Tag Archives: AstraZeneca

Australia abandons COVID-19 vaccination targets after new advice on AstraZeneca shots

Australia has abandoned a goal to vaccinate nearly all of its 26 million population by the end of 2021 following advice that people under the age of 50 take Pfizer’s COVID-19 vaccine rather than AstraZeneca’s shot.

Australia, which had banked on the AstraZeneca vaccine for the majority of its shots, had no plans to set any new targets for completing its vaccination program, Prime Minister Scott Morrison said in a Facebook post on Sunday afternoon.

“While we would like to see these doses completed before the end of the year, it is not possible to set such targets given the many uncertainties involved,” Morrison said.

Authorities in Canberra changed their recommendation on Pfizer shots for under-50s on Thursday, after European regulators reiterated the possibility of links between the AstraZeneca shot and reports of rare cases of blood clots.

Australia, which raced to double its order of the Pfizer vaccine last week, had originally planned to have its entire population vaccinated by the end of October.

Australia’s hardline response to the virus largely stopped community transmissions but the vaccination rollout has become a hot political topic — and a source of friction between Morrison and state and territory leaders — after the country vaccinated only a fraction of its four million target by the end of March.

About 1.16 million COVID-19 doses have now been administered, Morrison said, noting the speed of Australia’s vaccination program was in line with other peer nations, including Germany and France, and ahead of Canada and Japan.

Australia began vaccinations much later than some other nations, partly because of its low number of infections, which stand at just under 29,400, with 909 deaths, since the pandemic began.

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CBC | Health News

EU regulator places no new restrictions on AstraZeneca vaccine due to ‘possible’ blood clot link

The European Union’s drug regulator says it has found a “possible link” between the AstraZeneca-Oxford coronavirus vaccine and a rare blood-clotting disorder, but the benefits of the shot and the potential health consequences of suffering from COVID-19 still outweigh any risks.

The European Medicines Agency (EMA) said it would place no new restrictions on using the vaccine in people 18 and over, in both a statement and a subsequent news conference on Wednesday.

The EMA said most of the cases reported have occurred in women under 60 within two weeks of vaccination. The agency said based on the currently available evidence, it was not able to identify specific risk factors.

“The reported cases of unusual blood clotting following vaccination with the AstraZeneca vaccine should be listed as possible side-effects of the vaccine,” said Emer Cooke, the agency’s executive director.

Experts reviewed several dozen cases that came mainly from Europe and the United Kingdom, where around 25 million people have received the AstraZeneca-Oxford vaccine.

At a news conference from Brussels, Cooke said “the risk of mortality from COVID is much greater than the risk of mortality from these side-effects.”

Britain adjusts vaccine advice

The head of Britain’s drug regulator echoed that sentiment, but said on Wednesday people under 30 will be offered another product due to a rare blood clot risk.

The Pfizer-BioNTech and Moderna vaccines should be offered to people in that age group instead, the Medicines and Healthcare Products Regulatory Agency (MHRA) advised.

Dr. June Raine, the head of the MHRA, said the risk “remains extremely low” at “about four people in a million” who receive the shot.

WATCH | Britain’s Raine breaks down the number of cases:

The U.K.’s drug regulator says a rare side-effect from the AstraZeneca-Oxford COVID-19 vaccine has led to a change in its advice for what age groups should receive the shot. 1:33

Raine said that as of the end of March, there had been 79 reports, all after the first dose, out of approximately 20 million doses given within the U.K. Of the adverse reports, 51 came from women.

Raine said the British regulator had tracked 19 deaths among those reports, three of them in people under the age of 30. The regulator said the reports did not constitute proof that the inoculation had caused the clots.

Jonathan Van Tam, Britain’s deputy chief medical officer, characterized the new recommendation as a “course correction” not uncommon for the rollout of vaccines used in treating other illnesses.

“You can’t pick these kinds of things up until you’ve literally deployed tens of millions of vaccines,” he said.

According to reports in Britain, the majority of those under 30 have yet to be vaccinated.

In light of the follow up in Europe, the World Health Organization’s vaccine advisory committee said more specialized studies were needed into the blood clots.

“Based on current information, a causal relationship between the vaccine and the occurrence of blood clots with low platelets is considered plausible but is not confirmed,” the WHO committee said in a statement.

Canada already recommended shot for those 55 and over

The vaccine is one of five separate approvals so far during the pandemic from Health Canada, comprising two different sources.

Canada approved AstraZeneca-Oxford doses being manufactured in both Europe and in India, where it has been branded as Covishield. The vaccine first arrived in Canada in early March, and later that month, Ottawa announced it had received a loan from the United States of 1.5 million additional doses, as a hearing on the vaccine’s approval has yet to be held by American regulators.

Canada’s National Advisory Committee on Immunization (NACI) updated its recommendations in late March regarding the use of the AstraZeneca-Oxford vaccine in light of the blood clot reports seen in Europe. The committee recommended a pause in inoculating Canadians under 55 with that vaccine.

In its tracking of potential adverse events following vaccination, Health Canada has received no reports of the rare blood clotting in this country.

WATCH | Canada’s vaccine advisory committee adjusts AstraZeneca guidelines:

The European Medicines Agency says rare blood clots are a potential side effect of the AstraZeneca-Oxford COVID-19 vaccine, but it still says the benefits of the vaccine far outweigh the risks. 1:39

Dr. Shelley Deeks, co-chair of NACI, said at a virtual briefing on Tuesday that Canadian officials will study the updated data from their European counterparts to see if any advice needs to be updated.

She said it would be “premature” to say if the latest development in Europe will have any effect on confidence in the AstraZeneca-Oxford vaccine.

“What we’ve tried to be doing at NACI is actually being quite transparent about the evolution of the data so Canadians will have confidence that we are communicating what we know about safety, when we know it,” said Deeks.

The EMA is particularly focused on two types of rare blood clots: one that appears in multiple blood vessels and another that occurs in a vein that drains blood from the brain. It also evaluated reports of people who had low levels of blood platelets, which puts them at risk of severe bleeding.

Raine said 14 of the 19 fatalities noted were cases where cerebral venous sinus thrombosis with low platelets was present, while the other cases were associated with other kinds of thrombosis in major veins.

