Trudeau wants to address advisory council vaccine concerns


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Prime Minister Justin Trudeau holds a press conference in Ottawa on April 27, 2021.

Sean Kilpatrick / The Canadian Press

Prime Minister Justin Trudeau reiterated that Canadians should receive the first COVID-19 vaccine, which contradicts the recommendation of an independent vaccine advisory group that people who are at low risk of contracting the novel Coronovale should wait for a favorite shot .

Mr. Trudeau made his comment the day after the National Advisory Committee on Vaccination (NACI) maintained its position that waiting for an mRNA vaccine, such as Pfizer-BioNTech and Moderna, to receive the viral vector vaccine from Johnson & Johnson Is better for And AstraZeneca, when the personal risk of contracting Covid-19 is low.

Monday’s advice to NACI was criticized by physicians and scientists, who said it creates a hierarchy of vaccines and unduly distrusted the vaccine, which played a leading role in sustaining the UK’s third wave.

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Mr. Trudeau said his advice “has not changed” and he told the House of Commons that his message to Canadians is, “The most important thing is to be vaccinated with the first vaccine given to them. That’s it.” We get through it. “

On the issue of how NACI is communicating the risk of a very rare blood-clot syndrome in association with low platelets, which have been linked to astraZeneca and Johnson & Johnson vaccines, but not mRNA shots.

Eight cases of the syndrome, known as vaccine-induced immune thrombotic thrombocytopenia, or VITT, have been reported to Health Canada. A woman died in Quebec.

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On Monday, NACI stated “it continues to recommend preferably authorized mRNA COVID-19 vaccines.”

NACI said that Canadians who consider themselves at low risk from coronaviruses – such as healthy people who can work from home and who live in places in relatively few cases – would be better off waiting for mRNA vaccines. The advice attempts to balance the risk of blood clots against the risk of becoming seriously ill with COVID-19; It was also given by the group on 23 April. However, it received more attention on Monday, especially after comments made by NACI chair Carolyn Kwach-Than.

“If, for example, my sister was to get an AstraZeneca vaccine and die of a thrombosis, when I know it could have been prevented and she is not in a high-risk area, I’m not sure I could survive. Am “this, dr. Quach-Thanh told CTV News.

The comment and NACI’s advice came from social-media firestorms. Experts called it a failure of communication that did not properly refer to the individual risks along with the wider community benefits of the vaccine. Advisory Group on Tuesday Defended its guidance, and some experts sympathized with the challenges it faced, in response to quickly changing evidence and helping to explain complex and nuanced information to the public.

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Dr. Kutch-Than said The example he gave to CTV was a poor one. But she stood by the committee’s recommendation, which rests on the fact that Canada is receiving much more mRNA vaccines than the viral vector vaccine.

“What we’ve asked people to do is to do a personal risk assessment based on what’s happening [them], based on what [they] Dr. Said Quach-Than, who is an infectious disease specialist and professor at the University of Montreal.

Although the data varies by country, the risk of blood clots from the AstraZeneca vaccine is estimated to be somewhere in the range of 1-in-100,000. In April, Health Canada stated that the shot is “very low risk” for adverse reactions while the risk of COVID-19 is moderate in most parts of the country. Health Canada is using the Johnson & Johnson vaccine back, pending an unrelated quality assurance review.

Dr. Kwach-Than agreed with the low-risk assessment but said it did not mean NACI could “keep under the carpet.”

He said that not being transparent about where the group stands on the science developing around vaccines could further damage public confidence.

NACI has a “job”, said Timothy Qielfield, a professor of health law and science policy at the University of Alberta. But he said the advisory panel largely focused on personal risk and “underscoring the benefits to the public – which is achieving herd immunity and reducing community dissemination.”

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“I get a commentary as a philanthropic work. You do something for your community, ”he said. “I also feel that the rarity of these risks should be put into context. There is a risk in everything in life. “

Alberta currently has the highest infection rates in North America and Toronto’s hospitals are providing Canadian Armed Forces back-up. Through a combination of a lockdown and mass vaccination campaign that began months earlier in Canada, Britain has kept a lid on cases for almost a month. As of 21 April, 59 per cent of the vaccines administered in the UK were from AstraZeneca.

As of March 1, NACI has stated that mRNA vaccines are a preferred option for high-risk groups, which were preferred for early vaccination. At the time, however, the difference was purely academic: no viral vector vaccine was sent to Canada; mRNA vaccines were rare; And experts were warning of the third wave.

Now the committee’s viral vector vaccine and COVID-19’s expanded balancing act of risks are colliding with a straightforward public-health message that all approved vaccines are safe and that people should get the first offer.

In part, NACI’s role differs from Health Canada’s regulators, with different messages and ensuing confusion. Made up of independent, unpaid experts, the committee convenes to provide non-binding advice on how vaccines should be prioritized. And unlike regulators who approve individual vaccines based on safety and efficacy data, NACI is also in a position to compare individual vaccines and vote to receive them.

Canada’s Chief Public Health Officer Theresa Tam came to the rescue of NACI, noting that science is evolving. But it also underscored the value of the AstraZeneca shot.

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Dr. “The AstraZeneca vaccine is deployed in the midst of a third wave that has saved people’s lives and prevented serious illnesses,” Tam said.

Menka Pai, a hematologist and thrombosis medicine physician at Hamilton Health Sciences, said NACI’s recommendations are “correct, what they are saying, scientifically.” It made sense to me. “But he said the information was bad for people, leaving him with buyer’s remorse and confusing whether he made the right call to take the AstraZeneca shot.”

“It should really feel like a betrayal of people. I feel very bad on him, “he said.

Dr. Pai, whose specialty is treating blood clots, said NACI had little choice but to accept the small but severe risk of rare clotting syndrome associated with AstraZeneca and Johnston & Johnson vaccines, then COVID. Balancing against the risk of serious consequences from. -19

Soon after the AstraZeneca vaccine became available in March, cases of blood clots in Europe began to color a particular perception. Andrew Morris, an infectious disease physician at the University of Toronto’s Health Network, said the new information complicates the public-health message.

Dr. Morris said, “To me, it was a slam sting three or four weeks ago: any vaccine you could get you probably should take until you’re absolutely certain that you’re another Humans are not watching. ” “But we are in a different situation right now.”

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Vaccine surveillance systems in Europe, Canada, and the United States have identified more cases of clotting syndrome with reduced platelets with AstraZeneca and Johnson & Johnson vaccines, meaning that the risk, while still small, is higher than previously thought. Is not infinite in form. And at the same time a consignment of Pfizer and Modern Vaccine will arrive in Canada this month.

“It’s really important that the communication includes that it’s a different context,” he said. “It is very difficult, it is difficult for the public to absorb all this because the message is not really clear.”

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