As one of over 1.7 million Canadians with AstraZeneca teaching our immune system how to do immune system karate, my first instinct might be: what is NACI? Now are you telling me AstraZeneca is a third-rate vaccine? In all fairness, this is a third rate vaccine approved by Health Canada and far more likely to save my life than kill me. Also, messaging hasn’t changed much.
Still, Monday’s National Advisory Committee on Immunization update was about as neat as throwing a watermelon on the windshield of a moving car. “What we are saying – and what we have been saying from the start – is that mRNA vaccines are the preferred vaccines,” said Dr. Shelley Deeks, NACI vice president, in a session. information in the afternoon. Ah. Good.
So some of the 1.2 million people who got it may think we might have expected Pfizer, which, like Moderna, is an mRNA vaccine, compared to the more traditional viral vector from AstraZeneca and Johnson & Johnson. Pfizer’s supply schedule is reliable and growing, while Moderna is uncertain. NACI’s advice creating a form of vaccine reluctance, and buyer’s regret, is probably not the optimal solution here.
Of course, it’s not that AstraZeneca was promised to be the gold standard, in any respect. The risk is real and, critically, the data is changing rapidly. The associated risk of rare vaccine-induced blood clots, or VITT, has been found to be less rare over time and is now estimated to be one in 100,000, or winning the 50-50 in a pre-pandemic college football. from Michigan. Game. It may be lower. If you drive a lot it is statistically more dangerous. Johnson & Johnson has a similar problem, although less proven by the data. And the NACI recommended not to use it in people under the age of 30.
But it was more than we got the message that the first vaccine is the best vaccine, and that lacked nuance. The Prime Minister and his wife received AstraZeneca on April 23, the leader of the official opposition and his wife the next day, the leader of the federal NDP the day before. It came after the Premier of Ontario and his Minister of Health. So NACI saying the mRNA is the A-plus student and AstraZeneca is the student with white veil on his denim jacket, well that was like a bit of a bomb.
It wasn’t, precisely. The day Justin Trudeau took the vaccine, Deeks – one of the real heroes of the Ontario pandemic, before he left – said much the same.
“Currently, and based on current evidence, NACI recommends that the AstraZeneca COVID-19 vaccine can be offered to people 30 years of age and older, without contraindications, if the individual does not wish to wait for a mRNA vaccine, and the benefits outweigh the risks, ”Deeks said on April 23. It was the day that NACI recommended AstraZeneca for over 30s.
But she used the word ‘favorite’ this time, and then Dr. Caroline Quach-Thanh, president of NACI, told CTV: “If, for example, my sister had received the AstraZeneca vaccine and died of a thrombosis while I know it could have been avoided and is not in a high risk area I’m not sure I can live with.
This is a public health message delivered in the dark with a flashlight under your chin and a smiling skull above your shoulder. NACI is a very voluntary organization without serious communications staff, and the fact that the federal Liberals did not provide them with additional communications personnel, for example, from tourism, was probably a mistake.
But let’s take a look at this carefully. These vaccines save lives. “The best vaccine is the first vaccine” is true if it is an emergency, and in many places in Canada, with variations circulating, it has been and still is.
“There are four things you need to talk about: the risks, the benefits, the alternatives and the context,” says Dr. Isaac Bogoch, infectious disease specialist at the University of Toronto and a member of the Vaccine Working Group at the University of Toronto. ‘Ontario. “And sometimes we focus on one and ignore the other three, but you need all of that. And if you focus only on the risks and skimp on the benefits, alternatives, and context, people can get the wrong impression.
“But at the end of the day, when you really talk about these four things, you can help people make an informed decision. Sometimes we miss the context part, and the context is important. March, April, May, where we’ve been recently and where we are now: it’s not every day that tents are pitched in front of Sunnybrook. It’s not every day that you have adults in pediatric intensive care units. It’s not every day that you call health care providers from other provinces to help you with astronomical levels of COVID-19. It’s not everyday that you admit more and more people in their 20s, 30s and 40s to hospital and intensive care. Context is important. “
Indeed, vaccines are an emergency in so many parts of Canada because the provinces have horribly mismanaged a third wave that has never been blunted by vaccines and is not driven by borders.
NACI day was a picture of our pandemic. An underfunded NACI, as well as Health Canada, the Public Health Agency of Canada and the federal government, and the perception of confusing messages; disastrous decision-making at the provincial level; the hunt for vaccines, which has been politicized when in fact a relatively successful global pursuit of incredible and life-saving new products; and the iniquity built into this whole fucking thing. NACI said AstraZeneca and J&J should be used as part of a risk calculation: if you think your risk is high enough, you should take it.
Which means the same people who have been least protected in this pandemic: the homeless, migrant workers, new Canadians, essential workers, those in the poorest and most racialized neighborhoods. This inequality is a big part of how Canada truly failed in this pandemic, when the pandemic mirrored our self-satisfied and empowered society. Remember when Ontario’s Associate Chief Medical Officer of Health Dr. Barbara Yaffe said those who take the bus should consider the risk, as if people are taking the bus to see the sights and meet new people? It’s like that.
So NACI stepped in, and NACI needs to deal directly with Health Canada or get better public relations, but it’s not specifically NACI. It was a piece of Canada in the pandemic, and all of our faults. Well, except one. It is quite heartwarming right now that Canada has purchased a lot of different vaccines.