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
Dr. Supriya Sharma, Health Canada’s chief medical adviser, discusses NACI’s recommendation to pause the use of AstraZeneca’s COVID-19 vaccine on those under the age of 55. 1:34
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 to immunize young people who work in public-facing sectors like grocery and convenience stores. In New Brunswick, the shot was made available to first responders and some teachers last week.
Meanwhile, Health Canada — which approved the vaccine for use in Canada in February — said its regulators would be adding “additional terms and conditions on the authorizations” for AstraZeneca and a biologically identical version of the drug manufactured by the Serum Institute of India, which has been branded Covishield.
The manufacturers will be required to conduct a “detailed assessment of the benefits and risks of the vaccine by age and sex in the Canadian context,” information that could lead to “additional regulatory actions.”
“This information will support the ongoing evaluation of these rare blood clotting events, and allow Health Canada to determine if there are specific groups of people who may be at higher risk,” the department said in a press release.
Benefits outweigh risks: AstraZeneca
AstraZeneca issued a statement this evening saying that it respects the decision by NACI and noting that Health Canada’s guidance on the vaccine has not changed since last week.
“Regulatory authorities in the U.K., European Union, the World Health Organization and Health Canada have concluded that the benefits of using our vaccine to protect people from this deadly virus significantly outweigh the risks across all adult age groups,” said AstraZeneca spokesperson Carlo Mastrangelo in the statement.
The statement went on to say that tens of millions of people around the world have now taken the AstraZeneca vaccine and “real-world evidence demonstrates its effectiveness.”
“Patient safety remains the company’s highest priority. We continue to work closely with Health Canada to share and submit safety data as it becomes available to ensure the appropriate use of our vaccine,” Mastrangelo said.
‘We just won’t use it, simple as that’: Ford
Speaking to reporters in Niagara Falls, Ont., Ontario Premier Doug Ford said today that the province would follow NACI’s guidance and reserve the current supply of AstraZeneca for those in the older cohort.
“I won’t hesitate to cancel that in half a heartbeat. If it’s going to put anyone in harm, we just won’t use it, simple as that,” he said, adding he didn’t want to “roll the dice” by using AstraZeneca on a group that may have an outsized chance of developing complications.
“The guidance from the federal government is that it is safe for people over 55,” Ford said. “I’m talking about younger people taking it, 35 years of age and in that range, that’s where the problem is.”
Dr. Joss Reimer, the medical lead on Manitoba’s vaccine implementation task force, said that the province also would pause its deployment of the vaccine among people under 55 because of a “very rare subtype, one specific type of blood clot.”
She said that while there have been no complications reported in Canada, “out of an abundance of caution” Manitoba will restrict the shot to people 55 to 64, for now.
“This is a pause while we wait for more information to better understand what’s happened in Europe. This is an important and evidence-based change,” she said.
Dr. Caroline Quach-Thanh, chair of the National Advisory Committee on Immunization, responds to questions about Canadians being hesitant to receive the AstraZeneca COVID-19 vaccine. 1:27
Reimer said it’s “probably” fine to use the vaccine on all groups — but she’s not comfortable with just “probably” and wants to wait to see more data from Europe.
This is just the latest issue the company has faced over the last three months.
Earlier this year, a number of European countries halted vaccinations in response to questions about the AstraZeneca product’s efficacy in people over the age of 65, only to restart them after new evidence emerged.
After Health Canada approved the shot for all adults, NACI recommended the product be used only on people under the age of 65, citing a dearth of clinical trial data on the vaccine’s effectiveness in older people.
NACI changed course earlier this month after reviewing three “real-world studies,” saying the two-dose viral vector vaccine can and should be used on seniors.
Last week, the U.S. Data and Safety Monitoring Board (DSMB), which keeps an eye on clinical trials, found “outdated information” may have been reported by the company when it released data on U.S. trials.
Dr. Anthony Fauci, U.S. President Joe Biden’s chief medical adviser and the head of the NIAID, said the monitoring board was surprised by the the better-than-expected efficacy results published by AstraZeneca.
HALIFAX – Nova Scotia Premier Tim Houston says it’s “disgraceful and demeaning” that a Halifax-area school would request that service members not wear military uniforms to its Remembrance Day ceremony.
Houston’s comments were part of a chorus of criticism levelled at the school — Sackville Heights Elementary — whose administration decided to back away from the plan after the outcry.
A November newsletter from the school in Middle Sackville, N.S., invited Armed Forces members to attend its ceremony but asked that all attendees arrive in civilian attire to “maintain a welcoming environment for all.”
Houston, who is currently running for re-election, accused the school’s leaders of “disgracing themselves while demeaning the people who protect our country” in a post on the social media platform X Thursday night.
“If the people behind this decision had a shred of the courage that our veterans have, this cowardly and insulting idea would have been rejected immediately,” Houston’s post read. There were also several calls for resignations within the school’s administration attached to Houston’s post.
In an email to families Thursday night, the school’s principal, Rachael Webster, apologized and welcomed military family members to attend “in the attire that makes them most comfortable.”
“I recognize this request has caused harm and I am deeply sorry,” Webster’s email read, adding later that the school has the “utmost respect for what the uniform represents.”
Webster said the initial request was out of concern for some students who come from countries experiencing conflict and who she said expressed discomfort with images of war, including military uniforms.
Her email said any students who have concerns about seeing Armed Forces members in uniform can be accommodated in a way that makes them feel safe, but she provided no further details in the message.
Webster did not immediately respond to a request for comment.
At a news conference Friday, Houston said he’s glad the initial request was reversed but said he is still concerned.
“I can’t actually fathom how a decision like that was made,” Houston told reporters Friday, adding that he grew up moving between military bases around the country while his father was in the Armed Forces.
