Medical professionals urge B.C. to lower minimum age for AstraZeneca-Oxford vaccine after federal approval

Medical professionals in B.C. are calling on the province to lower the minimum age for the AstraZeneca-Oxford vaccine after the federal government announced provinces are free to expand eligibility to any adult over the age of 18.

B.C. health officials suspended the use of AstraZeneca vaccines in people under the age of 55 in response to an extremely rare blood clot condition that had been reported in younger people who received the shot.

On Sunday, Ontario and Alberta both lowered the minimum age to 40 after federal Health Minister Patty Hajdu gave provinces and territories the go-ahead based on new Health Canada rules.

Burnaby family physician Dr. Birinder Narang says now that the health agency has determined the AstraZeneca vaccine is safe, British Columbia should follow suit.

"If they have found data that it's safe [...] they should do that because now we've been waiting since March 29 and in that time period, we've seen upwards of 50 to 60 per cent increases in intensive care admissions in the province."

Narang notes the vaccine is approved for use in people over 30 in the United Kingdom and in South Korea.

"We know the only way out of this third wave and to make progress in the pandemic now is to vaccinate people as fast as possible," the doctor said.

Mortality rates drop below 50 years old

Victoria pharmacist Jason Cridge believes B.C. should go even further and make the AstraZeneca vaccine available to everyone over 18.

"For every five-year age group, the chance of dying from a COVID-19 infection is exponentially smaller," he explained. "So we're just seeing diminishing returns at that point. So what I'd like to see is just opening it right up to 18 plus."

In Canada, mortality rates from COVID-19 drop significantly below the age of 60. Approximately 0.5 per cent of patients between the ages of 50 and 59 have died from their infections, and the mortality rate drops further for those under 50.

According to Cridge, focusing on age brackets below the age of 50 is inefficient because deaths in that age range represent only 1.5 per cent of overall deaths in Canada from COVID-19.

He believes vaccines could be delivered more quickly by pharmacies if the province were to move away from five-year age increments once people above 50 are vaccinated.

"I think we are seeing diminishing returns after that age bracket and then you really have to wonder, is the complexity of trying to be perfect in the administration of this vaccine really the enemy of what's good?"

Cridge has heard of pharmacies in Vancouver that have had to hold unused doses of AstraZeneca because they can't find enough patients in the specified age range.

On top of that, he says the temporary suspension of the AstraZeneca vaccines has made people reluctant to get their shots.

"We got 200 AstraZeneca doses last week at my pharmacy, and even though we used those up within two days, about 50 per cent of the people that we approached, that we cold-called to ask if they wanted a vaccine, turned down the AstraZeneca because they were in favour of waiting for the Pfizer."

Provinces still waiting for national recommendations

The National Advisory Committee on Immunizations (NACI) is now reviewing updated information from Health Canada before issuing new recommendations on the use of AstraZeneca-Oxford vaccines.

On March 29, B.C. followed NACI recommendations that AstraZeneca be limited to people aged 55 and older after a small number of younger people in Europe developed a serious blood-clotting condition called Vaccine-Induced Prothrombotic Immune Thrombocytopenia (VIPIT). 

The odds of getting a blood clot are estimated to be between one in 100,000 and one in 250,000. An Oxford study found the risk of blood clots from a COVID-19 infection is eight to 10 times higher than from a vaccine.

Narang says B.C. should also follow Ontario's example and include primary care doctors in the immunization rollout.

"What we do know in Ontario is that this AstraZeneca parallel program is being done by pharmacies and primary care providers," he said. "We know that patients trust their family doctors the most and we know that they're not being leveraged and their skills are not being leveraged right now."