In a rare admission of the weakness of coronavirus vaccines developed in China, the country’s top disease control official says their effectiveness is low and the government is considering mixing them to get a boost.
China’s vaccines “don’t have very high protection rates,” Gao Fu, the director of China’s Centers for Disease Control, said at a conference Saturday in the southwestern city of Chengdu.
Beijing has distributed hundreds of millions of doses abroad while trying to promote doubt about the effectiveness of the Pfizer-BioNTech vaccine made using the previously experimental messenger RNA, or mRNA, process.
“It’s now under formal consideration whether we should use different vaccines from different technical lines for the immunization process,” Gao said.
Officials at a news conference Sunday didn’t respond directly to questions about Gao’s comment or possible changes in official plans. But another CDC official, Wang Huaqing, said developers are working on mRNA-based vaccines.
Gao did not respond to a phone call requesting further comment.
“The mRNA vaccines developed in our country have also entered the clinical trial stage,” Wang said. He gave no timeline for possible use.
Experts say mixing vaccines, or sequential immunization, might boost effectiveness. Researchers in the U.K. are studying a possible combination of Pfizer-BioNTech and the traditional AstraZeneca-Oxford vaccine.
The coronavirus pandemic, which began in central China in late 2019, marks the first time the Chinese drug industry has played a role in responding to a global health emergency.
Vaccines made by Sinovac, a private company, and Sinopharm, a state-owned firm, have made up the majority of Chinese vaccines distributed to several dozen countries including Mexico, Turkey, Indonesia, Hungary, Brazil and Turkey.
The effectiveness of a Sinovac vaccine at preventing symptomatic infections was found to be as low as 50.4 per cent by researchers in Brazil, near the 50 per cent threshold at which health experts say a vaccine is useful. By comparison, the Pfizer-BioNTech vaccine has been found to be 97 per cent effective.
Health experts say Chinese vaccines are unlikely to be sold to the United States, western Europe and Japan due to the complexity of the approval process.
Sinovac spokesperson Liu Peicheng acknowledged varying levels of effectiveness have been found but said that can be due to the age of people in a study, the strain of virus and other factors.
Beijing has yet to approve any foreign vaccines for use in China.
Previous mRNA skepticism
Gao gave no details of possible changes in strategy but cited mRNA as a possibility.
“Everyone should consider the benefits mRNA vaccines can bring for humanity,” Gao said. “We must follow it carefully and not ignore it just because we already have several types of vaccines already.”
Gao previously questioned the safety of mRNA vaccines. He was quoted by the official Xinhua News Agency as saying in December he couldn’t rule out negative side effects because they were being used for the first time on healthy people.
WATCH | Few people in China receive COVID-19 jabs despite vaccine development:
China has developed four vaccines for COVID-19, but only four per cent of its population has been inoculated. China’s government continues to donate millions of vaccine doses worldwide. 1:59
Chinese state media and popular health and science blogs also have questioned the safety and effectiveness of the Pfizer-BioNTech vaccine.
As of April 2, some 34 million people in China have received both of the two doses required for Chinese vaccines and about 65 million received one, according to Gao.
Liu said studies find protection “may be better” if time between vaccinations is longer than the current 14 days but gave no indication that might be made standard practice.
Much of Canada is in the grips of a worsening third wave as COVID-19 vaccinations slowly ramp up, and experts say the spread of more contagious coronavirus variants is throwing gasoline on an already-raging fire.
“We have a lot of virus moving around the country and escalating very, very quickly,” said Jason Kindrachuk, an assistant professor of viral pathogenesis at the University of Manitoba and Canada Research Chair of emerging viruses.
“Vaccinations are certainly starting to pick up, but we’re nowhere near where we need to be to get this thing under control.”
More than 15,000 cases of the more transmissible and potentially more deadly variants have been reported across Canada to date, with more than 90 per cent of those being the B117 variant first identified in the United Kingdom.
But the P1 variant first discovered in Brazil is also on the rise in Canada, with cases doubling in the past week to close to 1,000 — mostly in British Columbia, Ontario and Alberta.
And the B1351 variant first found in South Africa is also picking up steam, with over 150 cases identified in Quebec, more than 70 in Ontario and over 50 in B.C as of Tuesday.
WATCH | Variant first found in Brazil newest COVID-19 challenge in B.C.
The P1 COVID-19 variant, first seen in Brazil, is creating a big problem for health officials because of how quickly it spreads. Currently concentrated in the Vancouver area, modelling shows it could spread out of control by late April. 2:06
“People were hoping that we could get to the finish line and get everyone vaccinated without having to deal with another wave and unfortunately that doesn’t seem to be the case,” said Dr. Leyla Asadi, an infectious diseases physician at the University of Alberta in Edmonton.
“That’s a combination of both our reopening too quickly and now you add in these variants of concern.”
Canada has emerged as one of the only countries in the world with significant outbreaks of three different variants occurring at the same time — turning us into a giant experiment on the world stage.
“There’s no other country that’s kind of dealing with it as we are — we have all of them emerging at once,” said Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton.
“What happens to all three of them in the mix? Which one takes over? Which one is the fittest of the three?”