As recently as last week, the EMA said “there is no evidence that would support restricting the use of this vaccine in any population” — a response to several countries doing just that — though an expert said more brain clots were being reported than would be expected.

In March, more than a dozen countries, mostly in Europe, suspended their use of the AstraZeneca-Oxford vaccine over the blood clot issue. Most restarted — some with age restrictions — after the EMA said countries should continue using the potentially life-saving vaccine.

WATCH | European Union regulator says blood clot risk extremely rare:

Canada’s vaccine advisory committee has changed its advice and now says the AstraZeneca COVID-19 vaccine should only be given to people aged 55 and up following concerns it could be linked to a rare blood clot. 2:21

The suspensions were seen as particularly damaging for AstraZeneca because they came after repeated missteps in how the company reported data on the vaccine’s effectiveness and concerns over how well its shot worked in older people.

Cooke characterized the reports as evidence that caution and transparency have been guiding decisions.

“These very rare and unusual events were picked up, identified, analyzed and we have made a clear science-based recommendation to allow the safe and effective use of the vaccine,” she said.

Dr. Peter English, who formerly chaired the British Medical Association’s public health medicine committee, said the back-and-forth over the AstraZeneca vaccine globally could have serious consequences.

“We can’t afford not to use this vaccine if we are going to end the pandemic,” he said.

That’s because the vaccine is cheaper and easier to store than many others, is critical to Europe’s immunization campaign and a pillar of the United Nations-backed program known as COVAX that aims to get vaccines to some of the world’s poorest countries.

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CBC | World News

Why restricting AstraZeneca vaccines in Canada means balancing ‘vaccine risk vs. disease risk’

This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.


Canada’s decision to suspend the use of the AstraZeneca-Oxford vaccine in Canadians under 55 during a surging third wave and a slow vaccination rollout is a calculated risk.

The National Advisory Committee on Immunization (NACI) updated its guidance to provinces and territories against the use of the vaccine for younger Canadians on Monday, following reports of rare but potentially fatal blood clots in Europe connected to the shot.

Health Canada says the benefits of the vaccine to protect against COVID-19 still outweigh the potential risks, with more than 300,000 doses of the shot administered and no cases of the serious clotting condition, known as vaccine-induced prothrombotic immune thrombocytopenia (VIPIT), in Canada. 

But the decision to restrict the use of one of four approved vaccines at a time when COVID-19 levels are rising again in Canada’s hardest hit provinces is a tough pill to swallow for some.

“It can be a very powerful tool when we’re at this stage of the pandemic where we’re talking about, in hotspots at least, the system getting to a point of potential collapse,” said Dr. Susy Hota, an infectious disease specialist at the University Health Network and an associate professor of medicine at the University of Toronto. 

“There are humans behind that story, and when you’re in a hospital where you’re seeing an exponential rise in the number of COVID-positive patients coming in, and your staff to help manage these patients is the same pool of staff — then those numbers aren’t adding up.”

But on an individual level, experts say the lack of data on the risk of VIPIT to Canadians from the AstraZeneca vaccine is concerning and NACI was right to err on the side of caution in order to avoid putting lives unnecessarily at risk. 


Pharmacist Abraam Rafael administers a COVID-19 vaccine to Maureen Doyle at his pharmacy in Toronto on March 14 as Ontario starts administering the AstraZeneca vaccine for COVID-19 to residents aged 60-64. (Cole Burston/The Canadian Press)

Race between vaccines and variants

Ontario has more ICU admissions than at any other point in the pandemic, B.C. has had its highest single-day number of new cases to date, and Quebec saw its biggest one-day spike in almost two months as more transmissible variants are spreading rapidly across Canada.

The good news is that vaccines work; eight provinces and territories reported no new deaths in a single day this week, and the decision to prioritize COVID-19 vaccines in long-term care has led to a dramatic drop in deaths in residents. 

The bad news is that the race between vaccines and variants is taking on new urgency; the majority of vulnerable Canadians are still unvaccinated and the third wave is hitting younger adults harder and showing no signs of slowing down. 

“It’s so complicated, because I look at it as being two things: What is the absolute risk of this potentially related severe side effect versus the absolute risk of the disease?” said Dr. Lynora Saxinger, an infectious diseases physician and an associate professor at the University of Alberta faculty of medicine in Edmonton.

“The other consideration is, what is the public backlash to potential outcomes of any particular course of action?”

WATCH | AstraZeneca now only recommended for Canadians over 55:

Canada’s vaccine advisory committee has changed its advice and now says the AstraZeneca COVID-19 vaccine should only be given to people aged 55 and up following concerns it could be linked to a rare blood clot. 2:21

Health Canada says VIPIT occurs at a rate of about one in 100,000 people vaccinated, with a mortality rate of about 40 per cent, although more research is needed and that risk is reduced if treated early enough. The total number of people in Europe who got the rare blood clots after vaccination is small — as of Thursday, dozens of cases have been reported compared to millions who received the shot.

But crucially, the people who appear to have an elevated risk of the rare blood clots are not the same age group most at risk from COVID-19.

“If you look at the average 30 or 40-year-old Canadian, their risk of getting severely ill from COVID based on our current experience is substantially less,” said Dr. Andrew Morris, a professor of infectious diseases at the University of Toronto.

“You’re asking them for the good of the country to take on a risk that they wouldn’t even get with COVID. So why would you give them a vaccine that is more likely to give them harm then COVID is? It makes no sense.”

Canada has had close to 23,000 COVID-19 deaths in the year since the pandemic began, but fewer than a thousand of those have been in people under 60 and just over 300 in Canadians under 50.

“What happens to NACI if they say that everything is fine, despite the European experience which really brings it into question, and then we have even one death in Canada from this?” said Morris. “NACI would be just absolutely raked over the coals.”

‘Vaccine risk versus disease risk’

Dr. David Fisman, an epidemiologist at the University of Toronto’s Dalla Lana School of Public Health, said the debate over whether suspending the vaccine in younger Canadians was the right decision is due to a miscalculation of risks for that age group.

“I think what you see is a bit of wire crossing around vaccine risk versus disease risk,” he said.

There is also a risk of clots from getting COVID-19, but that’s conditional on getting the disease first, and there are other vaccines to protect against it, he said, rather than using a vaccine linked to adverse events in this age group.

