Amid a flurry of fear and frustration over new advice from Canada’s national vaccine advisers, Prime Minister Justin Trudeau told Canadians Tuesday if they want this pandemic to end, they still need to get vaccinated as soon as they can.
“The most important thing is to get vaccinated with the first vaccine offered to you,” he said in question period. “It is how we get through this.”
That is the same advice federal and provincial health officials have been giving Canadians since the first vaccines were approved in December. But it is in direct contrast to advice given Monday by the National Advisory Committee on Immunization.
NACI said the mRNA vaccines from Pfizer-BioNTech and Moderna are “preferred” because they don’t carry the remote risk of a new blood-clotting syndrome.
The 16-member panel of doctors and other vaccine experts said that Canadians who aren’t at high risk of COVID-19 may choose to turn down the offer of Oxford-AstraZeneca or Johnson & Johnson and wait until they can get an mRNA vaccine.
They came to that conclusion after looking at a risk-benefit analysis comparing the likelihood of vaccine-induced thrombotic thrombocytopenia or VITT, which is currently believed to be between one in 100,000 and one in 250,000, and the risk of COVID-19 among different age groups and different levels of the virus.
Seven cases of VITT have been confirmed in Canada out of 1.7 million people who received AstraZeneca. One of the cases was fatal.
NACI said Canadians under 30 shouldn’t be offered AstraZeneca or Johnson & Johnson at all, because their potential risk of contracting VITT outweighs their risk of severe illness or death from COVID-19.
NACI’s advice did not land well among some politicians or medical professionals this week.
New Brunswick Education Minister Dominic Cardy lumped NACI in with “anti-maskers” who are undermining the pandemic response.
“If a vaccine is approved by Public Health Canada … take that shot,” he said. “Ignore NACI, ignore anti-maskers, ignore the people undermining faith in science and do your part for New Brunswick.”
The Canadian Pharmacists Association, whose members are handling the injections of AstraZeneca in much of Canada, said NACI’s words were “disappointing” and could fuel vaccine hesitancy.
“I’m worried,” said Phil Emberley, the association’s acting director of professional affairs. “We need to get a lot of Canadians immunized in order to get over this pandemic.”
Emergency physician Dr. Brian Goldman said on Twitter Canadians should not be “choosy” about which vaccine they get.
“It pains me to say this but it’s past time to take NACI’s recommendations with a grain of salt,” he said.
Nova Scotia chief medical officer Dr. Robert Strang, however, sided with NACI.
“All our vaccines are good vaccines but the reality is the mRNA vaccines are better vaccines,” he said.
Neither Trudeau nor Chief Public Health Officer Dr. Theresa Tam would directly acknowledge the contradiction in advice, prompting Conservative Leader Erin O’Toole to accuse Trudeau of just adding to the confusion.
“For months Canadians have been told to get the first vaccine available to them,” O’Toole said. “Today, the prime minister refused to confirm that advice on 10 different occasions.”
Trudeau, who received AstraZeneca himself April 23, said he doesn’t regret it. Health Minister Patty Hajdu, who also received it last month, said the same thing.
Tam said she understands that people may be frustrated or angry about changing advice but she said recommendations evolve as science changes. She said there are different risk-benefit conclusions based on individual and community situations.
“But again, I’ll reiterate from our chief medical officers that the AstraZeneca vaccine deployed in the middle of a third wave has saved lives and prevented serious illnesses,” she said.
Some of the debate may not matter much because the shipments of mRNA vaccines vastly outweigh expected shipments of AstraZeneca or J&J.
Pfizer is sending 20 million doses by the end of June, including two million this week. Moderna is to ship another 8.5 million to 10.5 million, including a shipment of one million doses that will arrive Wednesday, a week ahead of schedule.
Comparatively, Procurement Minister Anita Anand said Tuesday there are only deliveries of about 1.6 million doses of AstraZeneca expected, though negotiations to get additional doses from a U.S. supply of that vaccine are ongoing.
There are no shipments of J&J even tentatively scheduled.
The first 300,000 doses of J&J arrived last week but are on hold because they were partly made at a Maryland facility with numerous safety violations. Health Canada is trying to verify the doses meet required standards.
By the end of September, Canada expects to get 44 million Moderna, 48 million Pfizer, approximately 24 million AstraZeneca and 10 million J&J.
Emberley said he’s also worried NACI’s advice will make Canadians who already received AstraZeneca afraid to get their second dose.
There are studies underway about mixing two different vaccines, with the first results expected later this month. Tam said Tuesday NACI will give advice on that before the second doses of AstraZeneca are due for the first people who got it.
On the current four-month schedule in Canada, that would be in July.
This report by The Canadian Press was first published May 4, 2021.
Mia Rabson, The Canadian Press