VICTORIA — The provincial health officer defended B.C.’s use of the AstraZeneca vaccine this week in light of a statement by Canada’s immunization advisory committee that some fear could increase vaccine hesitancy or vaccine shopping.
“With the amount of transmission we are seeing in this province the best advice, that I can give: The first vaccine that you have access to is the one that you should get,” Dr. Bonnie Henry told reporters. “That includes the AstraZeneca vaccine.”
Granted there was a small “safety signal” regarding use of the vaccine, related to a “very rare” risk of developing blood clots. But Henry’s position was “very clear” in the real world of limited supplies of vaccine and the goal of immunizing as much of the population as possible, as soon as possible, in the name of greater safety for all.
“We have real world data from the United Kingdom that shows a single dose of AstraZeneca or Pfizer vaccine provides excellent protection; in the high 80 per cent protection against transmission of the virus, but also (against) serious illness, hospitalizations and deaths. More recent studies have shown that both AstraZeneca and Pfizer vaccines prevent you from getting infected yourself, and make it less transmissible to your family if you do get infected.”
On a personal note, she added that members of her own family were vaccinated with AstraZeneca. Henry was vaccinated with Pfizer in late December of last year, two months before Health Canada approved AstraZeneca for use.
The provincial health officer was responding to the statement earlier Monday from the National Advisory Committee on Immunization, expressing a preference for the mRNA-based Pfizer and Moderna vaccines because of the rare risk of serious blood clotting with AstraZeneca .
“What we’re saying — what we’ve said all along — is that the mRNA vaccines are the preferred vaccines,” said NACI vice-chair Shelley Deeks. “The issue with the safety signal is that although it is very rare, it is very serious, and so individuals need to have an informed choice to be vaccinated with the first vaccine that’s available or wait in line for an mRNA vaccine.”
Committee Caroline Quach-Thanh tried to have it both ways.
“So if you are in an area where there is no COVID, then waiting for mRNA is OK. If you’re in an area where there’s tons of COVID, the transmission is high, then I absolutely agree, the first vaccine that comes is the one that you take,” she said. “If my sister was to get the AstraZeneca vaccine and die of a thrombosis when I knew that it could have been prevented — and she’s not in a high risk area — I’m not sure I could live with it.”
The mixed messaging had some front-line doctors and health officials seething. But Henry contented herself with a polite suggestion that there was nothing new or useful from the advisory committee. “NACI has always had recommendations based on the comparison with the mRNA vaccines,” she reminded reporters. “I still encourage everybody to receive the vaccine that is available to you first.”
The Committee’s tacit relegation of AstraZeneca to second-class status came just as B.C. was making a second attempt to boost immunization and rein in transmission in the Fraser Health region — especially in Surrey, which has been ground zero for the third wave of COVID-19 in B.C. for most of the year.
Last week’s first attempt involved the establishment of pop-up clinics at selected locations around the region. “It really was an attempt to try and reach out to communities where we weren’t getting a lot of registration and we wanted to be able to provide a vaccine in a way that was easier for people and less restrictive,” explained Henry, even as she apologized for the confusion and backlash over the clinics.
This week’s second attempt is led by Premier John Horgan, through an outreach to community and religious leaders. The focus, as with the pop-up clinics, will be those harder to reach communities in Fraser Health and especially Surrey.
The issue in Surrey is a high rate of transmission, explained Health Minister Adrian Dix. “Surrey actually has a higher level of immunization than the city of Vancouver, Burnaby and other communities in Metro Vancouver,” he said. “But we need it to be higher and we need more people to be registered there.”
Barriers to registration include language, unfamiliarity with the online system and mistrust of government, compounded by fallout over the pop-up clinics and suspicions that AstraZeneca is a second-class vaccine for second-class citizens. The latter concern is moot, as AstraZeneca supplies have run out. But more is expected to be on the way later this month.
Horgan is himself a poster premier for AstraZeneca. Though he was already on the waiting list for Pfizer vaccine with his age group, he switched to AstraZeneca to underscore confidence. On Sunday, he tweeted out a picture of himself in a “This is our shot” shirt, brandishing his immunization record.
“The best vaccine is the first one offered to you,” he declared. “I got mine as soon as I was eligible, so I could make everyone around me safer — and I challenge everyone in B.C. to do the same!”
Despite his enthusiasm, I doubt the selling job will be any easier after the National Advisory Committee on Immunization’s confusing and unrealistic recommendation.
