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COVID-19 Vaccine Bulletin - April 1, 2021

Volume 10 – Issued April 1, 2021

COVID-19 Vaccine Bulletin

With the surge in COVID-19 cases, including the increased predominance in cases of variants of concern across the province and in neighboring health units, there is much uncertainty and cause for alarm. Whether you are awaiting COVID-19 vaccination or have received one or two doses of the vaccine, diligence in using all public health measures at all times remains crucial to not only protect yourself but also in preventing the spread of COVID-19 to vulnerable populations who are at increased risk of severe illness, hospitalizations and death:

  • Limit close contact (less than 2 metres) to members of your immediate household,
  • Remain physically distant from others (at least 2 metres away),
  • Follow provincial gathering limits indoors and outdoors,
  • Wash your hands with soap and water, or use hand sanitizer frequently,
  • Masks that cover your nose, mouth and chin must be worn in all indoor public spaces,
  • Wear a properly fitted mask that covers your nose, mouth, and chin indoors and outdoors when unable to maintain a physical distance of 2 metres from those who do not live with you,
  • Frequently clear commonly touched surfaces, and
  • Cover your nose and mouth when coughing and sneezing.

Planning

Many community partners from across the Porcupine Health Unit district have been vital to the success of the COVID-19 vaccine program planning and distribution. While the Ministry requirements are outlined in Ontario’s Vaccine Distribution Implementation Plan, these collaborative efforts have ensured meaningful considerations are brought forward during planning phases for the COVID-19 vaccine program rollout in all communities and that decisions made are ethical and effective.

All the planning and decision making that occurs behind the scenes must be in line with human rights protection and prevent COVID-19 among vulnerable populations. The principles outlined in the Ethical framework for COVID-19 vaccine distribution included in planning efforts are:

  • Minimize harms and maximize benefits: Reduce overall disease and deaths by protecting those at highest risk, as well as promoting social and financial well-being and protecting vital public services.
  • Equity: Reduce inequalities in illness and death and distribute vaccines without stigma or discrimination and respect the human rights of all people.
  • Fairness: Ensure people within each phase of the provincial vaccination program has equal opportunity to receive the vaccine.
  • Transparency: Ensure decisions made are communicated clearly to the public.
  • Legitimacy: Decisions made are based on scientific data, shared values and input from diverse population groups and ensure decisions achieve anticipated benefits.
  • Public Trust: Enhance confidence and trust in the immunization plans.

 

The Porcupine Health Unit

If you or a loved one are eligible but are experiencing barriers to accessing the COVID-19 vaccine clinics and need support, call the health unit at 705-360-4819 or 1-800-461-1818.

Vaccine Plan

Vaccine Rollout & Announcements

On March 26, 2021, the province of Ontario issued a news release announcing that booking of COVID-19 vaccine appointment for individuals 70 years of age and older will be beginning in Toronto as of March 27, 2021. It is important to recognise that for various reasons, such as initiation date of the COVID-19 vaccine program and vaccine supply received from the government, each health unit across the province is at a different stage in the vaccine program distribution rollout. COVID-19 vaccine appointments are not yet available for residents 70 years of age and older in the Porcupine Health Unit area. The health unit is currently providing access to COVID-19 vaccines for individuals aged 75 years and older.

Exceptions to Extended COVID-19 Vaccine Dose Intervals

The Vaccine Clinical Advisory Group (VCAG) consists of clinical and public health physician experts who provide recommendations for the Ontario COVID-19 vaccine program. This group supports the National Advisory Committee on Immunization (NACI) guidance on increasing the interval between doses of COVID-19 vaccine up to 4 months for most populations. It was previously announced that the following populations groups will still receive the second dose of COVID-19 vaccine between 21 to 42 days:

  • Long-term care homes, retirement homes, Elder Care Lodges and Assisted Living residents who are at the greatest risk of both exposure to COVID-19 and serious illness and death.
  • Remote and isolated First Nation communities given the potential seriousness of COVID-19 infection in these communities with limited available health care facilities and resources.