Variants could threaten vaccine effectiveness
Canada’s Chief Public Health Officer Dr. Theresa Tam says another unanswered question that has huge implications for our ability to control the third wave is whether variants like P1 pose a threat to COVID-19 vaccine effectiveness.
“This virus might be capable of evading the immune response,” she said. “But we do not have an actual vaccine effectiveness estimate that is solidified.”
Tam says she has asked medical officers of health across the country to gather more information on vaccine effectiveness against P1 in particular, while encouraging Canadians to get vaccinated and provinces and territories to keep public health restrictions in place.
Amid that black hole of data, Tam says Canada may be able to fill the international research void due to our surging rates of variant cases — for better or worse.
“We don’t have enough information from other countries, including Brazil, about how well these vaccines work against P1,” she said. “If Canada is seeing the evolution of spread of P1, we might be a country where we will be able to produce some of this data.”
Tam says scientists believe one specific mutation common to all three variants, called E484K, could actually allow the virus to escape the immune response and even make it possible for someone who has previously had COVID-19 to become reinfected.
“That was the initial event that caused us to be concerned about this P1,” she said. “There was reinfection in a particular person that already had COVID-19 before.”
Tam said while there have so far only been laboratory studies done on the antibody response to P1 that showed in some cases there was a reduced ability for a vaccinated person’s antibodies to neutralize P1 — the evidence so far is still a “signal of concern.”
Officials warn against travelling within Canada
Health officials are imploring Canadians to avoid recreational travel within Canada as the third wave rages, but experts say stricter travel restrictions may not be enough now to prevent widespread outbreaks of more contagious coronavirus variants.
“Variants of concern are posing new challenges in different locations across the country. Now is not the time to travel for recreational purposes,” Tam said Tuesday. “Limit your travel to essential trips only and do your part to stop the spread.”
Deputy Chief Public Health Officer Dr. Howard Njoo said individuals need to take “personal responsibility to the extent that it’s possible.”
“Stay at home as much as possible, don’t have any sort of non-essential travel — especially vacations going from one province to another.”
WATCH | Alberta renews restrictions as communities battle P1 variant outbreaks:
Several Alberta communities fighting P1 variant outbreaks are frustrated by a lack of information from health officials as the province announces a return to tougher restrictions to get its COVID-19 situation under control. 2:09
Officials there are also investigating several major P1 outbreaks at large workplaces, at least one of which is tied to a traveller returning to Alberta from out of province.
“Even before the variants have taken hold, we could have been far more responsive. But we weren’t and now we’re in a situation where we have these variants that are far more transmissible,” said Asadi.
“We have to take far more strict measures than previously, at least for a while until we can get the vaccination rates up.”
Manitoba is the only province or territory outside of Atlantic Canada and the North to implement strict regional travel restrictions, requiring a mandatory 14-day quarantine for all travellers, and has so far avoided a third wave.
“Manitoba implemented it when they saw the variants and the rest of us just didn’t,” said Asadi.
“There’s just this reluctance to do anything that seems too drastic, whereas doing the same old things results fundamentally in then having to institute stay at home orders, which themselves are really quite drastic but become necessary once you lose control.”
Ontario announced sweeping restrictions and a stay at home order on Wednesday due to a surge in cases and overwhelming pressure on the healthcare system, but stopped short of regional travel restrictions to slow the spread of variants.
Ashleigh Tuite, an infectious disease epidemiologist and assistant professor at the University of Toronto’s Dalla Lana School of Public Health, says variants already make up close to 70 per cent of Ontario’s COVID-19 cases.
“It’s incredibly widespread, so I think there’s merit in restricting movement between areas,” she said. “But as a way to control the spread of variants? That ship has likely already sailed.”
Kindrachuk said Manitoba’s travel restrictions have been a key part of their ability to control the spread of variants in the third wave, but a recent spike in cases and variants locally could jeopardize that.
“Once they get in, they start circulating a little bit under the radar, and then they start to take off,” he said.
“Now what we’re seeing is really it’s raging in basically all the provinces with the exception of the Atlantic provinces, Manitoba, and the Territories. The question is going to be now, how long can it be maintained?”
Elaine McCartney typically keeps a list on hand of her 30 or so health issues following a bout of COVID-19 a year ago— in part because she just can’t keep track of them all.
There’s the severe fatigue and memory issues. Brain fog, much like after a concussion. Constant headaches, low appetite, round-the-clock dizziness. And on and on.
The 65-year-old from Guelph, Ont., has been experiencing those symptoms for close to a year, after developing what felt like a severe case of influenza in April 2020 and which a physician identified as a probable case of the COVID-19 illness.
Then last month she got her first dose of the Pfizer-BioNTech vaccine. Her condition quickly seemed to improve.
“I was able to go to the store on my own, which I haven’t done for eight months,” McCartney said. “And my energy was up, and my pain was less. I had chronic debilitating pain in my shoulder, and it was gone.”
McCartney’s experience may offer a glimmer of hope for a growing number of people around the world living with prolonged health concerns after being infected with the virus causing the COVID-19 illness.
