On Monday at the standard COVID-19 press conference, Nova Scotia’s top doctor spoke to Nova Scotians who got the AstraZeneca vaccine. “I am now recommending that anyone who got a first dose of AstraZeneca get a second dose with an mRNA vaccine,” Robert Strang said, officially advising AZ recipients to get a second dose of either Pfizer or Moderna, the two mRNA vaccines approved for use in Canada.
This direction is a change from a few days earlier, when the province re-approved AZ and Strang simply said: “Anyone who has received their first dose of AstraZeneca can now receive their second dose with the AstraZeneca, Pfizer or Moderna vaccine.” At Monday’s briefing, he said new studies from the UK and Spain showed that combining vaccines can be more effective than receiving two shots of AZ. On June 1, Canada’s National Advisory Committee on Immunization (NACI) changed its recommendations similarly.
“There is now a small study showing that a second dose of an mRNA vaccine—so, Pfizer or Moderna—after a first dose of AstraZeneca, results in a better immune response than two doses of AstraZeneca,” said Strang.
It’s been a rollercoaster for AZ in Nova Scotia—becoming available for small age cohorts of 60-to-64-year-olds, then 40-to-54-year-olds, then being put on hold before finally being permitted again, and now this.
Around 57,000 Nova Scotians received an AstraZeneca vaccine between March and May while it was available. Strang says those people will still be able to get a second dose of AZ if they choose to.
“Last week I said that anyone who got a first dose of AstraZeneca could choose which vaccine they got for their second dose. That remains true,” he said Monday. “But I’ve also said we’d make sure you have all the necessary information to make an informed decision.”
The province still has about 2,500 doses of AZ in cold storage, which are set to expire at the end of June. If more people still want AZ, Strang says we can get another shipment.
“For those folks that are going to get an email in the coming days, we do still have AstraZeneca vaccine if that’s what their choice is,” Strang said. “And we do have the ability to get additional vaccine with a longer shelf life if people are still looking to get their second dose of AstraZeneca in July or August.”
But Strang said that even if everyone chooses a different vaccine, it would not slow down Nova Scotia’s vaccine rollout.
“We have very secure and robust supplies of Pfizer vaccine,” said Strang. “We’re only talking about, at the most, 2,000 doses of AstraZeneca, so if the vast majority of those shift to Pfizer vaccine, we absolutely have sufficient supply to accommodate them and not slow down our progress.”
However, Strang says it’s unlikely the province could give back or give away any leftover AZ doses that remain unused. “Once it’s at the front line, if you will, there is no process to return that vaccine,” he explained. “And other provinces are facing the same issue with very low demand for the AstraZeneca vaccine. Unfortunately, it may well expire.”
Nova Scotia has only reported one case of VITT, the blood-clotting disorder related to AZ vaccines, and the patient, a man in his 40s in the Central zone, is apparently recovering. Strang says anyone who receives AZ as a second dose will receive and sign an informed consent packet, similar to the one they got the first time around. “I encourage you to read through it before you make your decision,” Strang said.
On Tuesday, the province sent out a press release indicating that AZ recipients will be able to re-book their second vaccine dose to an earlier date before June 30—and change which vaccine they want to receive if that’s what they want. “They absolutely still have the choice,” said Strang. “We’re just revising our informed consent process and the messaging that’s going to go out.”
The province says instructions will be sent “this week” to the email address AZ recipients provided when they first registered. Anyone who did not provide an email must call the toll-free line at 1-833-797-7772 to reschedule or request an email address be added.