Health Canada says people shouldn't hesitate to get AstraZeneca vaccine

[Bruce Weaver]

Here is the latest (but not necessarily the final word) from Health Canada on the AZ vaccine.

• https://www.cbc.ca/news/politics/health-canada-astra-zeneca-rare-side-effects-1.5986988

It is nice to see, for once, some context being provided to help people interpret the risks. 

[John Whittington]

Thanks.  I realise that opinions about this vary a lot, and in some cases are polarised and positively held but, in relation to my own views/feeling,I find it refreshing to see what I personally regard as a 'sensible' attitude being taken in at least one country!

As for'some context', you might be interesting in the following snippets from something I posted elsewhere earlier today ...

 There are an awful lot of things relating to "in perspective" that can be said about all this, many of which have attracted little discussion.  For example...

• In a sense we have been 'lucky'.  We have only been able to identify this possible effect of the AZ vaccine because the event is something which is 'normally' incredibly rare (and is also incredibly rare, even with vaccine).  Any of the vaccines could be increasing the incidence of (or deaths from) common things (heart attacks, strokes, even common cancers etc. etc.) by "1 in a million" (or even, probably "1 in 1,000") without our standing much chance of even 'noticing'.
• The scale and speed of the 'rollout' of the vaccines has been totally unprecedented. For 20 million people in just one country to have received a dose of a brand new medicine/vaccine within just 4 months of it first being approved (on the basis of trials in just a few tens of thousands) is quite incredible, but does mean that (probably inevitable) extremely rare side effects will be noticed, and noticed quite quickly.  No vaccine is ever going to be 100% safe, and I presume that every one has killed at least a few people.  In terms of the (ever increasing number of) routine childhood immunisations, in the UK we give first doses to little more than 0.5 million children each year, so it would be about 40 years before there had been as much exposure as there has already been to AZ vaccine in the UK - and it could well be a good few years before a "1 in a million" risk of a problem with a  childhood vaccine would even be noticed
• As I keep saying, the levels of risk we are talking about (generally "X per million", where X is usually <10) fade into insignificance in comparison with the normal 'risks of life' and causes of death which we seemingly 'accept'.  To cite a few examples:
  • The annual (all ages) risk of death due to accidents in the home in the UK is around 100 per million
  • Perhaps pertinent to UK vaccination policy, the annual risk of death due to suicide in males aged 10-29 is also about 100 per million
  • The annual (all ages) risk of death due to all accidents UK is around 200 per million
  • The annual (all ages) risk of death due to murder UK is around 13 per million
  • ... and, as I often cite, "1 in a million" is roughly the annual risk of being struck by lightning in the UK

I continue to be a little concerned about the "from the frying pan into the fire" risk if we decide to stop giving AZ vaccine (of which there is a lot of experience) to certain groups and,instead, give them a vaccine of which we have very little experience - and which, therefore, could be found to be 'more dangerous' than AZ vaccine after we have given it to 10 million (or tens of millions) of people.

Kind Regards,  John

John

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[Bruce Weaver]

It occurred to me that I should offer some clarification about the distinction between Health Canada (HC) and NACI (the National Advisory Committee on Immunization).  Here is a paragraph from the CBC article that mentions both of them, for example:

"Sharma said Health Canada still believes that the shot can be safely deployed in all adults regardless of age. However, the National Advisory Committee on Immunization (NACI) has recommended that provinces restrict access to adults over the age of 55 — for now."

This set of slides attempts to explain the role of NACI in COVID-19 vaccine planning.  Slide 4 illustrates the relationship between Health Canada and NACI.  The latter is part of the Public Health Agency of Canada (PHAC). 

I understand that (some/many) other countries have similar agencies/committees, and that (like HC and NACI), they do not always offer the same advice. 

Cheers,

Bruce

[William Stanbury]

Bruce,

Good evening, thank you.

A quick question please, if I may: in the text you quote within inverted commas, shouldn't the word "provinces" be spelt with a capital "P"?

Very best regards,

William Stanbury.

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[Bruce Weaver]

Hello William.  The advice about capitalization pasted below is from a British Columbia government website.  I imagine the other provinces do things the same way. 

Proper nouns

A proper noun is a specific name for a specific person, place, or thing. Always capitalize proper nouns, such as:

• Governor General's Award
• 'Ksan Historical Village and Museum
• Ministry of Attorney General
• Public Service Agency
• Ramadan
• University of Northern British Columbia

Words such as agency, department, division, centre and program are only capitalized when they're part of the formal title.

Always capitalize First Nations, Indigenous, Inuit and Métis.

Capitalize the word province only when it refers to the government of the province.

• The Province announced a government-to-government decision
• Over five million people are spread throughout the province

Cheers,

Bruce

[William Stanbury]

Thank you.

To view this discussion on the web, visit https://groups.google.com/d/msgid/medstats/a3795545-0ec7-4aba-98cf-ba26f7fed1cdn%40googlegroups.com.

[John Whittington]

Thanks for clarifying, Bruce.  Maybe some of my previous comments in praise of Canada may need to be withdrawn !