She’s not the only patient seeing unexpected improvements. Emerging research suggests vaccines may reduce symptoms for some of those suffering from what is now being called “long COVID”, where patients continue to suffer from a range of health concerns long after the infectious phase of the illness has passed.
‘Reassuring’ findings from U.K. study
More than a year into the pandemic, it’s not clear how many people are experiencing long-term health issues after having COVID-19, but their numbers are growing.
Researchers think around 10 per cent of people who get sick with COVID-19 continue to live with lasting symptoms — some suggest the number could be as high as 30 per cent — which could mean millions worldwide are coping with some lingering issues from the disease.
A new preprint study out of the U.K., which is still awaiting the peer review process, looked at a small group of such “long COVID” patients. It found those who had received at least one dose of the vaccine had “a small overall improvement” in long COVID symptoms and a “decrease in worsening symptoms” when compared to the unvaccinated patients.
The researchers followed 66 hospitalized patients whose symptoms persisted — issues like fatigue, breathlessness, and insomnia — including 44 who got vaccinated and 22 who didn’t.
A little over 23 per cent of the vaccinated patients saw some resolution of their symptoms, the researchers noted, compared to around 15 per cent of those who weren’t vaccinated — with no difference in response identified between the Pfizer-BioNTech or Oxford-AstraZeneca vaccines used among the participants.
The team also found another “reassuring result” — fewer vaccinated patients reported any worsening symptoms during the time period studied than the unvaccinated group, though they cautioned that there was a large potential for bias given patients self-reported their symptoms.
Dr. Fergus Hamilton, an infectious diseases researcher at the University of Bristol Medical School and part of the team behind the new study, said the findings offer a “slight hint” that vaccines might improve lingering symptoms.
“Although we’re a bit suspicious about that given the small numbers,” he added.
Science behind vaccine impact not clear
The study is limited by its small sample size, but other medical experts are observing a similar trend.
In the U.S., where roughly a quarter of the population is fully vaccinated, physicians now have a large pool of patients to follow.
Dr. Daniel Griffin, an infectious diseases physician at Columbia University in New York, said around 40 per cent of the patients he is treating for lingering health issues from COVID-19 are reporting either complete, or significant, improvement in their symptoms after being fully vaccinated.
He said the numbers in the U.K. study were “pretty on-target” with what he initially observed in his own patients, but that the impact seemed to bump up a couple weeks after people got their second dose.
“That’s the first bit of good news in a really a long time,” Griffin said.
But he acknowledged the mechanics behind why vaccination might clear up lingering COVID-19 symptoms isn’t yet clear.
WATCH | Long-COVID sufferers struggle with limited care options:
Kim Clark and Sonja Mally have jumped from specialist to specialist for the past year as they’ve sought relief for a series of crippling symptoms associated with post-acute COVID-19 syndrome. Some health experts say more dedicated funding and resources for COVID long-haulers would help sufferers like them and shed light on a little-understood aspect of the pandemic. 2:27
“I think the most persuasive theory for me is that the virus was never completely cleared, or whatever remnants might still be … are now able to be cleared because of the robust response that’s triggered by the vaccines,” Griffin said.
McCartney said her own post-vaccination experience felt nothing short of a miracle — even if the science behind what’s happening in her body remains hazy and more research needed to evaluate how much vaccines could actually help COVID long-haulers going forward.
“I was feeling so miserable, for so long,” she said.
“I’ve logged more than a thousand steps in the past four days and I haven’t done that for months and months and months — so I’ve definitely seen improvement.”
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.
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.
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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On an unusually warm spring morning, a class of seventh and eighth graders exits the doors of Charles Gordon Senior Public School in Scarborough, Ont. They walk single file through the yard, masked and distanced from each other by a strict two metres — a sign of the times in Toronto, where kids only recently returned to in-person schooling after another lockdown.
The day’s lesson is about COVID-19 vaccines, and appropriately, it was being held at an outdoor classroom. Students had been asked to read up on the vaccines and present questions they would like to ask Canadian officials about the inoculations and their distribution.
As vaccines roll out among older adults, many of the questions from this group of students focused on the fact that children aren’t on the current inoculation schedule. Of the vaccines approved in Canada so far, only the Pfizer vaccine has been cleared for people as young as 16 years old, and the other three are currently meant for ages 18 and up.
Their teacher, Tracey Toyama, said the lesson was a natural extension of current events. “They see it every day on social media; they come in, they ask questions,” she said.
“Why are children not more prioritized in terms of receiving the COVID-19 vaccine?” asked one girl.
“Why wouldn’t we vaccinate children so that they don’t put those who are vulnerable at risk?” asked another.
Indeed, since most children tend to experience milder cases of COVID-19, they weren’t prioritized in international vaccine trials. Still, kids do get sick and they can pass on the virus.
In fact, more than 157,000 Canadians aged 19 or younger have caught COVID-19. So until both adults and children are inoculated against the virus, it’s unlikely society will be able to go back to normal.
In recognition of this, a number of vaccines are now being tested on younger people.
Drug maker Sinovac submitted data to the Chinese government this week saying its vaccine is safe for children between the ages of three and 17.
