Many Canadians in their 40s and early 50s rushed to book AstraZeneca shots Monday as several provinces jumped ahead of the usual immunization advisory process to allow millions more people to get a shot.
British Columbia, Alberta, Manitoba and Ontario decided to open AstraZeneca COVID-19 vaccine bookings to 40 to 55 year olds after hundreds of thousands of doses went unused by older people. Quebec was expected to also lower the age of eligibility from 55 this week.
“Pharmacies are getting a lot of calls from these 40-plus people who haven’t had a chance to get any vaccine until now,” said Sandra Hanna, head of the Neighbourhood Pharmacy Association of Canada. “It’s reminiscent of when we initially were giving vaccinations and the phones were ringing off the hook.”
The provinces made the decisions following a Health Canada finding last week that benefits from the vaccine far outweigh the risk of rare blood clots for all adult ages. However, Canada’s National Advisory Committee on Immunization (NACI) has not changed its guidance that AstraZeneca should only be used on people 55 and older, who are at greater risk of serious illness from COVID-19.
NACI advice is not binding but is usually followed by most provinces. The expert body is expected to issue new guidance Tuesday.
Isaac Bogoch, an infectious-disease specialist at the University of Toronto, said NACI is struggling to keep up with evolving information.
“They are doing the best they can to turn emerging global data into meaningful national policy advice, but it’s hard to do in real time,” Dr. Bogoch said. “They are a group of expert volunteers in vaccination and other areas and they haven’t been resourced to do that.”
About 1.5 million AstraZeneca doses came from the United States in late March and early April. While distribution to people 55-plus started with enthusiasm in some areas, the 1-in-250,000 risk of a blood clot that Health Canada associates with the vaccine quickly limited uptake. It is unclear how many doses remain across the country. They expire at the end of May or the end of June.
Dr. Bogoch and Tania Watts, an immunologist at the University of Toronto who has received an AstraZeneca dose, both said while some healthy 40-year-olds who are not top priority for vaccination will now get a shot, it is important to move swiftly while also reaching vulnerable people.
“They need to get into areas of high incidence, but they also need to make sure they don’t let doses expire,” Dr. Watts said.
She added pushing AstraZeneca with its reputation problem too hard into vulnerable neighbourhoods could backfire. “You run the risk people in high-risk areas will ask, ‘Why that vaccine instead of the other ones?’ ” she said. “Vaccine equity has many facets.”
Ontario set the trend Sunday when it lowered the age of AstraZeneca eligibility to 40-plus from 55 and over. While Ministry of Health officials could not say Monday exactly how many AstraZeneca doses are left in Ontario, at least 400,000 to 500,000 doses likely remain for three million newly eligible Ontarians.
Brent Roussin, Manitoba’s Chief Provincial Public Health Officer, said the province has seen hesitancy to take AstraZeneca shots as he lowered the province’s legibility age to 40 and older. “With the risk of this third wave, the transmission we’re seeing right now, the risk of COVID far outweighs the rare outcome of this very small number of blood clot outcomes,” he said.
In Alberta, only about 98,000 doses were used by people older than 55. About 575,000 more people are now eligible for the province’s remaining 170,000 doses.
British Columbia also lowered the age eligibility to 40, saying it will use 75,000 doses to target 13 communities with the highest rate of transmission. They include Surrey, which has the highest rates of COVID-19, as well as several other communities including Squamish, Port Coquitlam and Dawson Creek.
Quebec has used half of its 411,200 AstraZeneca doses on its 55-plus campaign that included appointments, drop-in clinics and targeted campaigns in hard-hit neighbourhoods of Montreal. After an initial burst of enthusiasm that saw long lines and bookings quickly snapped up, at least 300,000 people in the 55-to-59 age bracket passed on the vaccine.
The provinces have carried on with their Moderna and Pfizer-BioNTech vaccination programs. Pfizer in particular has been the backbone of the vaccination campaign with weekly deliveries of one million doses.
An Angus Reid Institute poll published last week found 41 per cent of Canadians were comfortable with AstraZeneca compared with 90 per cent for Moderna and 92 per cent for Pfizer.
“What Canadians have heard is a mix of worrisome things,” said Angus Reid Institute president Shachi Kurl. “One organization warns about it, we hear about blood clots, Health Canada says one thing, NACI something else. Public opinion is deeply galvanized on this issue. It will take a concerted public-health effort to change it.”
With a report from Justine Hunter in Victoria
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