“The adverse effect here is rather devastating,” he said. “[VIPIT] seems to be killing about half the people who suffer these consequences, and is highly likely to cause permanent neurological damage in survivors.”

“Given that these are young people working in healthcare, it is likely that vaccination is conferring damage or death that they would not have suffered otherwise.”

Dr. Menaka Pai, a clinical hematologist at McMaster University and a member of Ontario’s COVID-19 Science Advisory Table, says the risks associated with VIPIT in younger adults are dangerous enough to warrant halting its use in those under 55.

“The clots that we see with VIPIT — they’re serious. If you’re not aware of them they can be hard to diagnose, they can be hard to treat,” she said. 

“If you’re older and likely to experience all the other horrible things that COVID does, including killing you, then your decision about urgency and needing any vaccine frankly is really different from somebody who is younger and probably better able to weather the storms of COVID.” 

WATCH | Should people who’ve had the AstraZeneca vaccine be concerned?

Infectious disease experts take questions about the changing advice for the AstraZeneca COVID-19 vaccine including if those who’ve had a shot should be concerned. 4:22

Pai says critics of NACI’s decision are inaccurately drawing comparisons with the risk of VIPIT to the risk of birth control pills, which also carry an increased risk of blood clots.

“The reality is that every year a little under one in 3,000 women will get a blood clot on the combined oral contraceptive pill and every year one in 300 pregnant women will get a blood clot,” she said. 

“But the clots that you get on those hormones are very different from the clots that we’re seeing related to the AstraZeneca vaccine.” 

Raywat Deonandan, an epidemiologist and associate professor at the University of Ottawa, says if the risk from the AstraZeneca-Oxford vaccine to younger Canadians can be mitigated with another COVID-19 shot, then the decision to halt the use of it makes sense.

“This is not the same as going to a place like Brazil where the disease is rampaging out of control,” he said. 

“Whereas this is the only vaccine you have available to you — take it now or I can’t guarantee you will be alive in a month. It’s a different scenario entirely.” 

But Deonandan says he can sympathize with critics of NACI’s recommendations to suspend the vaccine because of the damage the decision may do to the public perception of COVID-19 vaccine safety overall. 

“If you are saving any lives, you’re saving one or two lives [from VIPIT],” he said.  “On the other hand, you’re creating such distrust of the vaccine you may be causing hundreds, possibly thousands of deaths from people not taking the vaccine.” 

“But given what NACI’s job is, which is to advise how best to deploy vaccines, they used the best evidence and came upon the right decision for their mandate.” 


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CBC | Health News

British regulators increase number of blood clot cases after AstraZeneca vaccine to 30

British regulators on Thursday said they have identified 30 cases of rare blood clot events after the use of the AstraZeneca-Oxford COVID-19 vaccine, 25 more than the agency previously reported.

The Medicines and Healthcare products Regulatory Agency said it had received no such reports of clotting events following use of the vaccine made by BioNTech SE and Pfizer Inc.

The health officials said they still believe the benefits of the vaccine in the prevention of COVID-19 far outweigh any possible risk of blood clots.

Some countries are restricting use of the AstraZeneca vaccine while others have resumed inoculations, as investigations into reports of rare, and sometimes severe, blood clots continue.

On March 18, the U.K.’s medicines regulator said that there had been five cases of a rare brain blood clot among 11 million administered shots.

WATCH | Should people who’ve had the AstraZeneca vaccine be concerned?

Infectious disease experts take questions about the changing advice for the AstraZeneca COVID-19 vaccine including if those who’ve had a shot should be concerned. 4:22

On Thursday, it put the count at 22 reports of cerebral venous sinus thrombosis, an extremely rare brain clotting ailment, and eight reports of other clotting events associated with low blood platelets out of a total of 18.1 million doses given.

In Canada, the National Advisory Committee on Immunization recommended on Monday that the use of the AstraZeneca vaccine for Canadians under 55 be immediately suspended.

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CBC | World News

What’s happening with the AstraZeneca COVID-19 vaccine around the world

Canada’s vaccine advisory committee on Monday recommended suspending the use of the AstraZeneca-Oxford COVID-19 vaccine in people under 55 because of safety concerns, the latest setback for a vaccine seen as crucial in tackling the coronavirus pandemic across the globe.

The National Advisory Committee on Immunization (NACI) updated its guidelines to provinces and territories following reports out of Europe of very rare instances of blood clots in some immunized patients — notably among younger women.

Clinical and real-world data have suggested the vaccine, which is easier and cheaper to transport than rival shots, is highly successful in reducing serious illness and death connected to COVID-19. But it has been dogged by poor communications and questions about possible side-effects.

Here’s the latest on the vaccine’s status in other countries:

Germany

German health officials agreed Tuesday to only give the AstraZeneca vaccine to people aged 60 or older, unless they belong to a high-risk category for serious illness from COVID-19 and have agreed with their doctor to take the vaccine despite the small risk of a serious side-effect.

The move follows the recommendations of Germany’s independent vaccine expert panel and comes after the country’s medical regulator released new data showing a rise in reported cases of an unusual form of blood clot in the head — known as sinus vein thrombosis — in recent recipients of the vaccine.

The Paul Ehrlich Institute said its tally of the rare blood clots reported by March 29 had increased to 31, out of some 2.7 million doses of AstraZeneca administered in Germany so far. Nine of the people died and all but two of the cases involved women, who were aged 20 to 63, the regulator said.


A man gets an injection of the AstraZeneca vaccine in Ebersberg near Munich on March 22. (Matthias Schrader/The Associated Press)

Spain

Spain has decided to remove an upper age limit of 65 years on the AstraZeneca vaccine, Cadena Ser radio reported on Tuesday.

A public health commission approved the change at a meeting on Tuesday, the broadcaster said, citing a document it had seen. That comes a week after Spain decided to reintroduce the AstraZeneca shot for people aged 18 to 65.

Like Germany and several other European countries, Spain had suspended administering the shot over blood clot concerns but resumed its use after the EU’s drug regulator deemed the vaccine “safe and effective.”

Italy

Italy resumed using the AstraZeneca vaccine on all age groups on March 19 after briefly pausing usage earlier this month.