Pfizer, Moderna, AstraZeneca, and Johnson & Johnson are now testing their COVID-19 vaccines on younger kids, too. Moderna’s trial includes children as young as six months old. Early data from Pfizer on its trials for children aged 12 years and older is expected soon.
Quebec-based Medicago, which is working through Phase 3 adult trials for its plant-based COVID-19 vaccine, says it has plans to move on to younger age groups as data emerges.
According to Nathalie Charland, a senior director with Medicago, the trials will be similar to those they’ve conducted with people aged 18 and up, though children will likely receive half the vaccine dosage.
Along with monitoring each of the test cases to make sure they’re safe, she said, “We will be looking at the immunogenicity of the vaccine candidate to see if what we saw in adults is the same that we see in children.”
Dr. Noni MacDonald with Dalhousie University in Halifax said vaccinating children is “incredibly important.”
She said adults were “rightly” prioritized for COVID-19 vaccines because, “children have not been shown to be the big vector of transmitting this virus from one person to another; it’s mostly adults and young people.”
However, MacDonald added, “The problem we have is we know that we need to have the community immunity happen. So, if we have big pockets of children that are not immunized, that community is not immune.”
With variants circulating, she said, the impetus to vaccinate children as soon as possible is strong.
“This is not the end,” she said. “This is a wicked virus and we need to control it in all the ways we can.”
That urgency is especially acute in households where a family member is immunocompromised.
Torontonian Amerie Alvis, 15, has been worried about bringing the virus home to her mom this past year. Her mother, Jaeda Larkin, is a single parent with rheumatoid arthritis.
“What if she does get sick, and I’m all alone?” Alvis said.
At nearly 16 years old, Alvis should be eligible for the Pfizer vaccine in a few months and said she is “all for it.”
In the meantime, she has chosen to do online schooling rather than go back to class, in order to minimize the risk to herself and her mom. Alvis said she won’t go back until she gets a shot, but she’s hopeful life could look different next fall.
Having lost some relatives in the U.S. to COVID-19, Larkin is similarly keen to see the two of them vaccinated against the virus.
“The thought of risking my daughter or, you know, potentially having her get sick is terrifying to me,” Larkin said.
Without available vaccine data for kids under 16, some parents of younger children are hesitant to commit just yet.
Torontonians Barry Ayow and Gina Athanasiou aren’t sure whether they’ll want to vaccinate their two youngest kids, who are 12 and 14 years old, against COVID-19 right away.
“I’m willing to experiment on myself. I’m willing to be a guinea pig. But to volunteer my children to be guinea pigs, that’s a different thing, right?” said Ayow.
At the same time, a sense of duty to their older family members and neighbours is weighing on the couple.
“Will duty outweigh our obligation to our kids to make sure that they’re safe? I don’t know,” said Athanasiou, who has concerns about possible side effects of the vaccines on her kids.
She added, “Maybe we’ll feel more comfortable when we have the studies.”
Dr. MacDonald said parents can be reassured that a push to vaccinate children won’t be coming “out of nowhere.”
“This is going to be based on evidence,” she said.
In fact, according to MacDonald, information about the COVID-19 vaccines will be more robust than what was initially available for previous vaccines, such as polio.
When the time comes for children to get vaccinated, she said, “literally tens of millions of doses of these vaccines will have been used in the population. We’ve never had that kind of volume whenever we’ve used vaccines in children before when we were starting.”
In a show of hands, about half the students in the Grade 7 and 8 class at Charles Gordon Senior Public School said they themselves would take the vaccine based on what they currently know, with others mostly citing the need for more information on their own age group.
What’s clear from nearly all of them during their classroom discussion, though, is that the stress of the pandemic isn’t just affecting adults.
For seventh grader Isaiah Velez, keeping his family and friends safe is a personal priority, he said, as is putting an end to the pandemic. “I miss going out in public and meeting my friends — a lot,” he said.
Watch full episodes of The National on CBC Gem, the CBC’s streaming service.
New research from two small pre-print studies suggests delaying second doses of COVID-19 vaccines by up to four months may not be the best approach for some older Canadians.
The research comes as some experts are also questioning whether Canada’s vaccination advisers, who recommended the delay, can keep up with rapidly evolving science during the pandemic.
Prior to the pandemic, the National Advisory Committee on Immunization (NACI), which has provided guidance to the federal government on vaccinations since 1964, met just three times a year to discuss issues related to vaccines for influenza, mumps, measles and other viruses.
But a year after the pandemic was declared, with new data emerging daily, NACI has been thrust into the spotlight and forced to evaluate new vaccines for a novel virus faster than ever before.
“NACI’s committees are basically made up of volunteers, many with heavy daily responsibilities during the pandemic,” said Dr. David Naylor, co-chair of Canada’s COVID-19 Immunity Task Force.
“There’s no precedent for NACI to operate at this pace, and everyone is adapting on the fly.”
NACI has met nine times since Canada approved its first COVID-19 vaccine on Dec. 10, but it has plans to ramp up in the coming months with another 13 meetings scheduled between now and the end of June.
Delay could leave cancer patients less protected, U.K. study suggests
Perhaps one of NACI’s most impactful recommendations on Canada’s vaccine rollout was the decision to delay second doses beyond manufacturing guidelines by up to four months, but emerging research signals it may not be the best approach for vulnerable Canadians.