I suppose the UK situation is not dissimilar to what you describe.  Our regulator body (MHRA) is sticking to the view that 'benefit outweigh risk', and is imposing no restrictions on the use of the AZ vaccine, merely recommending (obviously sensibly) that, at least for the time being, people thought to already be at high risk of blood clots  (for whatever reason) should not be given AZ vaccine.  On the other hand, the Joint Committee on Vaccination and Immunisation (JCVI) is taking the published estimates of risk/benefit very literally, and is therefore saying that those under 30 should be offered something other than AZ vaccine (but should be allowed to have AZ if they ''prefer' - e.g. if, because of supply/logistical issues, it would be available to them earlier than an alternative)..

Given that it will probably be a month or two before we get around to vaccinating the under 30s (we are currently down to 45-49 year-olds, having vaccinated 'all' those of 50 and above), it's probably a bit silly for the government to be announcing 'policies' for them at this time (since knowledge and views about the blood clots may have changed by then) but, nevertheless, their current position is that they will follow the JCVI recommendation, as above.

What I'm not clear about in relation to what you say about Canada is, given the differing 'advice' coming from HC and NACI, who is going to decide which vaccine(s) will be given (or, at least, offered'), and which will not be given (or offered) to the under 55s - and, indeed, what that decision is likely to be?

Kind Regards,
John

https://www.cbc.ca/news/politics/health-canada-astra-zeneca-rare-side-effects-1.5986988

It is nice to see, for once, some context being provided to help people interpret the risks. 

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[Bruce Weaver]

JW wrote:  "What I'm not clear about in relation to what you say about Canada is, given the differing 'advice' coming from HC and NACI, who is going to decide which vaccine(s) will be given (or, at least, offered'), and which will not be given (or offered) to the under 55s - and, indeed, what that decision is likely to be?"

John, I think that most of us here in Canada are also confused about that.  But one key factor is that for the most part, health care falls under provincial jurisdiction in Canada, whereas HC and NACI are federal organizations.  If you want to dig into all the gory details, you can take a look at this webpage: 

• https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care-system/canada.html

;-) 

[John Whittington]

At 23:08 15/04/2021, Bruce Weaver wrote:

JW wrote:  "What I'm not clear about in relation to what you say about Canada is, given the differing 'advice' coming from HC and NACI, who is going to decide which vaccine(s) will be given (or, at least, offered'), and which will not be given (or offered) to the under 55s - and, indeed, what that decision is likely to be?"
John, I think that most of us here in Canada are also confused about that.  But one key factor is that for the most part, health care falls under provincial jurisdiction in Canada, whereas HC and NACI are federal organizations.  If you want to dig into all the gory details, you can take a look at this webpage: 

Thanks, Bruce.  I did actually think of that possibility soon after I asked the question - i.e. that the answer is probably "neither of the above"!

That said, is there any historical pattern to how the provinces tend to behave in such situations, or will they just be independent and essentially unpredictable local  decisions?

Kind Regards,
John

On Thursday, April 15, 2021 at 4:33:39 PM UTC-4 John Whittington wrote:

Thanks for clarifying, Bruce.  Maybe some of my previous comments in praise of Canada may need to be withdrawn !

I suppose the UK situation is not dissimilar to what you describe.  Our regulator body (MHRA) is sticking to the view that 'benefit outweigh risk', and is imposing no restrictions on the use of the AZ vaccine, merely recommending (obviously sensibly) that, at least for the time being, people thought to already be at high risk of blood clots  (for whatever reason) should not be given AZ vaccine. On the other hand, the Joint Committee on Vaccination and Immunisation (JCVI) is taking the published estimates of risk/benefit very literally, and is therefore saying that those under 30 should be offered something other than AZ vaccine (but should be allowed to have AZ if they ''prefer' - e.g. if, because of supply/logistical issues, it would be available to them earlier than an alternative)..

Given that it will probably be a month or two before we get around to vaccinating the under 30s (we are currently down to 45-49 year-olds, having vaccinated 'all' those of 50 and above), it's probably a bit silly for the government to be announcing 'policies' for them at this time (since knowledge and views about the blood clots may have changed by then) but, nevertheless, their current position is that they will follow the JCVI recommendation, as above.

What I'm not clear about in relation to what you say about Canada is, given the differing 'advice' coming from HC and NACI, who is going to decide which vaccine(s) will be given (or, at least, offered'), and which will not be given (or offered) to the under 55s - and, indeed, what that decision is likely to be?

Kind Regards,

John

At 18:32 15/04/2021, Bruce Weaver wrote:

It occurred to me that I should offer some clarification about the distinction between Health Canada (HC) and NACI (the National Advisory Committee on Immunization).  Here is a paragraph from the CBC article that mentions both of them, for example:

"Sharma said Health Canada still believes that the shot can be safely deployed in all adults regardless of age. However, the National Advisory Committee on Immunization (NACI) has recommended that provinces restrict access to adults over the age of 55 — for now."

This set of slides attempts to explain the role of NACI in COVID-19 vaccine planning.  Slide 4 illustrates the relationship between Health Canada and NACI.  The latter is part of the Public Health Agency of Canada (PHAC). 

I understand that (some/many) other countries have similar agencies/committees, and that (like HC and NACI), they do not always offer the same advice. 

Cheers,

Bruce

On Wednesday, April 14, 2021 at 5:22:46 PM UTC-4 Bruce Weaver wrote:

Here is the latest (but not necessarily the final word) from Health Canada on the AZ vaccine.

https://www.cbc.ca/news/politics/health-canada-astra-zeneca-rare-side-effects-1.5986988

It is nice to see, for once, some context being provided to help people interpret the risks.