On Tuesday, Prime Minister Mario Draghi and his wife Maria Serenella Cappello, who are both 73, received their first doses of the vaccine at a large vaccination centre set up at Rome’s main railway station, the prime minister’s office said.

The head of the health panel advising the government has said that Italians who decline to be inoculated with the AstraZeneca vaccine will be “reconsidered later for another type of vaccine.”


People wait to receive the AstraZeneca vaccine at the Clinique de l’Estree-ELSAN private hospital in Stains, France, on March 5. (Benoit Tessier/Reuters)

France

France’s medical regulator approved the resumed use of AstraZeneca’s vaccine on March 19 but said it should only be given to people aged 55 and older, breaking with guidance from the European Medicines Agency (EMA).

France said the decision was based on evidence that the clotting affected younger people.

Denmark

Denmark was among the first countries in Europe to suspend the use of the AstraZeneca vaccine this month over concerns about the rare cases of blood clots. On March 25, it extended its suspension for another three weeks, pending further investigation.

Authorities said they still could not rule out a connection between the vaccine and the very unusual illness in two local cases, which are still being analyzed, and cases elsewhere in Europe.

Approximately 150,000 people in Denmark had received AstraZeneca’s shot before it was suspended.

WATCH | Why Canada’s vaccine committee recommended pausing AstraZeneca:

‘It has been very challenging as a committee to make recommendations on these vaccines and to be nimble and change recommendations when the data merits it,’ says Dr. Shelley Deeks, vice-chair of the National Advisory Committee on Immunization. 7:03

Norway 

Like neighbouring Denmark, Norway suspended the rollout of the AstraZeneca vaccine on March 11. On March 26, health officials said they would delay a decision on whether to resume its use until April 15.

Norway had reported five cases in which healthy recipients of the vaccine were admitted to hospital with a combination of blood clots, bleedings and low platelets, three of whom died.

Sweden

The country’s health agency said on March 25 it will resume use of the vaccine for people aged 65 and older, but keep the pause in place for younger Swedes.

Thailand

Thailand began using the AstraZeneca vaccine on March 16, after it delayed rollout the week before over safety concerns.

Prime Minister Prayuth Chan-ocha was the first in the country to be inoculated with the vaccine.

“Today I’m boosting confidence for the general public,” Prayuth, who was soon to turn 67, told reporters at Government House before he received the shot.

South Korea

South Korea authorized the AstraZeneca vaccine for people 65 and older earlier this month after delaying its use for that age group, citing a lack of clinical data.

President Moon Jae-in received the vaccine at a community clinic on March 23, a day after authorities reaffirmed they had found no evidence of health risk.

Cameroon

Cameroon’s Health Ministry suspended administration of the batch of AstraZeneca vaccines it was scheduled to receive on March 20 as part of the global vaccines-sharing initiative COVAX.

The ministry said in a statement March 18 that the suspension was due to precaution and prudence. It gave no further reasons for the decision or say if it will go ahead and take delivery of its share of the vaccine.

WATCH | Should people who’ve had the AstraZeneca vaccine be concerned?

Infectious disease experts take questions about the changing advice for the AstraZeneca COVID-19 vaccine including if those who’ve had a shot should be concerned. 4:22

United Kingdom

The U.K. was the first country in the world to approve the AstraZeneca vaccine, on Dec. 30. On March 18, Britain’s medicines regulator gave its continued backing to the vaccine, saying the benefits outweighed the risks after finding there had been five cases of a rare brain blood clot among 11 million administered shots.

Britain’s Medicines and Healthcare Products Regulatory Agency (MHRA) said that use of the vaccine should continue while the five reports were investigated.

At a new conference that day, Prime Minister Boris Johnson said he was receiving a first dose of the AstraZeneca vaccine himself the following day.

“The Oxford jab is safe and the Pfizer jab is safe,” he said. “The thing that isn’t safe is catching COVID, which is why it’s so important that we all get our jabs as soon as our turn comes.”


British Prime Minister Boris Johnson reacts after receiving a dose of the AstraZeneca vaccine in London on March 19. (Frank Augstein/Reuters)

United States

While the AstraZeneca vaccine has been authorized for use in more than 50 countries, it has not yet been given the green light in the U.S.

U.S. health officials had publicly rebuked the drugmaker for not using the most up-to-date information when it published an interim analysis of its major U.S. trial on March 22 that said the vaccine had a 79 per cent efficacy rate at preventing symptomatic illness. An updated analysis showed a 76 per cent efficacy rate, AstraZeneca said a few days later.

AstraZeneca said it plans to seek U.S. emergency use authorization in the coming weeks and that the latest data has been presented to the independent trial oversight committee, the Data Safety Monitoring Board.

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CBC | World News

Why Canada is suspending use of AstraZeneca vaccine in people under 55

Canada’s vaccine advisory committee is recommending immediately suspending the use of the AstraZeneca-Oxford COVID-19 vaccine in Canadians under 55 following reports of rare but potentially fatal blood clots in Europe that appear to be connected to the shot.

The National Advisory Committee on Immunization (NACI) updated its guidelines to provinces and territories against the use of the vaccine for younger Canadians on Monday over safety concerns. 

Health Canada said Monday that 300,000 doses of AstraZeneca vaccine have been administered and no cases of the rare blood clotting adverse events have been reported in Canada, but that it was aware of additional cases that have recently been reported in Europe. 

Quebec, Ontario, Alberta, Saskatchewan, ManitobaNewfoundland and Labrador and Prince Edward Island have all suspended the use of the vaccine for anyone below the age of 55. Other provinces and territories are expected to follow. 

Dr. Isaac Bogoch, an infectious diseases physician and member of Ontario’s COVID-19 vaccine task force said that the discovery of a potential connection with the vaccine to blood clots raised a “red flag” that “warrants further exploration.” 

“People should appreciate that not all blood clots are created the same,” he said. “This is a very specific and particular method of blood clotting that likely has an association with the vaccine.” 

Risk of blood clots seems not to affect older age groups: NACI

NACI previously recommended earlier this month that Canadians over 65 not receive the shot, despite emerging evidence from around the world demonstrating its ability to prevent severe COVID-19 in older adults.

But that guidance changed on March 16 after more real-world data on the vaccine’s effectiveness was reviewed by NACI, and CBC News broke the story revealing documents on the federal government’s plans to allow those 65 and older to receive it.