On March 26, 2021, the Ministry of Health released the VCAG Recommendations on Exceptions to Extend Dose Intervals for COVID-19 vaccines document. The VCAG has identified populations for which there continues to be limited available information on vaccine efficacy and effectiveness who are at higher risk of poor outcomes from COVID-19 infection and who may have inferior immune response to vaccines because of underlying medical conditions. While considering Ontario’s vaccine supply constraints, the VCAG has outlined recommended dose intervals for these populations:

  • Pregnancy: The extended dose interval (up to 4 months) is believed to be appropriate for pregnant individuals as clinical trials for other types of vaccines administered to this population have demonstrated a normal immune response
  • Immunocompromising conditions and immunosuppressive therapies: Individuals in this population group were generally not included in COVID-19 vaccine clinical trials and the immune response to the vaccine could be highly variable for the diverse populations included in this category. THE VCAG was able to review evidence and make recommendations on the dose interval for only select sub-populations. There is a risk of poor immune response to COVID-19 immunization for other subpopulations which the VCAG will commit to ongoing review of evidence to inform recommendations for additional sub-populations.
    • Transplant recipients should receive the COVID-19 vaccine at the dose interval indicated in the product monograph.
    • Individuals with malignant hematologic disorders and non-hematologic malignant solid tumors receiving active treatment should receive the COVID-19 vaccine at the dose interval indicated in the product monograph.
  • Age: The extended dose interval is believed to be appropriate for older individuals as available real-world data shows that the first dose of the COVID-19 vaccine provides substantial protection against severe disease, hospitalization, and death in the older adult population.

AstraZeneca COVID-19 Vaccine - NACI Update

In response to rare reports of blood clots after receiving the AstraZeneca vaccine in Europe, the National Advisory Committee on Immunizations (NACI) is now recommending that the AstraZeneca COVID-19 vaccine not be used in adults under 55 years of age at this time due to possible safety concerns.

This recommendation is a precautionary measure while Heath Canada completes an updated evaluation of the benefits and risks of this vaccine. No adverse events related to the AstraZeneca vaccine have been reported to Health Canada.

Cases reported in Europe have mainly been in women under 55 years of age. However, cases in men have also been reported and further assessment is needed to determine if women are in fact at higher risk than men.  As there is an increased risk of hospitalization and death due to COVID-19 in older adults 55 years of age and older, and it appears that the risk of blood clots after vaccination is rarer in this age group, this population may still receive the AstraZeneca vaccine with informed consent.

This recommendation will continue to be re-evaluated and updated as further data becomes available.

NACI will assess the available data and research to determine the type of vaccine that is recommended for the second dose in those under the age of 55 who have already received 1 dose of the AstraZeneca vaccine.

Individuals receiving the AstraZeneca COVID-19 vaccine should be made aware of the potential adverse event of blood clots and seek medical attention if symptoms develop between days 4 and 20 after receiving the vaccine. Symptoms include:

  • shortness of breath,
  • chest pain,
  • leg swelling,
  • persistent abdominal pain,
  • neurologic symptoms like sudden onset of severe or continual worsening headaches, blurred vision,
  • skin bruising (other than where the vaccine was given),
  • petechiae (red or purple discolored spots containing blood on the skin).

To date, the province of Ontario has only administered the AstraZeneca vaccine to individuals 60 years of age and older. In response to NACI’s updated recommendations, Ontario will not be using the AstraZeneca vaccine for individuals under 55 years of age while Health Canada complete its evaluation. 

Resources

The Porcupine Health Unit wants to keep you informed about COVID-19 vaccines. Our website now includes a COVID-19 Vaccine page with more information on approved vaccines, vaccine safety and other general information.

Our COVID-19 Information lines remain open. Call us with any COVID-19 related questions you have at 705-360-4819 or 1-800-461-1818.

Moving Forward

COVID-19 vaccines are safe and effective. The Porcupine Health Unit urges everyone who is eligible to receive the COVID-19 vaccine to get immunized as soon as possible. Vaccines are another important tool that will help fight this pandemic. Waiting a few weeks or a few months to receive the vaccine could have serious consequences, like:

  • Getting COVID-19 infection and needing to self-isolate
  • Getting COVID-19 infection and having complications (severe illness, hospitalization and even death)
  • Spreading COVID-19 to others

The Porcupine Health Unit continues to recruit staff and volunteers to support COVID-19 vaccination across the district:

  • Visit Employment (porcupinehu.on.ca) to learn about employment opportunities or call 1-800-461-1818. Individuals who are seeking employment with the health unit should email information and resume to [email protected].
  • Community partners and independent volunteers are of great value to the rollout of COVID-19 vaccines across the district. Email [email protected] with your offer of support.

Additional Information: