EXCLUSIVE Canada's Ontario to expand use of AstraZeneca COVID vaccine as epidemic rages


Reuters 18 April, 2021 - 07:12pm 42 views

The Canadian province of Ontario will begin offering AstraZeneca’s (AZN.L) COVID-19 vaccine on Tuesday to people turning 40 or older this year, according to a government source.

The change will broaden access to vaccines as a third wave of infections threatens to overwhelm hospitals in Canada's most-populous province, and should make it easier to use doses that in some cases have been accumulating at pharmacies.

The change will be announced on Monday and go into effect across the province on Tuesday, according to the source. The vaccine has already been distributed to pharmacies but currently can only be given to people turning 55 or older this year.

Ontario announced new public health measures on Friday, promising checkpoints at provincial borders, new police powers and closing outdoor amenities, while leaving many workplaces open. The measures were widely criticized by doctors and public health experts, and the province quickly reopened playgrounds and modified the new police powers.

On March 29, Health Canada said it would review reports of serious blood clots and bleeding in a small number of people who had received the AstraZeneca vaccine in other countries, and an independent panel called the National Advisory Council on Immunization (NACI) recommended that it only be given to people 55 and older. All provinces followed that advice.

But NACI’s recommendations are not binding. Last week, Health Canada, the country’s drug regulator, said it had reviewed all available evidence and would not restrict the use of the vaccine, because its benefits outweigh its potential risks. Health Canada said at the time that NACI was reviewing its recommendations.

On Sunday, NACI's chair told Reuters that the panel would make a new recommendation on Tuesday.

Health Canada said regulators in the UK had estimated the risk of clots to be very small, roughly four in a million people who receive the vaccine. It also said the complication was treatable. Two people have developed it in Canada, and both are recovering.

Several other countries have limited the use of the vaccine to older people. Denmark has withdrawn the shot, and Norway said on Thursday it would take more time to decide whether to resume use.

Ontario reported 4,250 new cases of COVID-19 on Sunday. The Ontario Hospital Association said 59 patients were admitted to intensive care on Saturday, bringing the number of COVID-19 patients in ICUs to 737.

Health Canada says those who receive the vaccine should seek medical attention immediately if they experience shortness of breath, chest pain, leg swelling, persistent belly pain, neurological symptoms like severe headaches or blurred vision, or skin bruising or tiny blood spots under the skin beyond the site of the injection.

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The Canadian province of Ontario will begin offering AstraZeneca's (AZN.L) COVID-19 vaccine on Tuesday to people turning 40 or older this year, according to a government source.

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Vaccine to combat South Africa Cvoid variant by year end, AZ says

Daily Mail 18 April, 2021 - 09:23am

By Reuters

AstraZeneca will have adapted its vaccine to combat the South African variant of Covid by the end of the year, the company's boss of Austrian operations has said.  

Sarah Walters made the remark while being quizzed by an Austrian news site over recent studies which suggested the jab could be as little as 10 per cent effective at preventing mild or moderate Covid infections caused by the strain.

While dismissing current medical studies as 'too small to draw final conclusions' from, she added that AstraZeneca's current jab is already being modified to work better against the variant.

AstraZeneca is adapting its current Covid jab to be more effective against the South Africa variant and it will be ready by the end of the year, the firm's Austria boss has said

'We expect it will be ready by the end of the year, should it be needed,' Walters told Austrian news site Kurier.

During the same interview, Walters was also quizzed about supply issues that have affected AstraZeneca in Europe - sparking an almighty row with the EU amid accusations of vaccine nationalism in favour of Britain.

Sarah Walters said it is still too early to tell whether the South African variant makes the jab less effective, but it is be adapted anywa

Walters said the supply issues were down to the fact that AstraZeneca began supplying the vaccine as soon as it was ready, meaning there was no stockpile of the drug to draw from if factories under-produced.

She also pointed to the 'complex' process of manufacturing vaccines coupled with extremely high demand as a reason for the shortfall.

'Covid-19 is a very emotional issue,' she said. 'It affects each of us in some way.

'But we developed a vaccine, built a global supply chain, and received approvals in over 70 countries in less than 10 months. With a project of this size, it's not surprising that there are unforseen challenges.'

'We are confident that we will fulfill our commitment to deliver 300 million doses to the European Union this year,' she added.  

The Kurier interview did not directly address ongoing investigations into health concerns over the AstraZeneca shot. 

The EU has put a warning label on the vaccine over its possible linkage to extremely rare blood clots.