“This vaccine has had all the ups and downs — it looks like a roller coaster,” said Dr. Caroline Quach, chair of NACI and a pediatric infectious diseases expert. “The problem is because data are evolving, we are also evolving our recommendations.” 

Quach said the risk of rare blood clots appears to only occur in younger populations, which is why NACI recommended suspending the vaccine in those under 55.

“What we’re doing is trying to contrast the risks and benefits,” she said. “So if you have that vaccine versus having to wait for two months while COVID is ramping and you’re at risk of catching it and having complications from it, I think that taking the vaccine is the best option at this point.”

Quach added that the vaccine works well in preventing severe outcomes and death in older populations over 55, particularly in those over 70, and the risk of blood clots does not appear to be present in those age groups. 

WATCH | Canada pauses use of AstraZeneca vaccine in people under 55:

“We are being fully transparent. Maybe it’s too transparent, I don’t know,” says Dr. Caroline Quach-Thahn, Chair of the National Advisory Committee on Immunization. NACI issued guidance for the AstraZeneca vaccine for the third time, now recommending a pause for those under 55. 4:34

“What we need to have is continued confidence in our expert review panel that it’s looking at these vaccines and deciding what is going to be best, safest and most effective for Canadians,” said Alyson Kelvin, an assistant professor at Dalhousie University and virologist at the Canadian Center for Vaccinology in Halifax. 

“This is a new vaccine to a new virus, it’s really important that we’re following all the data as closely as possible and as the vaccines are rolling out, we’re understanding them more and reviewing what the guidance should be.”

Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton and an associate professor at McMaster University, said NACI is taking a calculated risk by recommending older Canadians still get the vaccine because they are at higher risk of severe outcomes from COVID-19.

“Scientifically, it makes sense,” he said. “This isn’t saying that everyone under 55 is going to get this complication. It’s the slight risk of this complication seems to be more predisposed in this age group. But again, the raw numbers seem to be very, very low.”

What led to Canada’s decision to suspend AstraZeneca

The decision to halt the use of the vaccine in Canadians under 55 comes after the European Medicines Agency (EMA) investigated 25 cases of the rare blood clots out of about 20 million AstraZeneca shots given. It concluded on March 18 that the benefits from the vaccine far outweigh its possible risks, although a definitive link could not be ruled out.

But 18 of the cases in Europe were of an extremely rare type of blood clot called cerebral venous sinus thrombosis (CVST) — where veins that drain blood from the brain are obstructed and can potentially cause fatal bleeding.

The EMA said on March 18 at least nine deaths have been associated with the adverse events in Europe and the agency is continuing to investigate the situation.

Germany’s medical regulator told The Associated Press on Monday it had received reports of 21 cases of rare blood clots in people who had recently received AstraZeneca’s coronavirus vaccine. 

The Paul Ehrlich Institute also said that seven people affected by the blood clots have died. It added that of the 21 cases reported in Germany until March 25, 12 also involved an abnormally low level of platelets in the patients’ blood.


The National Advisory Committee on Immunization (NACI) updated its guidelines against the use of the vaccine for younger Canadians on Monday. (Dado Ruvic/Reuters)

Nineteen of the 21 cases were in women ages 20 to 63, while two were in men ages 36 and 57. During the period covered by the reports, some 2.27 million first doses of the AstraZeneca vaccine were administered in Germany.

“You cannot ignore the blood clots that have been associated with AstraZeneca globally,” said Bogoch. “It’s not entirely clear what the true incidence of this is, but it does appear to be a rare event.” 

What Canadians need to know about the AstraZeneca vaccine

The federal health ministry said it would be requiring both manufacturers, AstraZeneca and India’s Serum Institute, to conduct risk assessments by age and gender — but is requesting more data before deciding whether or not to change authorization of it in Canada. 

Health Canada had previously updated the vaccine’s label with information on the rare blood clotting events.

Canadian health officials said during a press conference Monday the specific syndrome is being called Vaccine-Induced Prothrombotic Immune Thrombocytopenia (VIPIT) and that they are in contact with European officials about it. 


Dr. Isaac Bogoch said that the discovery of a potential connection with the vaccine to blood clots, particularly CVST, raised a ‘red flag’ that ‘warrants further exploration.’ (Cole Burston/The Canadian Press)

“I do understand why Canadians might feel worried,” said Canada’s Deputy Chief Public Health Officer Dr. Howard Njoo.

“What I can say is that the chief medical officers of health of the provinces and territories take vaccine safety very seriously and we want Canadians to have confidence in these vaccines.”

Officials added that Germany’s Paul Ehrlich Institute reported VIPIT has an incidence rate of about one in 100,000, with a mortality rate of about 40 per cent, although more research is needed and that risk is reduced if treated early enough. 

“Where the true rate is, we just don’t know at this point in time,” said NACI Co-Chair Dr. Shelley Deeks. “But we are continuing to follow the data, as it emerges.” 

Symptoms to watch for

The Public Health Agency of Canada released a statement on Monday saying that “there is no cause for concern” for Canadians who have already been vaccinated with AstraZeneca for more than 20 days, but that you should seek immediate medical attention in the rare event you develop the following symptoms four or more days after vaccination:

  • Shortness of breath.
  • Chest pain.
  • Leg swelling.
  • Persistent abdominal pain.
  • Sudden onset of severe or persistent worsening headaches or blurred vision.
  • Skin bruising (other than at the site of vaccination).

PHAC said decisions on the type of second dose that will be offered to those who have been vaccinated with AstraZeneca will be determined based on the “latest evidence and research.” 

Most of the complications in Europe occurred within 14 days of receiving the AstraZeneca shot, and the majority were in women under the age of 55. It’s worth noting that CVST is typically more common in women, particularly during and after pregnancy, while on birth control and hormone replacement therapy.

Germany and Italy resumed vaccinations with the shot on March 19, but France opted to vaccinate only those over 55 with it after discovering several cases of CVST. Denmark and Norway have suspended the use of the vaccine altogether for at least three weeks, while Sweden has resumed the use of the vaccine in those over 65. 

“The real question here is, how common is it, and are there identifiable risk factors for this? That way, we could probably continue to use this vaccine in people with very, very low risks of having a blood clot and selectively vaccinate people who would benefit,” Bogoch said.

