Is AstraZeneca still safe? Has it been safe all along? Is there enough kicking around in Manitoba for me to get my second dose?
Short answers: yes, yes and maybe not.
Manitobans who have already received a jab of the AstraZeneca-Oxford vaccine may have a few questions after learning that generally, no more first doses of that vaccine will be offered in the province.
The medical lead of the provincial vaccine campaign made that announcement on Wednesday, citing both supply chain issues and safety concerns.
“AstraZeneca has had a bit of a bumpy road with its rollout,” Dr. Joss Reimer said during a Wednesday news conference. “I know Manitobans have seen different advice coming from different players.”
First, a look at the supply issue.
Supply was disrupted beginning in March amid skyrocketing COVID-19 cases in India. The Serum Institute of India, which produces a biologically identical version of the AstraZeneca product called Covishield, has been blocked from shipping its product overseas.
AstraZeneca makes up a small portion of vaccines received by Manitoba — 84,260 of the 730,230 vaccine doses shipped to the province so far.
Manitoba has about 7,000 AstraZeneca doses left, and a shipment of about 23,000 is expected in the coming weeks.
After that, there are no assurances of when the next batch could arrive.
Mix and match
So where does that leave the over 75,000 Manitobans who have already received an AstraZeneca shot?
Reimer said most remaining doses will earmarked to give those people their second AstraZeneca shot. Some may get something else.
Manitoba is expecting hundreds of thousands of doses, primarily of Pfizer-BioNTech, but also some Moderna, in the coming weeks.
That robust supply is one reason those who received an AstraZeneca first dose might get Moderna or Pfizer for the second, said Reimer.
“I was pleased to get and I would be pleased to have another shot of AstraZeneca,” said Adele Perry, who lept at the opportunity to get a dose in April.
“I am also open to hearing the new information that’s coming about combining different kinds of COVID-19 vaccine.”
Provinces are eyeing a clinical trial in the U.K. on the efficacy and protection offered when mixing and matching mRNA-based vaccines, such as Pfizer and Moderna, with something like AstraZeneca, which uses a viral vector technology.
Early results from that trial were released Wednesday, but more results on the overall safety or effectiveness of mixing vaccines are expected in the coming weeks.
Still safe, still effective: Reimer
Now, the safety piece.
Health Canada approved AstraZeneca for emergency use earlier this year. It’s been approved by other countries, then paused, then approved for some ages, then paused for others.
Manitobans 40 and up, or those 30 and older with health conditions, have been eligible for an AstraZeneca shot for weeks at doctors’ offices and pharmacies.
Four provinces, including Manitoba, decided this week to suspend their AstraZeneca campaigns or reserve future doses for those who received that shot as a first dose.
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Alberta and Saskatchewan cited supply chain issues in their decision, while Ontario suggested it’s beginning to see an uptick in rare but serious blood clots associated with AstraZeneca, known as vaccine-induced immune thrombotic thrombocytopenia (VITT).
Most of the stopping and restarting abroad has been over concerns about VITT.
The current evidence suggests the risks of developing the clots is low — somewhere in the range of one in 100,000.
As of early this week Canada had administered roughly 2.3 million doses of AstraZeneca. There have been about a dozen confirmed cases of VITT in the country, including three deaths, according to the Public Health Agency of Canada.
An Oxford study of more than half a million people suggested people are eight to 10 times more likely to get a blood clot as a result of COVID-19 infection than because of any vaccine. The condition is also treatable.
The overriding theme from experts continues to be that AstraZeneca is safe and effective, and the benefits outweigh any risks associated with COVID-19.
“For Manitobans who chose to receive the AstraZeneca vaccine, they did a good thing for themselves, for their families by being protected as early as possible,” Reimer said.
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Perry has no regrets.
“The real goal is to end this pandemic,” she said. “I was and remain primarily interested in doing what is the best for myself and my family, but also for a wider community that is really in crisis.”
The latest advice on AstraZeneca is to wait a minimum of three months before getting a second dose.
“For the overwhelming majority of Manitobans, that’s going to be the timeline that best protects them and that’s what pharmacies are going to stick to,” said Tim Smith with Pharmacists Manitoba.
A pilot project launched days ago saw doctors and pharmacists giving out Moderna, and Smith said pharmacists want more of those doses soon.
Booking for second-dose appointments for all vaccines is expected to start up no later than May 22.
Appointments can be scheduled through the province’s online booking portal, or by calling 1-844-626-8222.