A new pre-print study, which has not yet been peer reviewed, analyzed 151 older cancer patients and compared their immune response with 54 healthy adults after receiving the first and second doses of the Pfizer-BioNTech COVID-19 vaccine in the U.K.
The researchers concluded that delaying second doses to between eight and 12 weeks for most cancer patients left them “wholly or partially unprotected” and had implications on their health and the potential emergence of coronavirus variants.
WATCH | Delaying some 2nd COVID-19 vaccine doses challenged by new data:
New early data suggests that Canada’s recommendation of delaying the second dose of COVID-19 vaccines to up to four months may not be effective in some older, more vulnerable patients, causing the vaccine advisory committee to re-examine its guidance. 2:36
“Our data advocates that bringing forward the second dose of the vaccine for patients who have cancer may benefit them,” said Leticia Monin-Aldama, lead author of the study and a researcher at the Francis Crick Institute in London.
“And that perhaps a sort of one-size-fits-all approach may not be ideal when delivering these vaccines to the population.”
NACI advocated for that universal approach to delay second doses by up to four months for all Canadians — the longest interval recommended by a country so far — based on limited real-world evidence and the reality of Canada’s vaccine supply.
The decision was also informed by findings from Dr. Danuta Skowronski, epidemiology lead at the British Columbia Centre for Disease Control (BCCDC), who determined that one dose of the vaccine was actually more effective than clinical trials had initially shown.
NACI said if second doses were stretched to four months across the country, close to 80 per cent of Canadians over the age of 16 could get at least one shot by the end of June.
But Canada’s chief science adviser, Mona Nemer, has said the decision to delay second doses amounted to a “population level experiment” and advised against the delay in older Canadians on CTV’s Power Play this week, citing a lack of data to back up the decision.
Darryl Falzarano, a research scientist with the Vaccine and Infectious Disease Organization (VIDO) lab in Saskatoon, is also against the decision to increase the time between doses and said there is a growing body of research that suggests it’s not the safest approach for immunocompromised and older adults.
“The initial data look like delaying the dose of the mRNA vaccines would still provide reasonable protection to the population from severe or moderate disease, and so vaccinating more people was looked at as the greater good,” he said.
“Now, in certain populations — older people, people with comorbidities and cancers — likely delayed boosting for them is sub-optimal and possibly will lead to revised recommendations for those groups.”
B.C. study analyzed long-term care residents
A second pre-print study released this week from researchers in British Columbia, which has also not been peer reviewed, cast further doubt on the dose delay for seniors and found that their immune response may not be as strong as in younger, healthier people.
The study analyzed antibody levels in a dozen long-term care residents in Vancouver a month after receiving their first dose of a COVID-19 vaccine, compared with 22 younger health-care workers — 18 of whom had not previously been infected by COVID-19 and four who had.
“The level of antibodies in older residents was fourfold lower, so significantly decreased,” said Dr. Marc Romney, a clinical associate professor at the University of British Columbia in Vancouver and one of the authors of the study. “The function of those antibodies in older people was also compromised.”
Romney said antibodies are just part of the picture, and he also plans to look at the immune system’s full response in future research. But he said the fact that antibodies in the elderly didn’t neutralize the virus as well as in the younger health-care workers suggests the dose delay may need to be revised for them.
“There is emerging evidence that demonstrates that there are some populations that will probably not fare as well and have the same degree of protection following single doses of a vaccine,” said Dr. Isaac Bogoch, an infectious diseases physician and member of Ontario’s COVID-19 Vaccine Distribution Task Force.
“These are groups you would want to shorten the time between dose one and two.”
WATCH | The science behind delaying the 2nd dose of COVID-19 vaccines:
Federal government scientists have put their support behind delayed second doses of COVID-19 vaccines — which several provinces were already doing — and ongoing research shows some of the benefits of the adapted strategy. 2:04
‘This isn’t a regular vaccine’
The speed with which NACI members are able to make these decisions has come under fire.
Falzarano said NACI is typically used to working under a “slow-moving” vaccine regulatory process where vaccines can take up to a decade to go from research to rollout.
“Their job is to review vaccines, but their experience is reviewing them under a much different scenario,” he said.
“They are normally looking at a full data set when they have to make decisions. They would normally make very conservative decisions, and now, they find themselves in a much different scenario than what they’re used to — and I think that’s highly challenging for them.”
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.
Alyson Kelvin, an assistant professor at Dalhousie University and a virologist at the IWK Health Centre and the Canadian Centre for Vaccinology, all in Halifax, said NACI should include more experts in emerging viruses and vaccine development to help navigate the research in the pandemic.
“This isn’t a regular vaccine that’s gone through the typical workflow for vaccine approval and vaccine development because it’s an emerging virus,” said Kelvin, who is also evaluating Canadian vaccines at the VIDO lab in Saskatoon.
“You need somebody who understands that dynamic, instead of what we would normally depend on for our medicines or vaccines.”
Dr. Caroline Quach-Thanh, who chairs NACI, responded to criticism during a news conference on March 16, saying that as new evidence emerged on the efficacy of the AstraZeneca-Oxford vaccine in older adults, NACI was “busy with other files” that delayed its guidance.