“If there is that risk, we would hopefully have better data to support who we could safely and selectively vaccinate with this product.”

Benefits still outweigh risks, says vaccine maker

A spokesperson for AstraZeneca Canada said in a statement the company respects the decision by NACI but stressed that Health Canada’s guidance to health care providers around the use of the vaccine remains unchanged.

“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,” the statement read. 
 
“Tens of millions of people have now received our vaccine across the globe. The extensive body of data from two large clinical data sets and real-world evidence demonstrate its effectiveness, reaffirming the role the vaccine can play during this public health crisis.” 

Chagla said NACI’s decision will likely hurt confidence in the vaccine in the eyes of Canadians, especially among those over 55 who may be left “scratching their heads” as to why the vaccine is being recommended for their age group but not younger people. 

“I, unfortunately, envision this vaccine is going to have a limited rollout in Canada moving forward,” he said.

“Even if the dust starts settling, and it’s a completely separate issue or it’s much lower risk than expected, I don’t think you’re going to get many under 55-year-olds to get this vaccine anymore ,and that’s the reality.”

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Immunization committee to recommend provinces stop giving AstraZeneca vaccine to those under 55: sources

Canada’s National Advisory Committee on Immunization (NACI) is expected to recommend today a pause in the use of the AstraZeneca-Oxford COVID-19 vaccine on those under the age of 55 because of safety concerns, sources told CBC News.

The updated guidelines will be issued later today, according to sources who spoke on the condition of anonymity. The expected change comes following reports of rare blood clots in some immunized patients.

Canada is expected to receive 1.5 million doses of this product from the U.S. on Tuesday.

Officials from NACI will provide an update to reporters at 3:10 p.m. ET. CBCNews.ca will carry the remarks live.

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.

The AstraZeneca shot has not been widely used in people under the age of 55 in this country. Some jurisdictions, such as 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. 

A spokesperson for P.E.I.’s health department confirmed use of the vaccine had been suspended for those 18 to 29 years of age.

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.

He said there have been reports of blood clots in younger women in other places.

“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.”

After a review, the European Union’s drug watchdog, the European Medicines Agency, found the vaccine is not linked to an increase in the overall risk of blood clots.

The EMA said, however, that it could not definitively rule out a link between the vaccine and rare types of blood clots associated with thrombocytopenia, or low levels of blood platelets.

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. 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.

Reimer said it’s not known yet how common this rare blood clot side effect is but early data out of Europe suggest it could be an outcome for 1 out of 100,000 AstraZeneca shots deployed, or even more than that — the science isn’t settled, she said.

“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, adding this sort of shift is a testament to Canada’s robust vaccine monitoring system.

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.

Last week, the Public Health Agency of Canada said it’s “possible” the vaccine may be associated with “very rare but serious cases of blood clots associated with thrombocytopenia.” Health Canada has maintained that the benefits of the AstraZeneca COVID-19 vaccine continue to outweigh the risks.

Health Canada has said it is aware that researchers in Europe have indicated that they have identified a possible cause for these very rare events, but says little information is available about the findings.

“We have been discussing the rare reports of blood clots and low platelet counts with the European Medicines Agency and other regulators,” Dr. Supriya Sharma, Canada’s chief medical adviser, said on Thursday. “Health Canada will make decisions for Canada based on the science and evidence.

“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.

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Health Canada changes AstraZeneca vaccine label to add information about blood clots

Health Canada is updating the label on the AstraZeneca-Oxford and Covishield COVID-19 vaccines to add information about “very rare reports of blood clots associated with low levels of blood platelets,” but says the shot remains safe and that the benefits of getting the vaccine outweigh the risks.

“Health Canada reassures Canadians that the AstraZeneca COVID-19 vaccine continues to be safe and effective at protecting them against COVID-19 and encourages people to get immunized with any of the COVID-19 vaccines that are authorized in Canada,” the agency said in a statement Wednesday evening. 

It has also issued guidance for health-care professionals and vaccine recipients on the potential symptoms to monitor — including shortness of breath, chest pain, leg swelling and persistent abdominal pain — or a sudden onset of severe or persistent worsening headaches or blurred vision. 

No reports of clots in Canada 

All of Canada’s current supply of the AstraZeneca-Oxford vaccine is manufactured by the Serum Institute of India, which secured separate regulatory approvals from Health Canada.

That version, which is biologically identical to the AstraZeneca shot but manufactured under different conditions, has been branded as Covishield.

WATCH: Recommendations on vaccine not changing, Health Canada says 

Dr. Supriya Sharma, Health Canada’s chief medical adviser, says federal recommendations on the use of AstraZeneca’s COVID-19 vaccine are not changing at this point in time. 1:40

Health Canada says there have been no reports of clots following administration of the AstraZeneca-Oxford vaccine in this country. 

Several European countries suspended administration of the AstraZeneca-Oxford vaccine following reports of blood clots in a small number of patients. 

The European Medicines Agency (EMA) last week amended its authorization of the vaccine to say there is no overall increase in the risk of blood clots after getting the vaccine but added a warning that a small number of patients had developed rare blood clots in the brain after getting it.

At the time the EMA couldn’t say if the clots were related to the vaccine. German and Norwegian scientists have since said in a very small number of patients the vaccine is causing an extreme immune response that is leading to the clots. It is a treatable condition, they said.

The EMA reported 18 cases of cerebral venous sinus thrombosis, out of about 20 million people who received the AstraZeneca-Oxford vaccine in Europe, the United Kingdom, and India, and seven cases of another type of clotting disorder related to very low platelet counts.

Health Canada said it is aware that researchers in Europe have indicated that they have identified a possible cause for these very rare events, but says little information is available about the findings. “Health Canada will be reviewing this evidence when available,” it said in the statement. 

Canada has so far received about 500,000 doses of the vaccine and expects to get 1.5 million more as soon as this week from the United States.

Health Canada says minor and temporary side effects are common after all vaccinations, but that people should seek medical attention if they experience any new or worsening symptoms.


