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Coming week will see trickle of COVID-19 vaccine doses before floodgates open – Burnaby Now

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OTTAWA — The Public Health Agency of Canada is expecting a smaller-than-normal shipment of COVID-19 vaccines this week, with fewer than 445,000 doses of Pfizer-BioNTech shots  scheduled for delivery over the next seven days.

Yet that seeming trickle is set to explode into a full-blown flood starting the week of March 22 as the companies dramatically ramp up their deliveries and other pharmaceutical firms start making good on their own promised shipments.

The Public Health Agency says this coming week will be the last in which Canada will receive fewer than 1 million doses over a seven-day period. Pfizer and BioNTech alone are on tap to deliver more than that each week for the foreseeable future.

Canada is also expected to start receiving more shots of the Oxford-AstraZeneca vaccine starting in April, as well as Johnson & Johnson’s one-dose inoculation. Those are in addition to the bi-weekly delivery of doses from Moderna, the next of which is scheduled for the week of March 22.

Public Procurement Minister Anita Anand said on Friday that Canada is on track to receive 7 million vaccine doses from the various companies by the end of April, with a total of 36.5 million delivered by the end of June and 118 million before Sept. 30.

This week’s expected lull comes amid a report that more than 3 million COVID-19 vaccine doses had been administered in Canada as of Sunday, according to COVID19tracker.ca, with more than six per cent of the population having received a dose.

The coming week is also expected to see Canada’s National Advisory Committee on Immunization release new guidance on the AstraZeneca vaccine for seniors after initially discouraging their use for older residents. 

Those vaccines have been under the spotlight over the past week amid concerns within some European countries about alleged links to blood clots, though Canadian officials have said there is no scientific evidence to support such a link.

“There’s not a good biological explanation about why a vaccine of this type, injected into a muscle, would cause that kind of adverse event,” Health Canada’s chief medical adviser Dr. Supriya Sharma told The Canadian Press last week.

Denmark, Iceland, Norway and Bulgaria are among almost a dozen European nations that paused the use of AstraZeneca’s vaccine last week — either entirely or specific batches — after reports of some patients developing blood clots afterward. Ireland joined the list on Sunday.

None of those countries’ health officials said there was evidence of a link, but rather they were pausing use of the product out of an abundance of caution pending a review.

AstraZeneca released a statement on Sunday saying a review of 17 million patients who received the shot in Europe and the United Kingdom showed no elevated risk of blood clotting.

Ann Taylor, the company’s chief medical officer, said there’s no increased risk of either pulmonary embolism, deep vein thrombosis or thrombocytopenia in any age group, gender, batch of vaccines or country.

The company said there are reports of 15 patients experiencing deep-vein thrombosis and 22 pulmonary embolisms as of March 8, which is much lower than what would occur naturally in a population of more than 17 million people.

Germany, France, Poland, Nigeria and the United Kingdom are all among the countries joining Canada in sticking with AstraZeneca injections.

This report by The Canadian Press was first published March 15, 2021.

Lee Berthiaume, The Canadian Press

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Factbox-Some countries limit AstraZeneca vaccine use, US pauses J&J shot

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(Reuters) -Some countries are restricting use of the AstraZeneca COVID-19 vaccine to certain age groups or suspending use after European and British regulators confirmed possible links to rare blood clots.

Denmark became the first country to stop using the vaccine altogether, as it said results of investigations showed “real and serious side-effects”.

Johnson & Johnson’s single-shot vaccine has also been hit by concerns over blood clots, with European regulators reviewing such cases and U.S. federal health agencies recommending pausing its use for a few days. J&J noted no clear causal relationship had been established between the clots and its vaccine.

The developments pose a risk to vaccination plans in Europe.

Regulators have said the benefits of the AstraZeneca shot outweigh risks.

Anglo-Swedish drugmaker AstraZeneca said it was working with regulators to list the possible brain blood clots as “an extremely rare potential side effect” on the vaccines labels.

As of April 4, the European Medicines Agency had received reports of 169 cases of a rare brain blood clot known as cerebral venous sinus thrombosis (CVST), after 34 million doses had been administered in the European Economic Area. Most cases were in women under 60 years of age.

ASTRAZENECA VACCINE BEING USED, WITH OR WITHOUT RESTRICTIONS

AUSTRALIA

Said on April 8 it recommends people under 50 should get Pfizer’s COVID-19 vaccine in preference to AstraZeneca’s shot.

AUSTRIA

Has resumed use.

BRAZIL

Authorities said they would not limit use of the AstraZeneca vaccine, saying benefits outweigh risks.

BRITAIN

The Joint Committee on Vaccination and Immunisation has said an alternative to the vaccine should be given for people under 30 where possible, but people should continue to have a second shot if they have received a first dose.