“The committee is very busy, obviously, meeting weekly to discuss the emerging data on these important topics,” said Matthew Tunis, executive secretary to the committee.
“So there’s always inevitably going to be a bit of a lag between when a committee deliberates and when the advice is made public.”
Decisions take time, NACI chair says
Quach-Thanh responded to further questions about the delay in revising recommendations on CBC’s Power and Politics on Wednesday, noting that NACI isn’t equipped to review new evidence one day and make recommendations the next.
“It’s not possible, we can’t be that reactive,” she said. “I don’t think any advisory committee can be that reactive because it would mean that every time something changes, you move the needle one way or the next.
“Then it just means that you’re changing your recommendation every other day. So you need to gather that base of evidence before you change something.”
But even after NACI has finalized its recommendations, Quach-Thanh said, it takes an entire week to translate and upload them to the Public Health Agency of Canada’s website — precious time in a pandemic where new data emerges daily.
Quach-Thanh said the committee is currently re-examining its guidance based on new research, and new guidelines on the timing of second doses for seniors and the immunocompromised could come as early as next week. But Skowronski, with the BCCDC, said it’s too early to make that call definitively.
“This is a kind of a signal that we might want to follow, it’s of interest, but we cannot change or make policy on the basis of this sort of small study,” she said.
“It may come to pass that we will want to adjust depending upon how far we have come in achieving that goal of getting at least one dose into these individuals at highest risk.”
Skowronski defended the decision to delay second doses by up to four months in Canada and stressed that the benefits of vaccinating more vulnerable groups with an initial shot outweigh the risks of delaying a second.
“My preoccupation is in at least getting a first dose into those at high risk of severe complications, and we’ve not achieved that yet,” she said, adding that age was by far the biggest risk factor for severe outcomes from COVID-19.
“That’s job one. Let’s get that job one done, and then let’s debate the timing of the second dose.”
Canada has delayed second doses of COVID-19 vaccines by up to four months — the longest interval recommended by a country so far — but has yet to provide any new guidance to Canadians on what they can or can’t do while waiting for the second shot.
NACI said it based its revised guidelines on emerging real world evidence and the reality of Canada’s limited supply of COVID-19 vaccines, although there is no research yet on the long-term effect the delay could have on immunity to the coronavirus disease.
NACI said if second doses were stretched to four months across the country, close to 80 per cent of Canadians over 16 could get at least one shot by the end of June.
But Canada’s chief science adviser, Mona Nemer, has said the decision to delay second doses amounted to a “population level experiment.”
The United Kingdom has delayed second doses by up to three months, but no other country is known to have delayed them by up to four months. Spokespeople from Pfizer and Moderna said they recommend sticking with intervals of three and four weeks for their respective vaccines as studied during clinical trials.
What can Canadians do after being vaccinated?
Many Canadians are wondering what they can do after getting vaccinated and if they can safely see their families, other vaccinated people or generally feel less at risk from COVID-19 after a year under strict public health measures.
But the recommendations still haven’t been updated weeks after the change was made — meaning Canadians could be tempted to make up their own rules in the interim.
The CDC also said those who have had both shots can visit with unvaccinated people from a single other household who are at “low risk for severe COVID-19,” as well as skipping quarantine and testing if exposed to COVID-19 without showing symptoms.
But unlike Canada, the U.S. hasn’t delayed second doses by up to four months and answers to those questions have been harder to come by for Canadians weeks after guidelines changed and close to 5 million doses administered.
Canada’s Chief Public Health Officer Dr. Theresa Tam said during a news conference Tuesday that the issue is being actively discussed with the provinces and territories and that while new guidance is coming, the country is in the “early days” of its vaccine coverage.
“For now, the key message is that everyone needs to keep up with their personal protective measures which are wearing a mask, handwashing, watching your distance and avoiding closed, crowded conditions,” she said.
“I think as more and more people get vaccinated I would expect the advice to evolve as we go along, but it’s a little bit too early.”
WATCH | ‘Too early’ to update guidelines for vaccinated Canadians: Tam
Canada’s Chief Public Health Officer Dr. Theresa Tam says guidance for Canadians who have been vaccinated will likely evolve as more people get vaccinated, but it’s too early in our roll out to update recommendations yet. 1:35
Tam said the spread of coronavirus variants across Canada amid already high levels of community transmission should factor into “local decisions” on what public health measures need to be put in place or lifted for vaccinated individuals.
She provided no timeframe for when Canadians can expect to see new guidance from the Public Health Agency of Canada on what they can and can’t do after being vaccinated.
Guidelines for Canadians with only one dose even less clear
And what about guidelines for Canadians who have only had one dose?
“It’s maybe not clear to the general public, but it should be clear that you’re only fully vaccinated after two doses,” said Prof. Alyson Kelvin, an assistant professor at Dalhousie University and virologist at the Canadian Center for Vaccinology.
“I can completely sympathize that it’s been a long haul for everybody, but it’s really important that we continue with those public health measures until we have a low level of virus transmission within the community.”
