AstraZeneca vaccine suspended in Ontario amid concerns

May 19, 2021

By Mike Riley

Local Journalism Initiative Reporter

Because of concerns over blood clots, and out of an abundance of caution, Ontario stopped offering AstraZeneca’s COVID-19 vaccine as a first dose option on May 11. Canada has seen 12 cases of blood clots with three patients dying, with eight cases in Ontario. Local pharmacies in Whitney and Bancroft have confirmed the pause on the AstraZeneca vaccine, and say they should have more supply of the Pfizer and Moderna vaccines within the next couple of weeks to compensate. Health Canada and the National Advisory Committee on Immunization, along with their provincial counterparts are currently determining how best to use the AstraZeneca vaccine going forward.

The blood clots associated with the AstraZeneca vaccine are called Vaccine Induced Immune Thrombotic Thrombocytopenia or VITT. In the few days before the halt to the AstraZeneca vaccine, the incidence rate of VITT had gone up from 0.9 in 100,000 shots to 1.7 in 100,000 shots. According to the Sciencetable COVID-19 advisory for Ontario, the symptoms of VITT may occur between four and 20 days after vaccination and are; a severe headache that doesn’t go away, a seizure, difficulty moving parts of your body, blurry vision that doesn’t go away, difficulty speaking, shortness of breath, chest pain, severe abdominal pain, new severe swelling and pain or colour change of an arm or leg. They also point out that these symptoms can also be signs of other serious conditions and people with them should seek emergency medical attention immediately.

Ontario’s chief medical officer Dr. David Williams says the suspension of the AstraZeneca vaccine for first doses was done out of an abundance of caution, and according to studies from the U.K., the risk of getting a blood clot after a second AstraZeneca shot drops dramatically.

Currently, federal and provincial health officials are looking into whether to give second doses of the AstraZeneca vaccine or to provide the alternate COVID-19 vaccines for that purpose. Dr. Williams also said supply issues came into play with the AstraZeneca vaccine, and that the government currently had a steady supply of Pfizer and Moderna vaccines for distribution. The downward trend in cases also factored into their decision.

Ontario is expecting to get over 250,000 doses of the AstraZeneca vaccine this week and will likely reserve these doses for second shots, pending a review by the NACI and Health Canada. There are also about 50,000 unused AstraZeneca doses that Ontario already has, and keeping in mind their expiry date in late May/early June, the province will attempt to use these doses safely before they spoil.

Dr. Williams maintains that the health and safety of Ontarians is the top priority in a news brief from Ontario.ca on May 11, and that they are encouraged to get vaccinated as soon as they are able.

Sir John Bell, the researcher who oversaw the development of the AstraZeneca vaccine blasted the move to suspend its use in an interview with CTV News, saying that the benefits of the vaccine far outweigh the risks, especially with the COVID-19 variants circulating around the globe.

According to Jim Etmanski, the executive director of the SAFHT, the Whitney Pharmacy in Whitney started offering the AstraZeneca vaccine to adults aged 55 years and up on April 13 and to those aged 40 years and up on April 20. However, the Whitney Pharmacy confirmed that they had stopped offering it as of May 11, following the province’s directive. In an email from May 14. Mitul Pavagadhi, the pharmacist and owner at Whitney Pharmacy, said they had not yet been given any dates for next vaccine shipments or when to resume second shots.

“Here is the info we received from the ministry. They said that we should pause any further administration of first doses of the AstraZeneca COVID-19 vaccine to eligible individuals and that if we had a current supply of it we should keep it in a secure refrigerated area in the pharmacy until the ministry gives us further directions. For any patients that have booked appointments for the AstraZeneca vaccine, we have been asked to contact them to reschedule for when the mRNA vaccines are available,” he says.

Lee Bay, the administrator at the North Hastings Family Pharmacy also confirms the interruption in vaccinations due to the halt on the AstraZeneca vaccine. However, she says that they had already faced an interruption in their store supply.

“We received an initial shipment of 200 doses at the beginning of April and immediately afterward were unable to restock while all the available does were redirected to the hot spots. Those initial doses only lasted us 10 days,” she says.

Bay says that their electronic booking system at nhfp.medmeapp.ca holds a wait list of clients and that they will receive an invitation to book once they get more vaccines. She says they had been advised it could happen within two weeks but she notes that nothing is guaranteed.

Bay also put a posting on the NHFP’s Facebook page on May 14, advising their clients of the pause in using AstraZeneca vaccine for first doses. The post explains that no more first doses of the AstraZeneca vaccine will be given in Ontario at this time due to an increased risk of blood clots and an abundance of caution, that its use in April was when cases in Ontario were at an all time high and that the benefits outweighed the risks, now that there is a greater supply of the mRNA vaccines [Pfizer and Moderna] it makes sense to switch over to those vaccines, concerns about getting a different vaccine for a second dose will be addressed shortly, and if clients have gotten the AstraZeneca vaccine as their first dose, their second dose is still booked. They emphasise that what they will be giving as the second dose is unknown at this time, but it will be the best choice when the time comes.

“We hope that we will have more first dose vaccines, either Moderna or Pfizer in stock by the end of May, and that the age criteria will be expanded to include all adults in the community,” she says. “We don’t know for sure yet though.”