As Alberta begins its rollout of the Oxford-AstraZeneca vaccine, there is still a lot of confusion about who should get it and who should wait.
On Wednesday at 8 a.m., all Albertans turning 64 this year (those born in 1957) can start booking their AstraZeneca vaccine through Alberta Health Service’s online booking portal or by calling Health Link at 811.
First Nations, Métis and Inuit people aged 49 (born in 1972) can book vaccines through Health Link only.
This is the first step in a staggered distribution plan for Albertans between the ages of 50 and 64 who want this particular vaccine and do not have a severe chronic illness. The province says appointments will be rolled out in stages by birth year, as long as supplies last.
Pharmacies are not yet carrying the AstraZeneca vaccine — which will be given in two doses about 16 weeks apart.
Those eligible also have the option to get the Oxford-AstraZeneca vaccine or “Covishield,” which is the Serum Institute of India’s version that Health Canada approved last month.
Who should get it?
There are a lot of questions about who should get the AstraZeneca COVID-19 vaccine. Some of the confusion was sparked by the release of conflicting information as it went through the Canadian approval process.
The National Advisory Committee on Immunization recommended against giving it to people aged 65 and older because the information on its efficacy in that age group was limited. That came after Health Canada authorized its use in adults of all ages.
As a result, it is not being offered to seniors over 65 in Alberta. Quebec, on the other hand, recently decided to offer it to seniors over 65.
“That core key information, does this vaccine work and is it safe? That message has been confused by the variability of the information that’s come out,” said Dr. Jim Kellner, infectious disease physician, professor of pediatrics at the University of Calgary and a member of the COVID-19 Immunity Task Force of Canada.
“I think in time we’ll see that this is a very good vaccine and that anybody should feel comfortable getting this as a vaccine as opposed to another vaccine.”
According to Kellner, while information about Pfizer and Moderna vaccines was distributed based on very large single clinical trials, there were a number of clinical trials for the AstraZeneca vaccine, which muddied the waters.
“I think with a vaccine like the AstraZeneca vaccine where the information has come from different sources — different clinical trials in different settings, using different doses, different dose schedules — it has inevitably led to some confusion about just how effective is this vaccine in all aspects.”
Alberta Health also recommends the AstraZeneca vaccine only be used in people who do not have a “severe chronic illness.” But, even as distribution begins, what constitutes a severe chronic illness has yet to be defined.
Albertans between 18 and 64 — who have chronic underlying health conditions — are included in Phase 2B of the vaccine rollout and are expected to be eligible for the Pfizer and Moderna vaccines in May.
“I acknowledge that that is confusing right now,” said Dr. Deena Hinshaw during Monday’s daily COVID-19 briefing. “Unfortunately I recognize the timing isn’t ideal for those who are trying to decide if they should get AstraZeneca or not. We will be making that list available publicly very soon.”
On Tuesday, CBC News contacted Alberta Health to find out when that information will be made public and a spokesperson would only say it will be released “soon.”
According to Kellner, the list will likely include conditions that are known to put people at higher risk of severe COVID-19 outcomes.
“I expect the list is going to … include things like obesity, important underlying conditions — I should expect — like diabetes, uncontrolled high-blood pressure and things like that.”
To further complicate matters, healthy Albertans in the target age group can choose to wait and get the Pfizer or Moderna vaccines instead. They would be eligible in Phase 2D of the rollout, which is expected closer to June.
Worries about waiting
“The numbers have shown that … although perhaps we saw slightly lower numbers for preventing infection, this vaccine was just as good as the others at preventing severe disease and critically preventing death,” said Craig Jenne, associate professor in the department of microbiology, immunology and infectious diseases at the University of Calgary.
Jenne says anyone with questions about whether the AstraZeneca vaccine is a good fit for them should ask their doctor.
But he’s concerned some eligible Albertans may decide to hold off — putting them unnecessarily at risk.
“It would be pretty tragic if you could have been vaccinated and you weren’t and then you caught the virus and ended up hospitalized, or worse in intensive care or lose your life because you didn’t opt for a vaccine that was made available to you,” he said.
Jenne also worries about the broader community impact if too many people decide against the AstraZeneca vaccine.
“If we have people that are offered a vaccine and people are refusing to receiving it or delaying receiving it, we are creating these holes in the community where we could have protection.… We’re really inviting a rise in infections, a rise in hospitalizations and the need to not only prolong restrictions, but a significant risk of losing other members of our community,” he said.
“So when we have an offer for protection I would really recommend that people take that offer and get protected as soon as possible.”
The province is expecting 58,500 doses of the AstraZeneca vaccine this week.
In an open letter to Albertans on Tuesday, AHS said while it will be offered in communities in each health zone, some people will need to travel outside their communities to receive it.
AHS — which has acknowledged serious problems with its earlier vaccine rollout for people 75 and older — says the online booking system and Health Link have been improved and have the capacity to book about 5,000 appointments an hour.
“It is one more step towards the end of the pandemic, and a return to normal life,” the letter said.
“With every dose administered, we reduce the pressure on our healthcare system, lower the risk of community spread, and further protect the health of Albertans.”
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