A study in South Africa found AstraZeneca's jab was just 10 per cent effective against mild to moderate forms of Covid, but Walters said the sample was too small to draw conclusions

Denmark has completely halted use of the vaccine and Britain will allow people under the age of 30 to get another brand of vaccine, if one is available.

Asked about 'thousands' of people in Austria who are cancelling their appointments for AstraZeneca shots, Walters said the company's plan was 'to continue to transparently provide information about efficacy and safety to doctors, so that they can adequately inform people' of benefits and risks.

British and European Union medicine regulators have said that the overall benefits of using the vaccine outweigh any risks.

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Canada records second case of rare blood clot after AstraZeneca shot

Medical Xpress 18 April, 2021 - 09:14am

Canada reported its first case of blood clotting associated with low platelets on Tuesday in a Quebec woman who received the same shot.

Blood clot formations linked to the AstraZeneca vaccine "remain very rare" and Canada still believes that the vaccine's benefits "outweigh the potential risks," Health Canada and the Public Health Agency of Canada said.

Canada's health authorities added that they would "continue to monitor the use of all #COVID19 vaccines closely and examine and assess any new safety concerns."

At the end of March Canada's National Advisory Committee on Immunization (NACI) recommended suspending the use of the AstraZeneca vaccine in people under the age of 55 while it evaluated the risks.

However Health Canada said Wednesday that according to its analysis, limiting the use of the vaccine to certain populations was not necessary for the moment.

After a slow start, Canada's vaccine campaign is gaining momentum. To date, 23.3 percent of the Canadian population has received at least one vaccine dose according to the COVID-19 Tracker Canada website.

The country is facing a third coronavirus wave, however, that has recently forced provinces to tighten restrictions.

Ontario, which has the highest number of cases, announced Friday it would strengthen and extend lockdown measures until May 19, and also close its borders with the provinces of Quebec and Manitoba beginning Monday.

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If You Have This Blood Type, You’re More Likely to Get Blood Clots

Best Life 18 April, 2021 - 06:06am

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If you have any concerns about the accuracy or timeliness of our content, please reach out to our editors by e-mailing editors@bestlifeonline.com.

Research has established a link between this blood type and blood clotting risk.

Researchers have long sought to determine the link between blood type and blood clotting—most recently in a Jan. 2020 study published in Arteriosclerosis, Thrombosis, and Vascular Biology, an American Heart Association journal. The researchers for this study examined more than 400,000 people and found that those with blood type B were most likely to suffer from blood clotting, also known as thrombosis. When compared to blood type O, people with blood type B were 45 percent more likely to experience thrombosis and 55 percent more likely to experience deep venous thrombosis, which is a type of blood clotting that occurs in one's deep veins. And for more recent blood clot news, Dr. Fauci Says Anyone Who Got the Johnson & Johnson Jab Should Do This.

Type A blood is also at heightened risk. When compared to blood type O, people with blood type A had a 44 percent higher risk of thrombosis and a 50 percent increased risk of deep venous thrombosis. In fact, when looking at any non-O blood type compared to blood type O, there was a clear and significant increased risk. People with non-O type blood were 44 percent more likely to experience thrombosis and 51 percent more likely to experience deep venous thrombosis. They were also 47 percent more likely to develop a pulmonary embolism, which is where a clot travels to the lung.

"Our results are concordant with previous smaller observational reports suggesting an increased risk of thromboembolic events in non-O blood group individuals compared to individuals with blood group O," the study explained. "In both blood groups A and B, we observed similar increased risks of developing thromboembolic events compared with blood group O." And for more useful information delivered straight to your inbox, sign up for our daily newsletter.

According to the study, there is an interesting link that may help explain the association between blood types and blood clots. People with type O blood have a reduced amount of von Willebrand factor (VWF), a protein which is responsible for helping blood clots form.

However, that's just one possible explanation. "Because thrombosis is a well-balanced and complex process, which is affected by a plethora of factors, there could be different biological mechanisms (ie, cell functionality, number of cell receptors) involved in the increased risk of thromboembolic events in blood group A and blood B individuals, besides the already established relation with VWF," the researchers concluded in their study. And for more on blood types, If You Have This Blood Type, Your Dementia Risk Is High, Study Says.

Knowing the signs and symptoms of blood clots is extremely important, as more than 100,000 people die each year because of blood clots, according to the CDC. The CDC says you should know the symptoms of the two main types of concerning blood clotting: deep vein thrombosis and pulmonary embolism.

