AstraZeneca shipment in storage as provinces mull how to use vaccine linked to rare risk

A plane carrying a shipment of AstraZeneca vaccine touched down on Canadian soil Thursday morning and landed in the middle of a national debate about how to use the shots linked to a very rare incidence of blood clot.

In the weekly update on vaccine distribution in the afternoon, Maj.-Gen Dany Fortin said the 655,000 doses, obtained through the global vaccine-sharing alliance known as COVAX, are being held at a facility near Toronto until the provinces put in orders for it.

Normally vaccines are repackaged and rushed out to provinces as quickly as possible, so they can get them into the arms of citizens.

But many of the provinces are still deciding how they want to use the doses.

“We want to assure everyone that sufficient supply will be available for those who want a second dose of AstraZeneca or who cannot take an mRNA vaccine (made by Pfizer BioNTech or Moderna),” he said.

This week, Ontario have paused use of the dose for first shots in part because of concerns about rare clotting called vaccine-induced thrombotic thrombocytopenia, or VITT, for short. There have been 18 confirmed cases in Canada so far, and 10 more suspected cases await laboratory confirmation. As of Tuesday, three people have died.

While provincial health officials in Ontario have said that the risk is still small, there has been an increase in reported incidents in recent days. While the rate was previously one in 100,000, it’s now closer to 1 in 60,000, they told reporters on Tuesday.

Given the healthy supply of mRNA vaccines, officials have time to pause and look into the issue, they said.

Some provinces, including Alberta and British Columbia, have paused first doses of the vaccine because of supply issues.

Much of the vaccine is made in India, which has restricted vaccine exports as it battles one of the worst outbreaks on the planet.

The pauses are just the latest disruption for the British vaccine, and they have confused people who have taken it.

Speaking to media this week, Dr. David Williams, Ontario’s chief medical officer, was quick to assure those who had received AstraZeneca as a first dose, that they “did absolutely the right thing” given the protection it afforded while cases remain high. Officials in provinces are now investigating whether those same people should still receive AstraZeneca shots as a second dose, or whether another vaccine might be an option.

Deputy chief public health officer, Dr. Howard Njoo, said Thursday that advice from the National Advisory Committee on Immunization on second doses of AstraZeneca is expected shortly, but that the NACI is waiting for the results from a U.K. study on mixing and matching vaccines.

Early results from that study suggest doing this is safe, albeit that there is a risk of side-effects, but final results, including those evaluating the efficacy of doing so, aren’t expected for a few weeks.

Maj.-Gen. Dany Fortin says he and his team are working on advice to provide to the Trudeau cabinet on whether Canada should continue to receive additional doses of the Oxford-AstraZeneca vaccine, although he did not say what that advice would be.

Right now, there is a desire on the part of the provinces to have enough doses to administer second shots to those who have already received AstraZeneca, but plans after that “remain to be seen,” Fortin said.

In addition to the new delivery, there are between 250,000 and 270,000 doses in the country, and Fortin said there is still time to use them before they expire.

He added provinces, which have doses that might expire, can ask for help redeploying those them to other provinces that can and want to use the vaccine.

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Were it get to a point that the doses could not be used in Canada, Fortin said his team would communicate that to the government, but, given that the doses can be stored for three months, it would be speculation at this point to say what could or would be done with the vaccine.

“I think it would be premature to jump to the conclusion today that we’re running into a problem with the doses that we have in the country. There’s still time to use them.”

—with files from The Canadian Press

TORONTO STAR