OTTAWA— For once, Prime Minister Justin Trudeau didn’t take his own advice to listen to the scientists.
Instead, on Tuesday the prime minister and his top public health officials went before cameras to try to clear the air, clouded by a federal advisory body the day before, and advised Canadians not to wait for any “preferred” vaccine but to take any COVID-19 vaccination as soon as they can.
For Trudeau, who has staked his government’s pandemic response on listening to the advice of health experts and “following the science,” it would have been hard if not hypocritical to directly challenge the credibility of the National Advisory Committee on Immunization (NACI) or throw it under the bus by reversing its Monday message.
So Trudeau avoided any talk of “preferred” shots, and downplayed the recommendation made Monday by NACI that people might want to wait for mRNA vaccines, which haven’t been linked to a risk of very rare blood clots. Then he embarked on an effort at damage control and injecting common sense into the discussion.
The “bottom line,” he said, is that all the vaccines approved by Health Canada are “safe and effective,” and that mass vaccination is “one of the key tools” to end the pandemic.
“The impacts of catching COVID are far greater and far deadlier … than potential side effects, which although serious, are rare,” Trudeau told a news conference on Parliament Hill.
He also said he was “very, very happy” to have had a shot of AstraZeneca.
“The reality is, the way we get through this pandemic is to get vaccinated with whatever vaccine is offered to us as quickly as possible.”
On Monday, NACI created confusion and concern when it said mRNA vaccines made by Pfizer and Moderna are “preferred” over the more traditional viral vector vaccines made by AstraZeneca and Johnson & Johnson.
The advisory panel suggested those are not as effective as Pfizer and Moderna, and carry an extremely slight risk — one in 100,000 — of blood clots, so individuals should make their own risk assessment on which vaccine to take.
The expert panel said Canadians should take this small risk into account, and weigh it against the threat of the virus. If you are younger, live in a place with low levels of infection, and have the privilege to work from home during the pandemic, it said you might consider waiting for NACI’s “preferred” shots — the mRNA vaccines from Pfizer-BioNTech and Moderna.
It represented a big change from the public health message to date, which had been to take the first jab you were offered.
Public health officials, physicians, epidemiologists, as well as Trudeau and senior government officials in the Prime Minister’s Office, knew instantly that the message they’d pushed for months had just been muddied.
In fact, it wasn’t a surprise to many of them.
NACI had previewed the message to both the government and some outside health experts who have been frequently contacted by media for public commentary. But because it is an independent body, the government’s officials were not in a position to control the NACI message.
Instead, through Monday evening and into Tuesday morning, they formulated how best to get that message back on track at the regular briefing by Trudeau and Canada’s chief public health officer, Dr. Theresa Tam.
Trudeau and Tam set out to steer the conversation back to the safety and efficacy of all vaccines approved by Health Canada.
So did many of those outside experts.
Speaking on CBC Tuesday morning, Dr. David Naylor, co-chair of a group called the National COVID-19 Immunity Task Force, questioned NACI’s conclusion that the mRNA vaccines should be preferred when clinical studies have shown the Johnson & Johnson and AstraZeneca shots are effective at preventing severe illness and death from COVID-19.
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“It is an unsettling message because it suggests you got the second-best vaccine,” Naylor said of NACI’s advice.
“Let’s not get into Gucci versus Rolex versus no-name branding of vaccines based on questionable effectiveness comparisons,” Naylor said.
In an interview with the Star, Naylor said NACI used “fraught” comparisons to suggest that the mRNA vaccines are more effective, saying that studies cited didn’t compare apples to apples. All the vaccines are effective, and risks, though real, are very minimal, he said.
And if NACI really believed the mRNA vaccines were better, Naylor questioned why its recommendation wasn’t to prioritize vulnerable populations, at-risk groups and essential workers for the “preferred” Pfizer and Moderna shots, rather than tell those most at risk to take an early AstraZeneca or Johnson & Johnson dose.
With COVID-19 still a big threat, especially in Alberta, Manitoba, Ontario and Nova Scotia, many feared the NACI caution could contribute to hesitancy to take the vaccines. Some say NACI’s message has cost an enormous amount of public trust.
“With due respect to NACI, there should be no ‘preferred vaccines’ for COVID-19. A thoughtful, informed choice based on individual risks related to age, gender, community transmission is a must. Implying vaccine superiority is dangerous,” tweeted Dr. Abdu Sharkawy, an infectious disease doctor.
“I keep hearing about ‘nuance’ when it comes to COVID19 vaccine choice,” he added. “My colleague’s ICU had several people under age 60 who declined an AZ vaccine the week prior. Nuance bought them a ventilator. Please don’t shop till you drop.”
Naylor, however, believes the damage to public trust will be minimal, partly because there’s a flood of Pfizer and Moderna vaccines on the horizon — three million doses will arrive this week alone — and because Canadians have “soldiered through some uneven decision-making and put up with lockdowns and mockdowns and restarts and false starts …
“I think people will figure out their way through the current vaccine confusion,” he said. “We will continue getting lots of jabs in arms.”
By the end of June, Canada expects to have received as many as 50 million vaccine doses from all suppliers, said Procurement Minister Anita Anand.
So far, Canada has received 300,000 doses of the Johnson & Johnson vaccine, but its distribution is on hold while production issues for one of its ingredients are investigated.
More than 2.3 million doses of the AstraZeneca vaccine have already been distributed in Canada, with about two million more expected by the end of June.
Conservative MP Michelle Rempel Garner called on the Liberal government to clear up confusion around vaccines.
“What Canadians need is clear, concise and constant communications when it comes to vaccine use,” Rempel Garner said in a written statement Tuesday.
It’s not the first time health officials have been accused of stirring confusion during the pandemic. In March, researchers criticized public health officials for issuing different advice on delaying the second shot of vaccines that require two doses.
NACI will soon offer more guidance, Tam said, on the optimal timing for second shots, and on whether people will be able to take a different kind of vaccine as their second shot.
While the advice for now is to stick with the same vaccine for the second shot, she noted that research is continuing, and there have been suggestions that there might be a benefit of mixing and matching doses.
Tonda MacCharles is an Ottawa-based reporter covering federal politics for the Star. Follow her on Twitter: @tondamacc
Alex Ballingall is an Ottawa-based reporter covering federal politics for the Star. Follow him on Twitter: @aballinga
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