BULGARIA

Resumed inoculations from March 19.

CYPRUS

Resumed inoculations on March 19.

CANADA

Authorities said in early April they would pause offering the vaccine to people under 55 and require a new analysis of the shot’s benefits and risks based on age and gender. On April 13, the country said it had recorded its first case of blood clotting with low platelets.

ESTONIA

Suspended use of the vaccine for people under 60 on April 7.

FRANCE

Approved resumption of the vaccine on March 19 but said it should be given only to people aged 55 and over. On April 9, recommended that recipients of a first dose of the AstraZeneca shot who are under 55 should receive a second dose with a messenger RNA vaccine.

FINLAND

Resumed using the AstraZeneca vaccine from March 29, but only for people aged 65 and over.

GEORGIA

Has limited use of the vaccine following the death of a nurse from anaphylactic shock, and vaccinations will continue only in full-fledged medical centres, Russian news agency TASS reported on March 19.

GERMANY

Sticking to its guidance from March 31 to limit use of the vaccine to those aged over 60. On April 1, Germany’s vaccine commission recommended people under 60 who have had a first shot of the vaccine should receive a different product for their second dose.

HUNGARY

Continuing the vaccine’s rollout.

ICELAND

Resumed use on March 25 after suspending it on March 11.

INDONESIA

Resumed using the vaccine on March 22 but warned against its use in people with a low blood platelet count.

IRELAND

On April 12, the country said it was restricting use of the vaccine to those over 60.

ITALY

Has recommended the vaccine be used only for people over 60, the country’s top health adviser said.

LATVIA

Announced it was restarting administering the shots from March 19.

LITHUANIA

Restarted use on March 19.

MEXICO

Drug regulator Cofepris said on April 7 it did not “at this time” plan to limit the vaccine’s use but was investigating the information raised by Britain.

NETHERLANDS

Limited use of the vaccine to people over 60, the Dutch government said on April 8.

NORTH MACEDONIA

Health minister said on March 31 the vaccine would be limited to people aged over 60 as a precautionary measure.

PHILIPPINES

Suspended use of the vaccine for people under 60 on April 8.

ROMANIA

Has resumed use of the vaccine after temporarily stopping vaccinating people with one batch of the vaccine on March 11.

SOUTH KOREA

Resumed use of the shot for people aged 30 or older on April 12. On April 7, it had suspended providing the AstraZeneca shot to people under 60.

SPAIN

From April 8, it was giving the vaccine only to people over 60.

SWEDEN

Resumed use of the vaccine on March 25 for people aged 65 and older.

THAILAND

Began use on March 15 after delaying rollout the week before.

COUNTRIES WHERE ASTRAZENECA VACCINE USE SUSPENDED

CAMEROON

Suspended administration of the vaccine it was scheduled to receive on March 20 as part of the global vaccines sharing scheme COVAX, the health ministry said.

DENMARK

In a world first, Denmark decided to stop using the AstraZeneca vaccine altogether after initially suspending use of the shot.

NORWAY

Authorities said on March 26 Norway would delay a decision on use of the vaccine, with a decision expected by April 15.

J&J VACCINE DELAYS AND RESTRICTIONS

UNITED STATES

On April 13, U.S. federal health agencies recommended pausing use of J&J’s COVID-19 vaccine for at least a few days after six women under the age of 50 developed rare blood clots after receiving the shot.

EUROPEAN UNION

The company said it would delay the rollout of the vaccine to Europe, after regulators said they were reviewing rare blood clots.

Widespread use in the EU had not yet started after the company began delivering the doses in the week beginning April 12. The European drug regulator recommended storing doses already received until its safety committee issues an expedited recommendation

SOUTH AFRICA

Suspended use of J&J’s vaccine on April 13.

(Reporting by Pushkala Aripaka, Yadarisa Shabong, Manas Mishra, Vishwadha Chander, Amruta Khandekar and Mrinalika Roy in Bengaluru; editing by Josephine Mason, Alison Williams, Timothy Heritage, Larry King, Barbara Lewis)

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Ontario hospitals may have to withhold care as COVID-19 fills ICUs

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By Allison Martell and Anna Mehler Paperny

TORONTO (Reuters) – Doctors in the Canadian province of Ontario may soon have to decide who can and cannot receive treatment in intensive care as the number of coronavirus infections sets records and patients are packed into hospitals still stretched from a December wave.

Canada‘s most populous province is canceling elective surgeries, admitting adults to a major children’s hospital and preparing field hospitals after the number of COVID-19 patients in ICUs jumped 31% to 612 in the week leading up to Sunday, according to data from the Ontario Hospital Association.

