Ontario will lower the minimum age for the AstraZeneca vaccine starting on Tuesday as the number of COVID-19 cases and hospitalizations in the province shows no sign of slowing down.
The province will start offering the vaccine to anyone aged 40 and older at pharmacy and primary care settings, according to Health Minister Christine Elliott’s office. The AstraZeneca shot has until now been available only to people 55 and older.
The change came on Sunday after an earlier discussion between Elliott and her federal counterpart, Patty Hajdu, who vowed to mobilize all federal resources and co-ordinate with lesser-hit provinces to send health-care workers and other support to Ontario as it battles record-breaking COVID-19 numbers.
During a media briefing on Sunday, Hajdu said Ontario had the choice to lower the eligibility age for the AstraZeneca vaccine per Health Canada advice.
The vaccine was approved by Health Canada for anyone over 18 but provinces limited its use to those over age 55 following a recommendation from a federal immunization advisory committee, due to concerns over the risk of very rare blood clots.
“There’s nothing to stop the province of Ontario from changing their advice for use to their physicians within Ontario,” Hadju told reporters.
She added that the National Advisory Committee on Immunization is currently reviewing its guidance, with an updated recommendation expected in the near future.
Experts said Ontario’s move is necessary because the health crisis has become so dire that Ontario residents cannot afford to pick and choose vaccines. All the vaccines approved in Canada have been shown to be highly effective in curbing COVID-19 infections and preventing severe illness and death.
“This has become clear that we don’t have the luxury of choice and we don’t have the flexility to create an ideal scenario. The situation has become completely out of hand,” said Dr. Abdu Sharkawy, an infectious disease specialist with the University Health Network.
“It is quite clear that the risk of acquiring COVID-19 and all of its potential complications, including dying, even if you are a woman between 20 and 55, start to outstrip the risk of a serious vaccine-related clot or any other adverse effect.”
This month, Canada reported its first case of a blood clot linked to the vaccine, involving a Quebec woman who received a Covishield shot — the brand name of the AstraZeneca vaccine made in India. A second case was reported Saturday in Alberta, involving a man in his 60s. Both patients are recovering.
The risk of blood clots from the vaccine has been estimated at one in 100,000, although some studies suggest they are even rarer.
As of April 10, the federal government reported that 221,484 Canadians had received at least one dose of the AstraZeneca vaccine and 499,038 had received at least one dose of Covishield.
Dr. Zain Chagla, an infectious disease physician for St. Joseph’s Healthcare, said the reduction of the minimum age for AstraZeneca makes sense.
“The average risk to individuals is very different now than two months ago when things were dying down. Now, the risk of someone getting COVID-19 and being hospitalized is much higher than it’s ever been,” said Chagla.
“Now there’s a recognition (of blood clotting) and there is counselling for people to make an informed consent around it. We don’t want these vaccines to burn. If there’s people to take them, take them. These are good vaccines to put into primary care and pharmacies to give to people. There’s a demand for people under the age of 55.”
Vaccinations are crucial to slowing down the pandemic and reducing the personal risks of hospitalization, given how precious ICU beds are during the third wave in Ontario, he said. As of Sunday, 741 patients were being treated for COVID-related illness in Ontario ICUs.
Chagla pointed out that Health Canada has approved AstraZeneca for anyone at 18 or over, and suggested Ontario should further reduce the age limit for the vaccine to at least 30, if not younger.
“We are in the worst public health emergency in recent history. Coming down to the age of 18 is not inappropriate,” he told the Star.
Sharkawy said the province doesn’t really have a choice but to relax the eligibility of AstraZeneca.
“The political gamesmanship that’s going on right now is largely related to a deflection of the provincial responsibilities with respect to a host of different things,” he said.
“But it has been clearly focused on blaming the federal government for not providing adequate supply of vaccines. You can’t take them to task for saying that we’ve got the AstraZeneca vaccine but we’re not able to use that.”
Right now, the choice is between getting some form of protection from COVID or no protection at all, he said.
“If the province really wants to do what’s right, you get every form of help you can, you get any form of support you can, you get any potential resource you can. That includes using a vaccine that’s been proven worldwide that takes care of the most dominant variant of concern,” Sharkawy said.