The new label will include information about a small number of clots experienced by patients who received the AstraZeneca-Oxford vaccine. (Jeff Stapleton/CBC)

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Health Canada says AstraZeneca shot is safe as U.S. questions vaccine’s clinical trial data

Health Canada said today Canadians should not be concerned about the safety of the AstraZeneca vaccine — even as a U.S. regulatory body raises concerns about the company’s clinical trial results.

Marc Berthiaume, the director of the bureau of medical science at Health Canada, said the issues flagged Monday by a U.S. federal health agency relate to the product’s published efficacy rate, not to whether it’s safe to use.

Berthiaume said Health Canada’s decision to authorize the product was not based on any of the clinical trial information U.S. authorities are now probing. He said Canada based its approval largely on data that emerged from AstraZeneca trials in the United Kingdom and Brazil, and on studies published in countries where the shot has been in use for some time.

“I think it would be alarmist to suggest that the results of additional clinical testing could lead to a change in the approval status of AstraZeneca here in Canada,” Berthiaume said.

“The additional information that was collected in the U.S. will be sent to Health Canada in the coming weeks. If there’s a need to readjust, then we’ll do that with Canadians later.”

Millions of people have received the AstraZeneca shot worldwide, including more than 17 million in Britain and the European Union — almost all without serious side effects.

Health Canada ‘concerned’ about vaccine hesitancy  

Dr. Supriya Sharma, Health Canada’s chief medical adviser, said U.S. questions about the efficacy rate change nothing for Canadians at this point. She conceded the barrage of headlines about the AstraZeneca shot are “something of a concern to us” because they could make some Canadians reluctant to take vaccines.

“We’ve said this many times before — that even the most effective vaccine only works if people trust it and agree to receive it,” she said.

“It’s like any other reputation. Once there’s some doubt that creeps into that reputation, it’s that much more difficult to gain that back. The press and the concerns around the AstraZeneca vaccine don’t help.”

WATCH: Health Canada says federal recommendations on AstraZeneca vaccine are not changing 

Dr. Supriya Sharma, Health Canada’s chief medical adviser, says federal recommendations on the use of AstraZeneca’s COVID-19 vaccine are not changing at this point in time. 1:40

In a statement released last night, the National Institute of Allergy and Infectious Diseases (NIAID) in the U.S. said the 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 some information yesterday.

The agency said the British-Swedish pharmaceutical giant may have released information that gives an “incomplete view of the efficacy data.”

“We urge the company to work with the DSMB to review the efficacy data and ensure the most accurate, up-to-date efficacy data be made public as quickly as possible,” the agency said — without stating what sort of data may have been  included improperly.

The statement came only hours after AstraZeneca released the results of its U.S.-based phase three clinical trials, which began last August and wrapped up earlier this month. Phase three is the point in a clinical trial when a vaccine maker gathers more information about safety and effectiveness and studies the effect of different doses on various groups.

The company said its COVID-19 vaccine had a 79 per cent efficacy rate for preventing symptomatic COVID-19 and was 100 per cent effective in stopping severe disease and hospitalization. Investigators said the vaccine was effective for adults of all ages, including older people — something which previous studies in other countries had failed to establish.

The product has not yet been authorized for use in the U.S.

Speaking to ABC’s Good Morning America on Tuesday, 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.

“They got concerned and wrote a rather harsh note to them and with a copy to me, saying that in fact they felt that the data that was in the press release were somewhat outdated and might in fact be misleading a bit, and wanted them to straighten it out,” Fauci said.

The board members pegged the vaccine’s efficacy at between 69 per cent 74 per cent — up to 10 points lower than what AstraZeneca itself reported — and said the company’s decision to issue a press release with better results served to erode public trust.

“We told the company they better get back with the DSMB and make sure the correct data get put into a press release.”

In response to the blowback, AstraZeneca said the efficacy numbers it released yesterday were current as of February 17 — a month before the clinical trial was actually completed. In a statement, the company said it would “immediately engage with the independent data safety monitoring board” and provide the U.S. regulator with “the results of the primary analysis within 48 hours.”

This is just the latest public communications 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 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, the National Advisory Committee on Immunization (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 last week after reviewing three “real-world studies,” saying the two-dose viral vector vaccine can and should be used on seniors.

The European Medicines Agency has also had to assure European Union member countries that the product is safe to use after reports of post-vaccine blood clots in a very small number of patients.

The agency concluded that the benefits of protecting against COVID-19 — which itself results in clotting problems — outweigh the risks.

The Public Health Agency of Canada has said it’s “possible” the vaccine may be associated with “very rare but serious cases of blood clots associated with thrombocytopenia” — a condition associated with very low levels of blood platelets. Health Canada has maintained that the benefits of the AstraZeneca COVID-19 vaccine continue to outweigh the risks.

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Is AstraZeneca vaccine safe for people who’ve had blood clots? Your COVID-19 questions answered

We’re still answering your COVID-19 questions. We’ve received more than 71,000 since the start of the pandemic. But vaccine questions are the main theme right now. We publish a selection of answers online and also put some questions to the experts during The National and on CBC News Network. Send your questions and stories to COVID@cbc.ca, and we’ll address as many as we can.

The AstraZeneca-Oxford COVID-19 vaccine has been in the headlines recently over concerns that some people were developing blood clots after receiving the shot. Some European countries suspended use of the vaccine, but many have since resumed.

You may be wondering what all of this means for you when it comes to taking the vaccine. Here’s what the experts are saying.

What are the latest findings on AstraZeneca’s safety?

A recent review from the European Union’s drug watchdog found the vaccine is not linked to an increase in the overall risk of blood clots. The European Medicines Agency (EMA) also concluded that the benefits of protecting against COVID-19 — which itself results in clotting problems — outweigh the risks.

At the same time, the EMA said it could not definitively rule out a link between the vaccine and specific, rare types of blood clots associated with thrombocytopenia, or low levels of blood platelets.

WATCH | AstraZeneca vaccine is safe, says EU drug regulator:

The AstraZeneca COVID-19 vaccine is safe and does not appear to cause blood clots, says the European Medicines Agency, after a review by an expert committee. But the EMA couldn’t rule out a link to blood clots entirely. 1:22

Specifically, it noted 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 incidents occurred within 14 days of receiving the AstraZeneca shot, and the majority were in women under the age of 55.

In its investigative document, the EMA said it would expect to see just 1.35 cases of CVST in the time period it looked at — but instead its researchers saw 12.