She says until Canada’s hardest-hit regions have significantly lowered their rates of community transmission, Canadians will have to continue practicing physical distancing, proper hand hygiene, avoiding crowds and wearing masks in public.
“You’re still at risk even though you’re fully vaccinated,” says Kelvin, who is also evaluating Canadian vaccines with the VIDO-InterVac lab in Saskatoon.
“Even with two doses, you can still be infected and transmit the virus — you just might not be as ill as somebody who wasn’t vaccinated.”
Until Canada has a large proportion of vaccinated people across the country who can help decrease overall COVID-19 levels, Kelvin says it makes sense for hard-hit regions to hold off on relaxing public health measures.
Dr. Nathan Stall, a geriatrician at Mount Sinai Hospital in Toronto, says communication from public health officials on what people can do after getting a COVID-19 vaccine has been lacking — especially for older Canadians.
“I’ve had patients who have showed up at the vaccination clinic expecting to get their second shot and have been turned away, so they are devastated emotionally, I’ve had people who have found out immediately beforehand,” he said.
“I think their questions are very reasonable, which [are]: ‘Do we have evidence to support this? Am I going to be at higher risk? How does this impact my behavior during the third wave now?'”
WATCH | The science behind delaying the 2nd dose of COVID-19 vaccines
Federal government scientists have put their support behind delayed second doses of COVID-19 vaccines — which several provinces were already doing — and ongoing research shows some of the benefits of the adapted strategy. 2:04
Stall, who is a member of NACI but does not speak on behalf of the committee, said it’s important for public health officials to be transparent about the emerging data on delaying second doses and that the guidelines will likely change.
“I think we need to do a much better job of messaging,” he said. “Because this population [of older seniors] has been living in terrible isolation for a year.”
Dr. Lynora Saxinger, an infectious diseases physician and an associate professor at the University of Alberta, says updated guidelines will likely come in the near future as new data emerges.
She said it was important to note that the recommendations allowed for a maximum interval of up to four months, though the actual interval between doses could be shorter and the guidelines revised if new data showed certain groups were at higher risk.
“So the main thing is to kind of stay light on your feet and make changes that make sense to try to protect everyone the best we can,” she said.
Saxinger said the second dose delay made sense given Canada’s limited vaccine supply, because it allowed for an expanded vaccination rollout and offered protection to a greater number of vulnerable Canadians.
“It really will actually save a great many lives,” she said.
“But if there’s populations where deferring the second dose will actually make them less likely to be immune in the longer term, then obviously that’s a place that has to be readdressed.”
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.
If he qualifies for this summer’s Olympic Games, Canadian swimmer Brent Hayden would prefer to receive a COVID-19 vaccination before arriving in Tokyo.
That doesn’t mean he wouldn’t go without getting his jab. He also isn’t sure if he would use the vaccine being offered to Olympic athletes as part of a recent partnership announced by the International Olympic Committee and China.
“I think that would be something I have to talk to my coach about, to figure out what we think is going to be the best decision,” said Hayden, who won a bronze medal in the 100-metre freestyle at the 2012 London Olympics.
“I do want to be vaccinated, I want to be covered at the Olympics. I don’t want to catch it and spread it. Now whether or not that’s the China one … I’m just going to have to wait to see what my coach or what Swimming Canada recommends.”
In the recently announced agreement, the IOC entered into a partnership with the Chinese Olympic committee to buy and provide vaccines for people participating in the Tokyo Games and next year’s Winter Olympics in Beijing.
None of the Chinese vaccines are approved for use in Canada.
In a statement, the Canadian Olympic Committee said it would prefer Canadian athletes use Health Canada approved vaccines.
“Our strong preference is that any vaccine a Canadian athlete receives has been approved by Health Canada,” COC boss David Shoemaker said in a statement.
“The COC will continue to follow Health Canada guidelines and the recommendations of our chief medical officer and the return to sport task force for all matters relating to the health and safety of Team Canada.”
WATCH | Should Olympians cut in line for vaccine?:
Some athletes say they want to wait their turn. 2:20
A Swimming Canada spokesman said they are encouraging athletes to follow the COC guidelines.
At least one Olympic expert said he isn’t surprised the by the IOC’s decision to buy vaccines or that they are being purchased from China.
Michael Naraine, an assistant professor with Brock University’s department of sport, said IOC president Thomas Bach has pushed for the Tokyo Games to go ahead, even though concerns remain about COVID-19.
“They weren’t going to force athletes to take the vaccine, but they wanted to do everything they could to ensure health and safety,” said Naraine, who studies major games and the Olympic movement.
“It’s not surprising that China would be the place where they were able to procure them. The supply chains are really tight now when you’re thinking about all the different countries that are trying to procure. When you think about scale in the supply chain, China’s clearly the top dog.”
WATCH | Why a COVID-19 vaccine isn’t the key to a fair Olympics:
Jacqueline Doorey speaks with Canadian middle distance runner Gabriela DeBues-Stafford to discuss the COVID-19 vaccine, how it can affect the Olympics, and whether athletes deserve to cut the line. 5:51
The IOC is also “very bullish on China” considering it’s hosting next year’s Winter Games and some of the major sponsors that comes with that, he said.
