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After supply, vaccine hesitancy in next hurdle

After a slow start, the U.S. has surged ahead of Canada in getting people vaccinated against COVID-19. The pace there is starting to slow, however, in large part due to vaccine hesitancy. Let’s hope we avoid that here.

Canadians are much less likely to see inoculation as a political issue (the same goes for masks and other public health measures designed to reduce the spread of the virus). What we are seeing now, though, is some uncertainty over specific vaccines, in particular the AstraZeneca variety. That’s the result of concerns about blood clots that have occurred in a very small number of people.

Despite the rarity, medical officials are questioning the use of the vaccine. In Ontario, for instance, a member of the province’s COVID-19 science advisory table has called for Ontario to stop administering the AstraZeneca vaccine. Alberta is already taking such steps to stop the use of that vaccine for first doses. In both cases, there are exceptions for high-risk patients, the reasoning being that the benefits outweigh any potential danger.

Likewise, medical officials across the country are reviewing the use of the AstraZeneca vaccine. The European Union has already decided not to renew a contract for that vaccine set to expire next month due to the blood clot scare.

As more supplies of the Pfizer-BioNTech and Moderna vaccine become available, there’s less need to press into service the AstraZeneca doses, and even the single-shot Johnson & Johnson variety, which has also been linked to clotting issues.

Doctors are calling such cases “vaccine-induced immune thrombotic thrombocytopenia” (VITT), “vaccine-induced prothrombotic immune thrombocytopenia” (VIPIT), or “thrombotic thrombocytopenic syndrome” (TTS). Those blood clots are different from the blood clots most people are familiar with in that they are more aggressive and are more likely to cause death or severe disability, even with early diagnosis and treatment, experts now say.

To date, 12 cases of VITT have been reported in Canada, leading to three deaths. Ontario’s science advisory group says estimates about the incidence of VITT range from one case per 26,000 to one case per 127,000 doses of AstraZeneca vaccine administered. For the Johnson & Johnson vaccine, that number is one in 500,000 doses.

While minimal, the risk is what has experts advising to go with other options where applicable. Luckily, Canada is expecting a large uptick in the deliveries of the Pfizer vaccine, ramping up this month to two million doses per week. Those numbers have Ottawa predicting there’ll be a large enough supply to provide a shot to everyone who wants one by July 1. As well, those waiting on a second dose may also be fully inoculated this summer.

With supplies increasing, that just leaves logistics – getting vaccine to more outlets in order to get more shots in arms – as the biggest hurdle. And, of course, there’s the issue of any vaccine hesitancy, which would slow down the process toward herd immunity. Public health officials estimate we’ll need at least 70 per cent of the population to be vaccinated to reach that state.

Fortunately, Canadians have been growing more, not less accepting of being vaccinated. A Leger poll last month found about 80 per cent of us are prepared to roll up our sleeves for the COVID-19 shot. That number is up from 63 per cent last October, 70 per cent in February and 73 per cent in March.

It may well be that the continued use of the AstraZeneca and/or Johnson & Johnson vaccines is fully warranted given the relatively low risk – few incidences, though the clotting is more dangerous than the standard kind – but the deciding factor could be the public’s comfort level. If switching them out lowers the likelihood of vaccine hesitancy, then it’s down that road we go.

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