Ontario reports first AZ blood clot death, issues with 2nd AstraZeneca dose bookings

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TORONTO — Ontario reported its first death linked to a rare blood clot associated with the Oxford-AstraZeneca vaccine Tuesday as many who received a first dose of the vaccine faced challenges trying to schedule second shots.

The province administered nearly a million doses of the AstraZeneca COVID-19 vaccine before halting first shots earlier this month due to what it said was an increased risk of blood clots.

Dr. Barbara Yaffe, Ontario's associate medical officer of health, said a man in his 40s who received a first dose of the AstraZeneca vaccine at the end of April passed away a few weeks later.

The death is still being investigated, but Yaffe said the man had vaccine-induced immune thrombotic thrombocytopenia, also known as VITT.

"The risks associated with this vaccine are rare, but they are real," she said, noting that those who received an AstraZeneca shot still made the right choice.

There have been 13 cases of VITT in the province so far, Yaffe said.

The Ontario death is the fifth fatal case of VITT in an AstraZeneca recipient in Canada. Experts maintain the syndrome is exceedingly rare and treatable in most cases.

News of the death came as the first cohort of Ontarians who received the AstraZeneca shot in March reported booking headaches and confusion after becoming eligible to schedule second jabs.

Those who got their first AstraZeneca shots between March 10 and March 19 during a pharmacy pilot project are being offered a second vaccine after a 10-week dosing interval as the province rushes to use of 45,000 doses expiring in roughly a week.

"I kind of feel that we're now being left in the lurch a bit," said Val Logan, an early AstraZeneca recipient.

Logan, 60, said she called the Toronto pharmacy where she got her first shot to ensure she was on a wait-list for the second, but was directed to call another location.

She said the new venue added her to their list, but advised her that people who got their first doses at that location would be prioritized.

"We took the advice that the best vaccine is the first one you're offered, and we're more than happy to take the AstraZeneca, but now I feel we might fall through a crack here," she said.

Others reported similar challenges while some said they were unsure where to call to book their second doses.

Sharon Saslove of Kingston, Ont., was considering a four-hour drive to Toronto for her second shot after learning her local pharmacy had no supply.

"Looking for a second dose is like trying to find a needle in a haystack," she said in an email.

The head of the Ontario Pharmacists Association said a handful of pharmacies received doses on Tuesday, but the "vast majority" would receive supply on Wednesday.

Justin Bates said pharmacists would reach out to clients directly.

Late in the day on Tuesday, the province published the list of 162 pharmacies administering soon-to-expire doses this week.

Bates said some of the 325 pilot locations were unable to participate due to the short window of time and other ongoing vaccinations.

Pharmacies are aiming to dispense the supply within five days to avoid wastage. The holiday Monday complicated some of the logistics, as many stores were closed, Bates said, and pharmacies are working to reach clients and manage the excess demand from eligible people.

"There's a lot to manage there from an administrative perspective," Bates said.

"Yes, it's going to be a challenge and we're up for it and we're going to do everything we can to hopefully achieve that success."

Approximately 90,000 people are eligible to receive their second AstraZeneca vaccine at the shortened 10-week interval, according to provincial data – about double the number of doses available.

Bates said more doses will be on the way once those expiring May 31 are used up.

For Paul Hogg of Brampton, Ont., the timing of his second dose is critical for managing his other health conditions and scheduling medications.

The pharmacy where he received his first AstraZeneca shot didn't have information on second doses on Tuesday, and other efforts to find a shot came up short, he said.

"I need a date, I need a time, I need a location," he said. "If I get that, then I can move on with our life."

Ontario's top doctor apologized for the confusion.

Dr. David Williams said the province is working to prioritize pharmacies in the Toronto, Kingston and Windsor areas – where the initial pilot ran – for the second doses.

He said people should talk to their pharmacists about eligibility and some might have to wait the original 12 weeks after the province has used up the soon-to-expire vaccines.

"I understand there's a bit of confusion there," Williams said. "The good point is that we have lots of people who are looking eager to get their second dose."

A spokeswoman for the health minister said many pharmacies and doctors would reach out to patients directly, and asked people to only contact participating pharmacies listed on the province's booking website.

The province has said those who got their first dose of AstraZeneca after March 19 will be able to book their second in the near future.

Another 10,000 doses of AstraZeneca expire next month, and the province has more than 300,000 doses in stock.

Ontario reported 1,039 new COVID-19 cases on Tuesday and 33 more deaths linked to the virus.

This report by The Canadian Press was first published May 25, 2021.

Holly McKenzie-Sutter, The Canadian Press

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