believed before.
She said most of the patients in Europe who developed a rare
blood clot after vaccination with AstraZeneca AZN, +0.34% AZN, -1.10% were
women under age 55, and the fatality rate among those who develop clots is as high
as 40%.
Dr. Joss Reimer of Manitoba’s Vaccine Implementation Task
Force said despite the finding that there was no increase risk of blood clots
overall related to AstraZeneca in Europe, a rare but very serious side effect
has been seen primarily in young women in Europe.
Reimer said the rare type of blood clot typically happens
between four and 20 days after getting the shot and the symptoms can mirror a
stroke or a heart attack.
“While we still believe the benefits for all ages outweigh
the risks I’m not comfortable with probably. I want to see more data coming out
of Europe so I know exactly what this risk benefit analysis is,” Reimer said.
The AstraZeneca shot, which has been authorized in more than
70 countries, is a pillar of a U.N.-backed project known as COVAX that aims to
get COVID-19 vaccines to poorer countries. It has also become a key tool in
European countries’ efforts to boost their sluggish vaccine rollouts. That
makes doubts about the shots especially worrying.
“This vaccine has had all the ups and downs. It looks like a
roller coaster,” said Dr. Caroline Quach-Thanh, the chair of the National
Advisory Committee on Immunization, when asked if the latest news will lead to
further vaccine hesitancy.
Health Canada said it has not received any reports of blood
clots in Canada, and the department’s chief medical adviser, Dr. Supriya
Sharma, said she still believes the vaccine’s benefits outweigh the risks.
Last week, the department changed its label on the vaccine
to warn about the rare risk of blood clots.
Only those 60 and above have received AstraZeneca in
Ontario, Canada’s most populous province.
“We have no concerns with those who have received it so
far,” said Dr. David Williams, Ontario’s chief medical officer.
Mark Mendelson, a 63-year-old Toronto man who has had heart
surgery, said that he has no regrets about getting his first AstraZeneca dose
two weeks ago and that he will get the second.
“Get what you can,” Mendelson said. “I had no ill effects at
all from the AstraZeneca. I am in a better position than those who don’t have
any vaccine at all. If you are betting person you would take those odds any day
of the week. I’m quite prepared to roll the dice.”
Several European countries that had suspended using the
vaccine over concerns it could cause blood clots have resumed administering it
after the EU’s drug regulator said the vaccine was safe.
The vaccine is used widely in Britain, across the European
continent and in other countries, but its rollout was troubled by inconsistent
study reports about its effectiveness, and then more recently the scare about
clots that had some countries temporarily pausing inoculations.
Canada is expected to receive 1.5 million doses of
AstraZeneca from the U.S. on Wednesday.
“The messaging has been brutal overall. I am fearful it is
toast. It shouldn’t be,” said Dr. Andrew Morris, a professor of infectious
diseases at the University of Toronto and the medical director of the
Antimicrobial Stewardship Program at Sinai-University Health Network.
Morris thinks those who are at a high risk for a bad
COVID-19 outcome and over the age of 55 should get AstraZeneca if the other
vaccines are not available to them, especially during a third wave of coronavirus
infections.
Canadian regulators approved the Pfizer, Moderna,
AstraZeneca and Johnson & Johnson vaccines. Canada has placed bigger bets
on Pfizer and Moderna, ordering up to 76 million doses of Pfizer and up to 44
million of Moderna, compared with up to 20 million of AstraZeneca. It’s not
known when Canada will receive its first shipment of Johnson & Johnson JNJ,
+0.67%.
Canada received its first shipment of AstraZeneca this month
— 500,000 doses from India. Of the 194,500 doses that Ontario received, about
10,000 remain. They expire April 2.
Canada has lagged on vaccinating its population because it
lacks the ability to manufacture the vaccine and has had to rely on the global
supply chain for the lifesaving shots, like many other countries.
With no domestic supply, Prime Minister Justin Trudeau’s
government bet on seven different vaccines manufactured elsewhere and secured
advance purchase agreements — enough to get 10 doses for each of Canada’s 38
million people. While acquiring them has proven difficult, deliveries have
ramped up this month. Canada expects to have more than 36.5 million doses by
July and officials hope to get at least one dose into all adults who want one
by the end of June.
The National Advisory Committee on Immunization earlier
recommended a four-month delay between doses after data from the U.K. and
Quebec showed a good level of protection offered by the first shot. The U.K.
has instituted a similar delay.
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