“A causal link with the vaccine is not proven, but is possible and deserves further analysis,” the agency said in its findings.

Around the same time the EMA released its report, researchers in Germany and Norway announced they had found a mechanism that could cause the AstraZeneca vaccine to create the blood clots in very rare circumstances, in addition to identifying a possible treatment for it.

Dr. Theresa Tam, Canada’s chief public health officer, acknowledged the possible link said in a statement on Sunday.

“It is possible that the vaccine may be associated with very rare but serious cases of blood clots associated with thrombocytopenia,” she said.

Overall, Health Canada has maintained that the benefits of the AstraZeneca COVID-19 vaccine continue to outweigh the risks. 

WATCH | Benefits of AstraZeneca vaccine outweigh risks, Tam says:

Canada’s Chief Public Health Officer Dr. Theresa Tam says the benefits of the AstraZeneca COVID-19 vaccine outweigh the rare risks. 1:53

Meanwhile, AstraZeneca announced on Monday that scientists found no increased risk of clots among the more than 20,000 people who received at least one dose of the shot in a late-stage study in the United States. The vaccine has not yet been given the green light in the U.S.

The company said the study also showed the vaccine provided strong protection against disease and complete protection against hospitalization and death across all age groups.

Is AstraZeneca safe for people with a history of blood clots?

Amid the developments, many readers are still wondering if having a history of blood clots means they’re at a higher risk of developing them after getting an AstraZeneca jab.

Some of the experts we spoke to said no, the vaccine is safe, even for people with a history of blood clots.

“Anyone who has a history of blood clots might have an increased risk of blood clots at any point anyway,” Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta in Edmonton, said in a recent CBC News interview.

“But I don’t believe that there would be a rationale to make a recommendation against using [the vaccine],” she said.


A medical worker receives a dose of the AstraZeneca vaccine in Taipei, Taiwan, on Monday. (Ann Wang/Reuters)

Dr. Cora Constantinescu, an infectious diseases specialist from the Vaccine Hesitancy Clinic at Alberta Children’s Hospital in Calgary, said if you are still worried about blood clots, you should be more concerned about catching the coronavirus than the vaccine.

“If you looked at five million people hospitalized with COVID-19, you would expect 100,000 to 500,000 of them to have clots,” Constantinescu said in a recent interview with CBC News Network.

“Keep in mind the risk of the disease itself is so much higher, and the more you wait to [get the vaccine], the less protected you are.”

On the other hand, Dr. David Fisman, an epidemiologist at the University of Toronto’s Dalla Lana School of Public Health, said Germany’s data offered a “compelling picture” that the rare blood clots were potentially linked to the vaccine in rare cases.

“I find myself in disagreement with Health Canada’s guidance on the use of AstraZeneca,” Fisman said.

“I do think that the use of this vaccine should be suspended in Canada until we have more data. At a minimum, I do not think it should be used in women aged 20 to 50 until we know more.”

Have blood clots been associated with the other vaccines?

If the overall rate of reported blood clots after AstraZeneca is no more than the rate in the general population, a number of readers, including Carolyn W., wanted to know why we’re not hearing similar issues with the Pfizer and Moderna vaccines.

“That’s a great question,” Constantinescu said.

In terms of a blood clot, she said, the numbers appeared similar “across the board” for all of the vaccines, including the mRNA vaccines.

Constantinescu tried to put the figures into perspective.

“If you took five million people, you would expect 5,000 to 15,000 cases of blood clots versus the 37 that were noted,” she said. “So if anything, even in the vaccinated population, there seemed to be a lower baseline rate than you would [have] in the general population.”

WATCH | Can AstraZeneca vaccine overcome mixed messaging, distrust?

Top U.S. infectious disease expert Dr. Anthony Fauci says interim data shows that the AstraZeneca-Oxford COVID-19 vaccine is 78.9 per cent effective overall. 1:05

There haven’t been any substantial reports of clotting during the clinical trials for the vaccines, Saxinger noted.

Most of the vaccine data has been “basically equal in the vaccine versus placebo recipient group,” she said. “And there certainly hasn’t been a strong population-based signal specifically for [deep vein thrombosis or pulmonary embolism] so far.”

What if you’re immunocompromised?

If you’ve got an autoimmune disease or are taking an immunosuppressant drug, it’s probably a good idea to talk to your doctor.

That’s because each condition is so different, Dr. Isaac Bogoch, an infectious disease physician in Toronto and a member of Ontario’s COVID-19 Vaccine Distribution Task Force, advised in an earlier article.

In general, the experts we spoke to said AstraZeneca is probably safe for immunocompromised people, but we’re still learning more.

The National Advisory Committee on Immunization (NACI), which makes recommendations on the use of newly approved vaccines in Canada, notes there is currently no data on COVID-19 vaccination in individuals who are immunosuppressed, as they were not included in the clinical trials.

“The concern is not so much about a safety issue,” Saxinger said, noting that AstraZeneca is considered as safe as any other non-live vaccine. You can read more about different types of vaccines here.


British Prime Minister Boris Johnson reacts after receiving his first dose of the AstraZeneca vaccine in London on March 19. (Frank Augstein/Reuters)

The real issue, Saxinger said, is “whether or not your particular immune change will allow you to get a fully protective response.”

“That’s where we’re still learning more.”

But even if immunocompromised people have slightly less protection than others, they should go ahead and get the vaccine, she said, because even a partially protective response against a severe COVID-19 infection is worthwhile.

Constantinescu added that it’s likely immunocompromised people may need booster doses in the future.

If you’re offered AstraZeneca, can you refuse?

Sure. No one is going to force you to take any one vaccine if you don’t want it. COVID-19 vaccines aren’t mandatory.

But that doesn’t mean you will immediately be offered another vaccine. That would depend on the province you live in, Constantinescu said.

For example, Quebec’s director of public health has said that people who refuse to take the AstraZeneca-Oxford vaccine will be bumped to the back of the line and have to make another appointment.

And waiting could be risky, especially as some provinces are seeing case counts rise, Constantinescu said.

“You are putting yourself at risk waiting for a different vaccine when we know that this vaccine works really well at preventing hospitalization, severity and death,” she said.

Have a question? 

Send your questions to COVID@cbc.ca

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