As eligibility for AstraZeneca vaccine expands, uncertainty looms around Manitoba's next shipments

Days after expanded immunization criteria left some pharmacies swamped as Manitobans over 40 rushed to get the COVID-19 vaccines they were suddenly eligible for, health officials said they don't know when the province is getting more of the AstraZeneca-Oxford shots.

That uncertainty stems largely from delayed exports of vaccines from India, the medical lead of Manitoba's vaccine rollout said on Wednesday. That country — a major producer of COVID-19 shots — is grappling with a surge in coronavirus cases and shifting its focus to domestic demand for immunization.

"We don't know when AstraZeneca is coming. It's still being produced — it's not a matter of there not being doses in the world — it's really a matter of India not allowing those doses to leave their borders," Dr. Joss Reimer said.

"We do expect that that will change. India will be allowing doses to leave. It's more a question of when."

Manitoba's rollout of the AstraZeneca vaccine is happening in pharmacies and medical clinics across the province. Those shots were previously set aside for Manitobans 65 and older and those 55 to 64 with certain health conditions. But as of Monday, anyone 40 or older now qualifies, regardless of medical conditions.

So far, Manitoba has received 84,100 doses of that vaccine, according to the province's online dashboard. A provincial spokesperson said pharmacies and clinics have reported using roughly 35,000 of them.

Johanu Botha, operations lead of the province's vaccine task force, said the sites that have received shipments of the AstraZeneca vaccine are hoping to dole out those doses as soon as possible — likely within the next week or two.

Vaccines from Pfizer-BioNTech and Moderna are also part of Manitoba's vaccine rollout at supersites and temporary vaccine clinics. As of Wednesday, those shots were available to people in the general population age 50 and up and First Nations people 30 and up.

Current estimates suggest Manitoba will get 70 per cent of its adult population vaccinated by June 9. If the province gets more vaccines than it's expecting, that date could be bumped up a few days to June 5, Botha said.

He also stressed that vaccine rollout leaders aren't worried about whether the delays and uncertainty around shipments will affect Manitobans getting their second doses.

"I want to be very clear that this supply chain pressure that we're feeling at the moment is a short- to medium-term pressure. All the signals from the federal government have been very clear that every one of these vaccines will see a stable and robust supply chain going forward," Botha said.

"The concern right now is simply about getting doses in arms quickly for those who haven't gotten a vaccine yet." 

As of Wednesday, Manitoba has vaccinated 27.4 per cent of its adult population with first doses. That leaves 42.6 per cent who still need their first doses to reach the 70 per cent needed to create herd immunity in the province, Botha said.

AstraZeneca benefits outweigh risks

Reimer said she's worried there are people who qualify for the AstraZeneca vaccine but won't get it because of reports of rare blood clots in connection with that shot.

She said the risk of getting COVID-19 far outweighs the risk of blood clots related to the vaccine — especially for people over 40 who now qualify for it.

"I do understand that people have questions and may have concerns. This pandemic has given us a lot to handle and the vaccine is no different," Reimer said.

"But I do worry that people who aren't sure won't take the opportunity to be immunized and therefore leave themselves at risk."

Reimer also said it's unlikely delays in vaccine shipments will affect second doses in Manitoba. But even if they do, the people making the decisions in the province's vaccine rollout have options like using a different shot for the second dose or further delaying the time between the two shots, she said.

"None of those decisions have been made at this point because there's just so many unknowns about what will be available and when," Reimer said.

By the time most Manitobans are getting their second shot, she said her best guess is that the province will have doses of all four currently approved vaccines available — and possibly even more if the fifth shot under Health Canada review is approved.