The sharp increase in Ontario hospital admissions is also straining supplies of tocilizumab, a drug often given to people seriously ill with COVID-19.

Hospital care is publicly funded in Canada, generally free at the point of care for residents. But new hospital beds have not kept pace with population growth, and shortages of staff and space often emerge during bad flu seasons.

Ontario’s hospitals fared relatively well during the first wave of the pandemic last year, in part because the province quickly canceled elective surgeries.

The College of Physicians and Surgeons of Ontario told doctors last Thursday that the province was considering “enacting the critical care triage protocol,” something that was not done during earlier waves of the virus. Triage protocols help doctors decide who to treat in a crisis.

“Everybody’s under extreme stress,” said Eddy Fan, an ICU doctor at Toronto’s University Health Network. He said no doctor wants to contemplate a triage protocol but there are only so many staff.

“There’s going to be a breaking point, a point at which we can’t fill those gaps any longer.”

In a statement, the health ministry said Ontario has not activated the protocol. A September draft suggested doctors could withhold life-sustaining care from patients with a less than 20% chance of surviving 12 months. A final version has not been made public.

Ontario’s Science Advisory Table had been forecasting the surge for months, said member and critical care physician Laveena Munshi. During a recent shift she wanted to call the son of a patient only to discover he was in an ICU across the street.

“The horror stories that we’re seeing in the hospital are like ones out of apocalyptic movies,” she said. “They’re not supposed to be the reality we’re seeing one year into a pandemic.”

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In COVID-19 vaccination pivot, Canada targets frontline workers

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By Anna Mehler Paperny

TORONTO (Reuters) – Canada is shifting its vaccination campaign to target frontline workers, moving away from a largely age-based rollout as the country tries to get a handle on the raging third wave of the pandemic.

Canada‘s approach thus far has left unvaccinated many so-called “essential workers,” like daycare providers, bus drivers and meatpackers, all of whom are among those at higher risk of COVID-19 transmission. Provinces are now trying to adjust their strategy to tackle the surge driven by new variants.

Targeting frontline workers and addressing occupation risk is vital if Canada wants to get its third wave under control, says Simon Fraser University mathematician and epidemiologist Caroline Colijn, who has modelled Canadian immunization strategies and found “the sooner you put essential workers [in the vaccine rollout plan], the better.”

Initially, Canada prioritized long-term care residents and staff for the vaccines, as well as the very elderly, health workers, residents of remote communities and Indigenous people.

Targeting vaccinations by age made sense early on in a pandemic that ravaged Canada‘s long-term care homes, Colijn said. But now, immunizing those at highest risk of transmission brings the greatest benefit.

“If you protect these individuals you also protect someone in their 60s whose only risk is when they go to the store. … The variants are here now. So if we pivot now, but it takes us two months to do it, then we will lose that race.”

Data released on Tuesday from the Institute of Clinical and Evaluative Sciences showed that Toronto’s neighbourhoods with the highest rates of COVID-19 infections had the lowest vaccination rates, underscoring the disparities in vaccination.

‘IT’S A JUGGERNAUT’

On Wednesday, Ontario Premier Doug Ford announced a plan to have mobile vaccine clinics target COVID-19 “hotspots” and high-risk worksites, although he stopped short of giving people paid time off to get the shot.

Karim Kurji, medical officer of health in York Region north of Toronto, characterizes the shift in vaccination priority from age to transmission risk as moving from defence to offence.

“It’s a juggernaut in terms of the immunization machinery, and turning it around takes a lot of effort,” Kurji said.

Meanwhile, officials in the western province of Alberta say they are offering vaccines to more than 2,000 workers at Cargill’s meatpacking plant in High River, site of one of Canada‘s largest workplace COVID-19 outbreaks. Provincial officials said in a statement they are looking to expand the pilot to other plants.

Quebec will start vaccinating essential workers such as those in education, childcare and public safety in Montreal, where neighbourhoods with the highest vaccination rates have been among those with the lowest recorded infection rates.

The people doing the highest-risk jobs, from an infectious disease perspective, are more likely to be poor, non-white and new Canadians, health experts say. They are less likely to have paid leave to get tested or vaccinated or stay home when sick and are more likely to live in crowded or multi-unit housing. They need to be prioritized for vaccination and their vaccination barriers addressed, experts say.

Naheed Dosani, a Toronto palliative care physician and health justice activist, said making vaccines available to high-risk communities is not enough without addressing barriers to access.

“The face of COVID-19 and who was being impacted changed dramatically. The variants seemed to take hold in communities where essential workers live. … This [pivot] is a step in the right direction and will hopefully save lives.”

 

(Reporting by Anna Mehler Paperny; Editing by Denny Thomas and Aurora Ellis)

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