While athletes in some countries may be hesitant over the IOC’s offer, for others it might be their best chance to access the vaccine.
“If I’m an athlete in a country which has a very heavy strain on health care and the public health system, you’re looking at this as jumping the global queue as far as vaccination and inoculation is concerned,” said Naraine.
Wrestler Erica Weibe, a gold medallist at the 2016 Rio Games, supports more athletes having access to the vaccine.
It would be great if the IOC’s partnership “can help athletes and citizens of countries with less robust vaccination plans than Canada,” the Stittsville, Ont., native told The Canadian Press last week.
Prime Minister Justin Trudeau has promised that every Canadian adult who wants a vaccine will be able to receive a shot by the end of September.
In B.C., where Hayden lives, his age group is scheduled to receive their first round of the vaccine in May or June.
The Tokyo Games, which have been delayed a year due to COVID-19, are scheduled to open July 23.
Hayden, who retired after the London Games but decided to make a comeback for Tokyo, said not being vaccinated won’t stop him from competing.
“My goal is to go to the Olympics,” he said. “If I’m vaccinated or not vaccinated, I’m planning on going until they tell me I can’t go.”
Canada is about to get a big boost in vaccine doses, with a first cross-border shipment from the United States, as the southern neighbour ever-so-slightly eases the tight grip on its supply.
The White House confirmed Friday that the U.S. will allow exports of four million AstraZeneca-Oxford COVID-19 vaccine doses to Canada and Mexico, with 1.5 million doses headed to Canada.
That’s equivalent to a more than a one-third boost in total doses administered in Canada, an influx that will still leave Canada far behind the U.S. in its overall rate of vaccinated citizens.
The shipment dates are still being finalized, though one Canadian official said vaccines could arrive in Canada within a few days.
“We’re able to announce that we are lending a portion of our releasable AstraZeneca vaccines to Mexico and to Canada,” said Jeffrey Zients, the White House co-ordinator for the COVID-19 response.
“This action will allow our neighbours to meet a critical vaccination need in their countries, providing more protection immediately across the North American continent.”
Zients’ colleague Andy Slavitt also tweeted the news. The White House had said Thursday the countries were finalizing plans, and, amid numerous conversations between the capitals, the news was made official Friday.
The Canadian official said the vaccine doses have expiry dates in May and June, leaving ample time to get them administered to Canadians.
Vaccines were sitting unused in the U.S.
White House officials, aware of the potential for political blow back at home over exporting vaccines during a pandemic, said the decision would not affect the U.S.’s own immunization schedule: the country plans to have enough supply for all Americans by May 31.
This transfer involves a product Americans aren’t currently using. The U.S. has yet to approve the AstraZeneca vaccine, and is sending some of the doses it has stockpiled before they risk the threat of expiring.
The country has also vaccinated its residents at a rate four times faster than Canada’s. On Friday, the U.S. President Joe Biden’s administration celebrated news that 100 million vaccine doses have been administered in 58 days, well ahead of its stated target.
Canada and Mexico will return the doses to the U.S. later this year, Zients said. He said the return would be handled through AstraZeneca.
Marc-André Gagnon, a pharmaceutical policy expert at Carleton University in Ottawa, says the export of these particular vaccines, at this particular time, makes obvious sense.
He said the U.S. couldn’t sit on unapproved doses for much longer, lest it invite the worrying scenario of coveted vaccines going to waste in U.S. warehouses.
Why this is happening now
“I think that the expiry consideration can be the best explanation [for] why the U.S. would waive the export ban,” he said in an email.
At the same time, he said, it would have been politically toxic for the Biden administration to export other vaccines Americans are currently using — so he said shipping Astrazeneca doses was the safest political bet.
But he said the fact these AstraZeneca vaccines haven’t been approved by the U.S. Food and Drug Administration raises a worrying question: Why?
The delay in approval is problematic whether it stems from a valid scientific concern or non-scientific considerations, he said.
Steve Morgan, a pharmaceutical-policy expert at the University of British Columbia, said the threat of vaccines expiring also looms large.
“The Biden administration would far rather loan these vaccines to neighbours than wear the potential disaster of having millions of vaccines expire in the U.S.,” he said.
Another consideration at play: migration.
The continental migration angle
Some border-state lawmakers have urged the administration to get vaccines next to Canada and Mexico, in order to help get America’s land borders reopened earlier.
The shipment also potentially buys some goodwill with Mexico, whose help the Biden administration needs to stem a surge in undocumented migrants coming from Central America.
White House reporters have pressed Biden’s spokespeople on whether the vaccine shipments are intended as part of a plan to get Mexico to clamp down on migration.
Biden spokespeople have replied that they’re having different conversations with Mexico at the same time.
“As you can imagine, when you’re having conversations with different countries, you’re talking about different issues,” deputy White House press secretary Karine Jean-Pierre told reporters Friday on Air Force One.
“So that is that is what’s happening. … When you think about Mexico, when you think about Canada, those are our neighbours, we have similar interests,” Jean-Pierre said.
“And we want to make sure that we’re doing our part in beating back this pandemic. There are no borders when it comes to the pandemic.”