In what Dr. Deena Hinshaw described as a “precautionary measure taken across Canada,” Alberta is pausing the use of the AstraZeneca COVID-19 vaccine in anyone under the age of 55.
Alberta’s chief medical officer of health said the decision comes after “rare reports of blood clots” in people in Europe. Some who received the dose reported a blood clot in the brain four to 20 days after.
She said there are no reports of this happening in Alberta or Canada.
Hinshaw also said there is no evidence of similar incidents linked to other vaccines approved for use in Canada.
Earlier Monday afternoon, Canada’s National Advisory Committee on Immunization (NACI) announced it is now recommending AstraZeneca’s COVID-19 vaccine not be administered to people under the age of 55.
“As you’ve heard, rare cases of serious blood clots that have been associated with low platelets have been reported in Europe following use of AstraZeneca vaccine in those populations,” Dr. Shelley Deeks, vice-chair of the NACI, said.
Deeks said NACI has “determined there is substantial uncertainty” around the benefit of providing AstraZeneca to adults under 55 years of age given the potential risk.
So far, Deeks said the majority of the cases of the adverse effect– known as vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) — have been identified in women under the age of 55.
However, she said cases in men have also been reported.
Hinsahaw said Monday this pause will provide Health Canada time to conduct further assessments, gather additional information and “provide a robust, informed consent to that younger age group.”
About 900 Albertans under the age of 55 have received one dose of AstraZeneca. Hinshaw said those who have “already received the dose of AstraZeneca are not considered to be high risk of blood clots.
“This is a very rare condition… the most common event is one in 25,000 doses in that Norwegian report… ranging to one in one-million.
“The risk, I believe, to be extremely low. And we do not believe this is likely to happen but we are taking a precautionary approach,” Hinshaw said.
She said the AstraZeneca vaccine remains a good choice for those who are at risk of severe outcomes from COVID-19 who would otherwise have to wait several months for a different vaccine.
Alberta will continue to offer it to those over 55 in the coming weeks.
“The benefits of getting the vaccine far outweigh the risks,” she said.
Hinshaw said there are less than 200 AstraZeneca doses left in Alberta and none will expire before May.
Hinshaw said she understands that some people might feel confused or hesitant about this particular vaccine.
“Of course it can be confusing for people because there have been different recommendations when it comes to the use of AstraZeneca,” she said.
“It’s important for people to know that the initial recommendations regarding use of the vaccine only for those under 65 was not based on any kind of safety issue; but rather based on a lack of information from the initial clinical trials about how well it worked on those over 65.
“Once we were able to get additional information from real-world use of the vaccine in the U.K. — where use of the AstraZeneca vaccine in those over the age of 65 showed significant protection against those severe outcomes of hospitalization and death — then we had the ability to say: ‘Yes, this vaccine has proof now that it does perform well in those age groups.’
“It was a different reason for that recommendation. But I recognize, for some people, they may be feeling concerned.”
Hinshaw urged Albertans to look for reliable sources of information.
Phase 2B of the province’s vaccine rollout will open on Tuesday, meaning Albertans born in 1963 or earlier with eligible underlying medical conditions will be able to book a vaccine appointment through participating pharmacies that have supply in Calgary, Edmonton and Red Deer.
Phase 2B includes more than 945,000 Albertans with underlying health conditions, including cancer patients, transplant recipients, people living with disabilities, dementia and other conditions that put them at a higher risk of severe outcomes of COVID-19.
Appointments for this group can be booked directly through participating pharmacies.
Dr. Howard Njoo, the country’s deputy chief public health officer, said Health Canada will be pausing the use of the vaccine in those under 55 as a “precautionary measure,” while the agency conducts further “risk benefit assessment.”
Njoo said if you have received an AstraZeneca vaccine more than 20 days ago and have experienced no adverse effects there is “no cause for concern.”
Even without AstraZeneca, Hinshaw said officials “believe it may still be possible to meet the target” of offering a first dose of vaccine to any Albertan who wants one by the end of June, “based on what we’re currently anticipating.”
Alberta is expected to receive 175,400 doses of the AstraZeneca vaccine this week, according to the federal government’s vaccine rollout site.
Daily COVID-19 Numbers
On Monday, Alberta identified 545 new cases of COVID-19, including 249 cases of variants of concern.
The percentage of current active cases that are variants sits at 27 per cent.
Alberta conducted about 8,300 tests in the last 24 hours, putting its positivity rate at 6.5 per cent.
As of Monday, there were 288 Albertans in hospital with COVID-19, 64 of whom were being treated in intensive care.
There were no deaths linked to COVID-19 reported to Alberta Health in the last 24 hours.
As of March 29, Alberta has administered more than 608,000 doses of vaccine.
Potential restriction changes?
Alberta’s top doctor revealed the R value of variants in the province is 1.35.
Hinshaw is imploring people to follow the rules over spring break to prevent further spread.
She said Alberta officials are constantly looking at data and may need to put additional measures in place, but no decisions have been made.
“We are always monitoring our data; not only our overall trends.
“The rise that we’ve seen lately in new cases — and subsequent beginning to some increases in our hospitalization — are concerning, so we are monitoring those things. We’re also watching to see where our new cases are coming from.
“One of the biggest challenges we have right now is that across many different sectors, many people that are perhaps feeling frustrated or tired of restrictions are not following the measures as much as they were before.
“So the real question is: what kinds of additional measures would be most effective to help remind all of us that we’re not through this yet and we don’t have enough immunizations offered to our population to be able to reduce the risk of a wave of cases becoming a wave of admissions in acute care?”
Immunologist responds
Immunologist and retired Simon Fraser University professor Dr. Jamie Scott said it’s important to look at risk versus benefit in the context of R value and rising spread of variant cases.
“Right now, from what Dr. Hinshaw reported, Alberta has a 1.3 R value when it comes to these variants, so they’re taking over the population.
“The incidence (of blood clots) is somewhere between one in 25,000 and one in a million. You have to look, to my mind, at the infection rate and ask yourself the question: what are the chances, given this worry about the blood clots, what’s our supply, how much RNA vaccine are we getting, how much is this slowing down the vaccination effort by pausing this vaccine?
“What’s the trade off between the potential for… how many people could get the blood clots versus how many people could end up in the hospital — which means they’re definitely going to have long-term COVID stuff happening to them; even people with moderate COVID infection have that — and dying?”
Scott said the data is showing that even after one dose of any of these vaccines, there’s already significant protection.
“If you don’t want to get vaccinated, you should really try to protect yourself in every other way possible. In other words, you need to stick to your bubble, stay away from other people you could potentially infect, mask, socially distance and don’t go to restaurants and stuff.”
— With files from