“My story of growing up in a military family is not unique in our province. The tradition of service is something so many of us share,” he said.
“Saying ‘lest we forget’ is a solemn promise to the fallen. It’s our commitment to those that continue to serve and our commitment that we will pass on our respects to the next generation.”
Liberal Leader Zach Churchill also said he’s happy with the school’s decision to allow uniformed Armed Forces members to attend the ceremony, but he said he didn’t think it was fair to question the intentions of those behind the original decision.
“We need to have them (uniforms) on display at Remembrance Day,” he said. “Not only are we celebrating (veterans) … we’re also commemorating our dead who gave the greatest sacrifice for our country and for the freedoms we have.”
NDP Leader Claudia Chender said that while Remembrance Day is an important occasion to honour veterans and current service members’ sacrifices, she said she hopes Houston wasn’t taking advantage of the decision to “play politics with this solemn occasion for his own political gain.”
“I hope Tim Houston reached out to the principal of the school before making a public statement,” she said in a statement.
This report by The Canadian Press was first published Nov. 8, 2024.
REGINA – Saskatchewan Opposition NDP Leader Carla Beck says she wants to prove to residents her party is the government in waiting as she heads into the incoming legislative session.
Beck held her first caucus meeting with 27 members, nearly double than what she had before the Oct. 28 election but short of the 31 required to form a majority in the 61-seat legislature.
She says her priorities will be health care and cost-of-living issues.
Beck says people need affordability help right now and will press Premier Scott Moe’s Saskatchewan Party government to cut the gas tax and the provincial sales tax on children’s clothing and some grocery items.
Beck’s NDP is Saskatchewan’s largest Opposition in nearly two decades after sweeping Regina and winning all but one seat in Saskatoon.
The Saskatchewan Party won 34 seats, retaining its hold on all of the rural ridings and smaller cities.
This report by The Canadian Press was first published Nov. 8, 2024.
HALIFAX – Nova Scotia‘s growing population was the subject of debate on Day 12 of the provincial election campaign, with Liberal Leader Zach Churchill arguing immigration levels must be reduced until the province can provide enough housing and health-care services.
Churchill said Thursday a plan by the incumbent Progressive Conservatives to double the province’s population to two million people by the year 2060 is unrealistic and unsustainable.
“That’s a big leap and it’s making life harder for people who live here, (including ) young people looking for a place to live and seniors looking to downsize,” he told a news conference at his campaign headquarters in Halifax.
Anticipating that his call for less immigration might provoke protests from the immigrant community, Churchill was careful to note that he is among the third generation of a family that moved to Nova Scotia from Lebanon.
“I know the value of immigration, the importance of it to our province. We have been built on the backs of an immigrant population. But we just need to do it in a responsible way.”
The Liberal leader said Tim Houston’s Tories, who are seeking a second term in office, have made a mistake by exceeding immigration targets set by the province’s Department of Labour and Immigration. Churchill said a Liberal government would abide by the department’s targets.
In the most recent fiscal year, the government welcomed almost 12,000 immigrants through its nominee program, exceeding the department’s limit by more than 4,000, he said. The numbers aren’t huge, but the increase won’t help ease the province’s shortages in housing and doctors, and the increased strain on its infrastructure, including roads, schools and cellphone networks, Churchill said.
“(The Immigration Department) has done the hard work on this,” he said. “They know where the labour gaps are, and they know what growth is sustainable.”
In response, Houston said his commitment to double the population was a “stretch goal.” And he said the province had long struggled with a declining population before that trend was recently reversed.
“The only immigration that can come into this province at this time is if they are a skilled trade worker or a health-care worker,” Houston said. “The population has grown by two per cent a year, actually quite similar growth to what we experienced under the Liberal government before us.”
Still, Houston said he’s heard Nova Scotians’ concerns about population growth, and he then pivoted to criticize Prime Minister Justin Trudeau for trying to send 6,000 asylum seekers to Nova Scotia, an assertion the federal government has denied.
Churchill said Houston’s claim about asylum seekers was shameful.
“It’s smoke and mirrors,” the Liberal leader said. “He is overshooting his own department’s numbers for sustainable population growth and yet he is trying to blame this on asylum seekers … who aren’t even here.”
In September, federal Immigration Minister Marc Miller said there is no plan to send any asylum seekers to the province without compensation or the consent of the premier. He said the 6,000 number was an “aspirational” figure based on models that reflect each province’s population.
In Halifax, NDP Leader Claudia Chender said it’s clear Nova Scotia needs more doctors, nurses and skilled trades people.
“Immigration has been and always will be a part of the Nova Scotia story, but we need to build as we grow,” Chender said. “This is why we have been pushing the Houston government to build more affordable housing.”
Chender was in a Halifax cafe on Thursday when she promised her party would remove the province’s portion of the harmonized sales tax from all grocery, cellphone and internet bills if elected to govern on Nov. 26. The tax would also be removed from the sale and installation of heat pumps.
“Our focus is on helping people to afford their lives,” Chender told reporters. “We know there are certain things that you can’t live without: food, internet and a phone …. So we know this will have the single biggest impact.”
The party estimates the measure would save the average Nova Scotia family about $1,300 a year.
“That’s a lot more than a one or two per cent HST cut,” Chender said, referring to the Progressive Conservative pledge to reduce the tax by one percentage point and the Liberal promise to trim it by two percentage points.
Elsewhere on the campaign trail, Houston announced that a Progressive Conservative government would make parking free at all Nova Scotia hospitals and health-care centres. The promise was also made by the Liberals in their election platform released Monday.
“Free parking may not seem like a big deal to some, but … the parking, especially for people working at the facilities, can add up to hundreds of dollars,” the premier told a news conference at his campaign headquarters in Halifax.
This report by The Canadian Press was first published Nov. 7, 2024.
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