For deep vein thrombosis, you may experience swelling, pain, tenderness, and redness of the skin in your arm, leg, or stomach—depending on where the blood clot is located. With a pulmonary embolism, you're likely to experience difficulty breathing, faster than normal or irregular heartbeat, chest pain or discomfort that usually worsens with a deep breath or coughing, coughing up blood, and very low blood pressure, lightheadedness, or fainting. "If you have any symptoms, see your doctor as soon as possible," the CDC warns. And for more guidance from the CDC, The CDC Is Warning You to Avoid This One Place, Even If You're Vaccinated.

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Alberta confirms 1st case of blood clot after AstraZeneca COVID-19 vaccine use | CBC News

CBC.ca 17 April, 2021 - 06:13pm

Alberta has confirmed its first case of a rare blood clot linked to the AstraZeneca COVID-19 vaccine.

The case was identified in a man in his 60s after receiving the vaccine, according to a statement released by Alberta's chief medical officer of health on Saturday. 

"I continue to recommend AstraZeneca for anyone who is 55 and older, and to recommend that all Albertans get vaccinated as soon as they are able," Dr. Deena Hinshaw said.

"It is the best way to protect your health and the health of those around you."

Today, we announced a case of a rare blood clot disorder linked to the AZ vaccine. The patient was diagnosed, treated promptly and is recovering. Now that we know about this rare side effect we can watch for it and reduce the risk of serious harm or death even further. (1of5)

The man has received treatment and is recovering. The case marks only the second instance of the rare blood clot in Canada after more than 700,000 doses, Hinshaw said.

Hinshaw spoke at length earlier this week about the rarity of these cases, especially compared with the severe outcomes from COVID-19. 

She said the global frequency of vaccine-induced immune thrombotic thrombocytopenia (VITT) has been estimated at about one in 100,000 to 250,000 doses of vaccine.

As of 6 p.m. ET on Saturday, Canada had reported 1,113,913 confirmed cases of COVID-19, with 86,763 considered active. A CBC News tally of deaths stood at 23,591.

Saskatchewan announced its full COVID-19 update has been delayed on Saturday, but preliminary numbers show 249 new cases and two more deaths.

Manitoba registered 183 new cases on Saturday — the most since January — and three more deaths.

In Ontario, the provincial government walked back some of its new policing powers that it announced Friday.

In a statement Saturday, Solicitor General Sylvia Jones said officers will no longer have the right to stop any pedestrian or vehicle to ask why they are out or request their home address.

"If a police officer or other provincial offences officer has reason to suspect that you are participating in an organized public event or social gathering, they may require you to provide information to ensure you are complying with restrictions," Jones said

Several police forces had already said they do not intend to make use of the additional powers.

Earlier, Premier Doug Ford backtracked on restricting access to playgrounds. Ford initially announced the measure on Friday, along with new powers for police, in an effort to curb the spike of COVID-19 in the province, which saw 4,362 new cases, along with 34 deaths on Saturday.

Quebec confirmed 1,537 new cases and eight more deaths on Saturday.

In Montreal, local and provincial health officials are calling on everyone over the age of 55 to get their first shot of the AstraZeneca-Oxford vaccine, with 20,000 doses available at drop-in centres in Montreal this weekend. 

Trucks equipped with loudspeakers will be driving around some Montreal neighbourhoods, including Côte-des-Neiges, in the coming days, encouraging residents to head to the drop-in sites. 

Nova Scotia reported eight new cases on Saturday, while New Brunswick added 11.

In Nunavut, an outbreak in Iqaluit has grown by six new infections. There are now 19 active cases in the territorial capital. 

The global death toll from COVID-19, caused by a novel coronavirus first reported in central China at the end of 2019, has now surpassed three million, according to data from Johns Hopkins University in Maryland.

In the Americas, hospitals in Brazil are running out of critical sedatives, leading to reports of some doctors diluting what supplies remain and even tying patients to their beds while breathing tubes are pushed down their throats.

In Europe, Italy will ease curbs in many areas beginning April 26 but warned caution was still needed to avoid any reversals in the reopening of many long-shuttered activities.

In Africa, Zimbabwe has begun releasing about 3,000 prisoners under a presidential amnesty aimed at easing congestion to reduce the threat of COVID-19 in the country's overcrowded jails.

With files from The Associated and Reuters

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Opinion | Understanding the blood clot issue behind the AstraZeneca vaccine and its safety

Toronto Star 17 April, 2021 - 12:00am

The AstraZeneca vaccine and the rare but serious blood clots it’s associated with have been on everyone’s mind lately. That condition has been given the term Vaccine Induced Immune Thrombotic Thrombocytopenia or VIIT. As physicians, health advocates and science communicators, we are frustrated with the confusing discourse around AstraZeneca and the many misguided opinions on the topic. We see sensational posts from both sides of this discussion. Here is our more nuanced, balanced take using science:

When we compare the risk of these rare kinds of blood clots against what we would normally see in the general population in a specific time period, there is a clear increase compared to the background rate. The European Medicines Agency discusses a risk of approximately 6.5 events per million doses. For Johnson & Johnson, we see 6 cases in 6.8 million doses, for an event rate of under 1 per million doses. In the Canadian context, the event rate appears to be 1 in 250,000 doses. We must keep in mind that these rates include all of the individuals who are eligible to receive the vaccine — which is why they differ between jurisdictions. But it is still important to note that the absolute risk for these events is low.

There are few decisions we make in life that are “risk free.” For example, there are risks of serious events that can occur when driving, crossing the road, smoking, or even eating peanut butter for the first time. There is a risk of liver damage when you take acetaminophen with alcohol. Yet, I’m sure many people would feel comfortable popping a Tylenol before bed after having a few drinks. We take calculated and informed risks every day and are exposed to many unknown risks daily. Nearly everything we do is a balancing act between risk and benefit.

Ontario is in the middle of a third wave, shaping up to be the most devastating one to date. We’ve had to build field hospitals in parking lots, fly ICU patients across the province, care for adult patients in pediatric ICUs, and re-deploy our finite number of healthcare workers to areas where they have not been trained to work. We are also beginning to cancel non-emergent care - which means at some point we will begin to defer life-saving cancer and cardiac surgeries. This past week, we lost 145 people to COVID, with thousands more infected.

When we look at the risks of COVID-19, we begin to appreciate that the benefits of getting vaccinated with AstraZeneca vaccine far outweigh the risks of serious adverse events, especially when community spread crosses a certain threshold. As of April 15, Ontario has a weekly case average of 199.9 per 100,000 people. Community spread is objectively high. This graph from the UK Winton Centre for Risk and Evidence Communication illustrates nicely how in a high covid exposure risk situation (defined as 20 cases per 10,000, for example, like Ontario right now), the benefits of the AstraZeneca vaccine far outweigh its risks.

Scientists measure population level risks, but for the average person, population risk is neither intuitive nor representative. For example, when we talk about the COVID-19 vaccine’s efficacy being 95 per cent, it does not mean that the average person has a 5 per cent chance of getting COVID. In fact, a given person’s individual risk can be higher or lower based on a multitude of individual factors. Similarly, when people say the risk of VITT is “only one in a million,” this could be higher or lower for an individual level. For example, the risk of VITT might be higher than one in a 250,000 doses in a young woman.

There are graphics being widely circulated that compare the risk of VITT - a very specific and rare event - to blood clots associated with other phenomena. Here is an example of one I found on twitter:

The problem with this and graphics like this is that they compare apples to oranges.The type of blood clots you get from oral contraceptive pills are quite different from the blood clots associated with VITT, making it an unfair direct comparison. While COVID-19 infections carry a higher risk of blood clots than the vaccine, the percentage quoted in this graphic are in fact for those hospitalized with COVID-19; it does not capture the individual’s risk of first catching COVID-19. These comparisons are reductive; they dismiss and misrepresent concerns about vaccine associated clots and other kinds of clots. What happens when someone who is apprehensive realizes you’re trying to persuade them with misinformation? You lose their confidence and trust.

Downplaying the concerns people have about medical conditions feels dismissive. It is dismissive. At this point in the pandemic, many of us are overwhelmed and frightened by the continued uncertainty around our health and wellbeing. Both vaccine hesitancy and vaccine demand are at their peak. It’s not uncommon for someone to be desperate to get a vaccine but terrified of it being the AstraZeneca vaccine. We need to take the time to understand their concerns and address them with respect and empathy. This means taking the time to explain the nuances and acknowledge that people are scared and overwhelmed.

It’s also extremely important that people understand why there is currently a pause in the use of the AstraZeneca vaccine if you are under 55. This decision, made by the National Advisory Committee on Immunization, did not concede that the vaccine is unsafe or that approvals were rushed. Rather, it shows how seriously Canadian regulators and public health officials are taking even the rarest of side effects, taking swift and transparent action at the first sign of an adverse event.

The pause allows us to investigate serious clotting events further to understand the true incidence, factors that might increase susceptibility, and importantly, increase awareness among the public and health care providers. This ensures anyone who suffers a clot is quickly diagnosed and appropriately treated.

The AstraZeneca vaccine and the Johnson & Johnson vaccine are highly effective vaccines that will prevent you from having severe illness, hospitalization and death due to COVID-19. Due diligence is being done on every single vaccine in Canada. We implore you to take the first vaccine that is offered to you, and encourage those you love to as well.

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