AstraZeneca and blood clots: Those under 55 should not get the vaccine: NACI- Canada’s new vaccine guidelines


Those under 55 should not get the vaccine: NACI

“The best vaccine for you to take is the very first one that is offered to you.”

These were the words of Prime Minister Justin Trudeau earlier this month when speaking on the safety of the AstraZeneca COVID-19 vaccine. This came after reports began emerging in Europe linking the vaccine to blood clots, leading a number of countries to issue temporary suspensions. 

Similar statements have been echoed over the past month by scientists, politicians and medical experts across the country, but as of March 29, the National Advisory Committee on Immunization (NACI) has changed its advice on the vaccine’s safety and is now recommending that those under the age of 55 should not get the vaccine.

The blood clots reported in Europe are rare adverse reactions to AstraZeneca called Vaccine-Induced Prothrombotic Immune Thrombocytopenia (VIPIT), primarily reported in women under the age of 55.

Based on the latest data, VIPIT currently has a 40 per cent mortality rate, Dr. Shelley Deeks, vice-chair of NACI, said during a federal update on Monday.

Adults 55 years of age and older will still be able to get the AstraZeneca vaccine with informed consent, she said, adding that VIPIT appears to be rarer in that age group.

On March 29, P.E.I., Manitoba and Quebec became the first provinces to suspend the AstraZeneca vaccine to those under 55. 

In Ontario, those 60 years and older are currently being vaccinated with AstraZeneca in select local pharmacies and primary care settings.

However, on March 29, Premier Doug Ford said he won’t hesitate to cancel the vaccine in Ontario, if it will cause people any harm.

AstraZeneca suspensions 

Earlier this month, multiple countries around the world temporarily suspended the vaccine as an investigation was conducted into the possibility that it causes blood clots in some people who receive it.

The suspensions began in Austria in early March after a person who got the vaccine was “diagnosed with multiple thrombosis” and died, according to a report from the European Medicines Agency (EMA). 

As more reports emerged, Denmark followed suit with the suspension, as did more than a dozen European countries, as well as the Democratic Republic of Congo, Thailand and Indonesia. 

Blood clot investigation 

On March 18, the EMA completed its preliminary investigation into the connection between the vaccine and blood clots, concluding that the benefits of the vaccine outweigh the risk of side effects, the vaccine is not associated “with an increase in the overall risk of blood clots,” and there is no evidence linked to specific bad batches of the vaccine.

However, the EMA report continued: “the vaccine may be associated with very rare cases of blood clots associated with thrombocytopenia i.e. low levels of blood platelets.” 

“The number of reported events exceeds those expected, and causality although not confirmed, cannot therefore be excluded,” the EMA wrote.

The agency is further investigating this. 

On March 29, experts in hematology, cardiovascular medicine, infectious diseases, virology, neurology, immunology and epidemiology met with EMA’s safety committee to offer their expertise, decide what additional data is needed and discuss potential next steps for action.

What Canada is doing

Based on NACI’s latest advice, Health Canada will be issuing additional conditions on the AstraZeneca-Oxford and Covishield COVID-19 vaccines.

“These will include a requirement that the manufacturers conduct a detailed assessment of the benefits and risks of the vaccine by age and sex in the Canadian context,” Dr. Supriya Sharma, chief medical adviser at Health Canada, said. “This information will support the ongoing evaluation of these rare blood clotting events and allow Health Canada to determine if there are specific groups of people who may be at higher risk.”

Last week, Health Canada announced it would be changing the labels on the AstraZeneca vaccines to include information about rare reports of blood clots.


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