NACI accused of contributing to confusion and hesitation over recommendations on “preferred” vaccines – fr

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COVID-19 vaccinations open to over 50s and many essential workers Thursday: MLHU – fr


TORONTO – The National Advisory Committee on Immunization is accused of causing confusion over COVID-19 vaccines after it reaffirmed that mRNA vaccines were “preferred” over viral vector vaccines.

On Monday, NACI doubled down on its position that the Pfizer-BioNTech and Moderna vaccines were “preferred” over the Johnson & Johnson and AstraZeneca vaccines, and that Canadians should weigh the risks before deciding which to receive.

AstraZeneca and Johnson & Johnson viral vector doses have been associated with an extremely rare and life-threatening blood coagulation syndrome called vaccine-induced immune thrombotic thrombocytopenia (VIITT). The risk of developing this syndrome is estimated between one in 100,000 doses and one in 250,000.

The Johnson & Johnson vaccine has been approved for use by Health Canada, but the agency said it had the first 300,000 doses in order to conduct further quality assurance testing after one of its ingredients was discovered in a vaccine plagued by problems. manufacturing plant in United States.

Although vaccine-related blood clotting syndrome is very rare, with only seven cases of VIITT reported across the approximately 1.7 million doses of AstraZeneca that have been administered in Canada to date, the vice -Committee chair Dr. Shelly Deeks said it should be considered.

“Viral vector vaccines are very effective vaccines, but there is a safety signal, a safety risk… And the problem with the safety signal is that although it is very rare, it is very serious” , she said. “Individuals must have an informed choice to be vaccinated with the first vaccine available, or to wait for an mRNA vaccine.”

Viral vector vaccines use a weakened or attenuated cold virus, which is not the same SARS-CoV-2 virus that causes COVID-19, and manipulate it so that it cannot reproduce or cause disease. The SARS-CoV-2 spike protein is then attached to the vector virus so that the immune system can learn to recognize it and fight off a potential infection if it is confronted with the real coronavirus and its spike protein in the future.

MRNA vaccines, on the other hand, use technology that teaches cells in the body to make a protein that can trigger an immune response to ward off infection with the SARS-CoV-2 virus.

This latest announcement from NACI appears to contradict Health Canada’s oft-repeated guidance to Canadians that the best vaccine is the first available to them.

Asked about it on CTV News Channel’s Power Play on Monday, NACI President Dr. Caroline Quach-Thanh said it really comes down to where people live and their potential exposure to COVID-19.

“It basically depends on where you are. So if you are in an area where there is no COVID then waiting for the mRNA is OK, ”she said. “Do an individual risk assessment. If you are in an area where there are tons of COVID, the transmission is high, then I totally agree, the first vaccine that comes is the one you take.

Deeks said that while someone who is able to work from home in an area where there are not many cases may want to wait for one of the mRNA vaccines, someone who works in a manufacturing facility in a province with a lot of infections may want to get the first vaccine. at their disposal.

While Quach-Thanh described NACI’s advice as a “transparent” message to send to Canadians, several doctors took to Twitter to express their frustration at the conflicting guidelines and their potential to contribute to the reluctance. immunization in Canada.

Toronto-based family physician and medical researcher Dr. Iris Gorfinkel said she was dreading going to her clinic the next day, as she expected to have to answer patients’ questions about NACI’s latest recommendations.

“The level of risk remains acceptable. It is the mixed messages of NACI that are difficult to understand. ” she wrote.

Dr Brian Goldman also shared his disappointment with advice from NACI in a Twitter post.

“It pains me to say this, but it is high time to follow NACI’s recommendations with a grain of salt. For the sake of your health, DO NOT be selective about #covidvaccines. Take the first one that is offered to you, ”he says.

Hospice palliative care physician Dr Naheed Dosani also tried to make sense of the new guidelines by noting that it appeared NACI was recommending frontline and essential workers take the less safe virus vaccines.

“So let me clear it up: NACI recommends that you wait to get an mRNA vaccine, but if you can’t wait (for example, you are an essential worker in a hotspot) you should just settle for vaccine that has a higher risk of blood clots? ” he wrote.

The news that Canadians should consider waiting for “preferred” Pfizer-BioNTech and Moderna vaccines also raised concerns among those who had already received a dose of AstraZeneca.

“I received the AstraZeneca vaccine last week. Today’s NACI guidelines have thrown me into a loop. Not only does NACI say that I should have waited for Pfizer or Moderna, if I work from home, but that the extremely rare risk of blood clots that I have taken is still acceptable for low-paid workers. a woman said in a tweet Monday.

“I’m so confused and actually angry about this. My husband got the AZ vaccine last week. Should he have waited ?? This is NOT what they have been saying from the start. They said people should get the first vaccine available, ” a nurse wrote on twitter.

During the NACI announcement, Deeks attempted to allay the concerns of those who had previously received the AstraZeneca vaccine by calling them safe and effective. She also said the committee was considering the idea of ​​mixing and matching vaccines for second doses.

“There is no reason why people should not get a second dose of an AstraZeneca vaccine or an mRNA vaccine… NACI will make a recommendation on mixed schedules as soon as we see information from certain studies She said.

In the House of Commons on Monday, Conservative MP and health critic Michelle Rempel asked Health Minister Patty Hajdu about the confusion surrounding NACI’s favorite vaccines.

“It’s very different from what we’ve heard. Does Health Canada advise taking the first vaccine offered or waiting, if possible, for an mRNA vaccine (Pfizer or Moderna)? ” she asked.

In response, Hajdu said Canadians should talk to their health care provider if they want to know which vaccine is right for them.

Quach-Thanh, however, said she did not think the advice would contribute to confusion or reluctance to get vaccinated and that it was aimed at helping people make a decision about which vaccine to get based on their risk of contracting COVID-19.

“It has to be informed consent,” she said. “If, for example, my sister were to receive the AstraZeneca vaccine and die of thrombosis when I knew it could have been avoided and was not in a high risk area, I am not sure. that I could live with. ”

So far, the majority of vaccine doses Canadians have received have come from Pfizer, followed by Moderna, then AstraZeneca.

With files from Rachel Aiello of CTVNews.ca and The Canadian Press

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