Canada’s National Advisory Committee on Immunization (NACI) is recommending provinces pause the use of the AstraZeneca-Oxford COVID-19 vaccine on those under the age of 55 because of safety concerns — guidance most provinces said today that they would follow.
The change comes following reports out of Europe of very rare instances of blood clots in some immunized patients — notably among younger women.
But 300,000 of these shots have been administered in Canada already, with no reports of blood clots here, officials said. The blood clotting problem also has not been reported in people who have received mRNA vaccines like the Pfizer and Moderna products.
Speaking to reporters Monday, Dr. Shelley Deeks, the vice-chair of NACI, said that with “substantial uncertainty” around cases of vaccine-induced thrombocytopenia (VIPIT) in people with low platelets, the committee is recommending the suspension of shots in all people under 55 as a “precautionary measure.”
Based on early research out of Europe, VIPIT seems to be rare, occurring in anywhere from 1 in every 125,000 to 1 in 1 million people.
The European Union’s drug watchdog, the European Medicines Agency, has said it could not definitively rule out a link between the vaccine and rare types of blood clots associated with thrombocytopenia.
Specifically, it pointed to 18 cases of an extremely rare type of blood clot called cerebral venous sinus thrombosis (CVST), a condition that is much more common in women than men. Most of the cases occurred within 14 days of receiving the AstraZeneca shot, and the majority were in women under the age of 55.
Dr. Howard Njoo, Canada’s deputy chief public health officer, said people who develop stroke-like medical symptoms after receiving the AstraZeneca vaccine — shortness of breath, chest pain, leg swelling, abdominal pain, sudden onset of headaches or blurred vision — should immediately seek medical attention. There is no risk for people who have not developed such symptoms 20 days post-vaccination.
Asked why the shot is still recommended for people over the age of 55 given the many unknowns, Dr. Caroline Quach-Thanh, the chair of NACI, said the early data indicate that the rare blood clots are most common in younger people.
She said older Canadians should take whatever vaccine they can get because contracting COVID-19 poses a much greater health risk to them than the outside chance of developing this sort of blood clot.
“If you look at this overall, it’s a vaccine that prevents complications and deaths. We’re trying to contrast the risks and benefits,” she said.
WATCH: Vaccine committee recommends a pause on use of AstraZeneca vaccine among those under 55
Quach-Thanh conceded the barrage of bad headlines about AstraZeneca could increase vaccine hesitancy but said that with the pandemic running “rampant,” seniors should get a shot that greatly reduces their risk of COVID-19-related death and hospitalization.
“This vaccine has had all the ups and downs — its looks like a roller coaster,” she said, citing the changing guidelines on AstraZeneca.
Asked if he still has confidence in the safety of this product, Marc Berthiaume, the director of the bureau of medical science at Health Canada, said reports of rare, adverse health events are always possible when millions of people are treated with a vaccine.
“This vaccine remains relevant,” he said.
“This is something that is very rare and we need to continue to monitor it,” said Dr. Supriya Sharma, Health Canada’s chief medical adviser, adding this is a sign that Canada has a robust monitoring system.
“It’s reasonable to pause for a period of time while this continues to be evaluated,” she said. “I fully understand this can be confusing.”
… the benefits of using our vaccine to protect people from this deadly virus significantly outweigh the risks across all adult age groups.– AstraZeneca Canada
The policy shift comes as Canada is expected to receive 1.5 million doses of this product from the U.S. on Tuesday. The product has not yet been approved for use in the American marketplace.
The AstraZeneca shot has not been widely used in people under the age of 55 in this country.
Some jurisdictions, such as B.C. and P.E.I., have been using some of their supply…