Ontario pauses AstraZeneca, leaving people with one dose asking what comes next

Tuesday’s announcement left some of those who have received one dose of AstraZeneca frustrated and angry.

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Ontario will no longer give AstraZeneca vaccinations as first doses because of the risk of rare blood clots.

The announcement by public health officials came late Tuesday after increased reports of the rare blood-clotting syndrome known as VITT in Ontario in recent days after people received the AstraZeneca vaccine.

“This decision was made out of an abundance of caution due to an observed increase in the rare blood clotting syndrome known as VITT linked to the AstraZeneca vaccine,” said Dr. David Williams, Ontario’s Chief Medical Officer of Health.

There have been eight cases of VITT in Ontario out of more than 850,000 administered doses of AstraZeneca and Covishield, which is the same vaccine manufactured by the Serum Institute of India. A month ago, the risk of the rare blood-clotting syndrome after a first dose of AstraZeneca was estimated at anywhere between one in 125,000 and one in one million. Today, as a result of cases reported in recent days, that risk is one in 60,000 said officials.

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Tuesday’s announcement left some of those who have received one dose of AstraZeneca frustrated and angry.

OTTAWA -May 11, 2021 –Andrea Smith is concerned about her future dose of Astra Zeneca. She received the first dose but is unsure if she will get second dose.Assignment 135646Jean Levac/Ottawa CitizenORG XMIT: 135646
OTTAWA -May 11, 2021 –Andrea Smith is concerned about her future dose of Astra Zeneca. She received the first dose but is unsure if she will get second dose.Assignment 135646Jean Levac/Ottawa CitizenORG XMIT: 135646 Photo by Jean Levac /Jean Levac

“I stood in line to get my vaccine because that is what we were told to do,” said Ottawa swim coach and Olympian Andrea Schwartz Smith who got vaccinated with AstraZeneca late last month as soon as she qualified. “Now I feel like I have got to start from square one. It does make you think: Should I have bothered?”

Schwartz said she wants to know what the plan is for people like her.

There was no answer to that question Tuesday. Officials say they are waiting for more information to know whether people who received one dose of AstraZeneca will get a second dose of the same vaccine or another vaccine, or even whether there will be enough AstraZeneca available to offer second doses of it.

Williams took pains to say that people who got a first dose of AstraZeneca — a list that includes Premier Doug Ford, Health Minister Christine Elliott, Prime Minister Justin Trudeau and many others — made a “good choice.”

“Based on the higher risk of COVID infections in Ontario, those who received first doses of AstraZeneca did the right thing to prevent illness and protect their families, loved ones and Canadians,” he said.

Still, the announcement following a similar one in Alberta has added to the confusion that has marked the rollout of AstraZeneca in Canada.

At the beginning of May, with the link between AstraZeneca vaccines and a very rare but serious blood clotting disorder established, Canada’s National Advisory Committee on Immunization (NACI) recommended that people who are not at high risk of COVID-19 might want to wait for a Pfizer or Moderna mRNA vaccine instead of AstraZeneca. NACI was criticized for sowing confusion and vaccine hesitancy when it called the mRNA vaccines preferential.

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Later, the chair of NACI clarified that people who got AstraZeneca did not get a “second-best” shot.

But Justin Bates, CEO of the Ontario Pharmacists Association, whose members administered much of the AstraZeneca in the province, said pharmacists saw “quite a bit of vaccine hesitancy” as a result of those comments from the NACI.

Pharmacists are now ramping up to deliver Pfizer and Moderna vaccines.

Global public health officials were hoping AstraZeneca would be the “workhorse” of COVID-19 vaccines, said uOttawa virologist Earl Brown, because it is inexpensive to produce and easy to transport. It also provides excellent coverage against severe COVID-19 illness, up to 95 per cent after one dose, according to a study conducted in Scotland. But the risk of rare blood clots has made it less acceptable, especially in wealthy countries when other vaccines are available.

Still, for those, like Schwartz Smith and others who heeded the call to take the first vaccine offered and not vaccine shop, the chaotic messaging around the vaccine and Tuesday’s decision to stop offering initial doses has led to anger and concern.

Dr. Nili Kaplan-Myrth
Dr. Nili Kaplan-Myrth Photo by Ashley Fraser /Postmedia

Ottawa’s Dr. Nili Kaplan-Myrth vaccinated 825 people with AstraZeneca over the weekend during an outdoor “jabapalooza”. On Tuesday she said she was “sad and confused” about the mixed messaging around the vaccine.

“I am so willing to help encourage people to get a vaccine but it is sad that we are now sending out confusing messages about it.”

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Science communicator and neuroscientist Samantha Yammine, who goes by Science Sam on social media, said she understands that some people who received AstraZeneca feel “snubbed”, but they shouldn’t.

Among the most common questions she hears on social media are people with one dose of AstraZeneca asking whether they made a mistake.

“It is very valid to feel confused and perhaps left behind,” she said, “but I would reassure you, you didn’t make a mistake. You made a good decision to get the AstraZeneca vaccine.”

Meanwhile, though, people who got one dose of AstraZeneca are waiting to find out what comes next. Many of them never got an appointment for a second vaccine.

The UK is studying mixing doses of vaccine. That is among information that will inform Ontario officials’ advice about what options are available for people who got AstraZeneca.

Schwartz Smith said her biggest concern now is how and when she is going to get a second dose.

Like many who received AstraZeneca from pharmacies, she does not have an appointment for a second dose.

She does not want to be forgotten.

“Am I going to need to get in line for Pfizer and get two doses or will there be AstraZeneca available for me when it is time for my second dose?”

“Don’t forget me. I went and did what I was told and really do need to finish up my vaccines.”

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