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Vaccine-induced blood clots under more scrutiny as Canada reports first case

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OTTAWA — Concerns about vaccine safety emerged again Tuesday, as Canada reported its first case of vaccine-induced blood clots linked to Oxford-AstraZeneca, and the United States put the brakes on the Johnson & Johnson vaccine following six reports of blood clots there.

Officials in both countries, however, continued to stress the vaccines are safe, and their benefits outweigh their risks, even as investigations into what is causing the clots continue.

The vaccine news is also dropping as the third wave of COVID-19 is exploding. Canada now has one of the highest rates of new cases in the world, and a record number of patients in critical care.

The Quebec health ministry and Public Health Agency of Canada reported the Canadian blood clot in separate statements Tuesday afternoon. The woman, whose age was not specified, received the AstraZeneca vaccine made at the Serum Institute of India, known by the brand name Covishield.

"The person was taken care of by the health and social services network and received the care appropriate to their condition," said Quebec's statement. "She is now recovering at her home and there is no fear for her life."

Quebec said it has given out 185,000 doses of AstraZeneca so far, and this is the first and only blood clot report, making it an extremely rare event. Nationally, Health Canada only has data up to April 3, which showed less than 500,000 doses had been given out at that point. Updated data is expected Wednesday.

Last week, Europe and the United Kingdom reported 222 cases of blood clots out of more than 34 million shots given.

Health Canada said with all the information it has, the benefits of the vaccine continue to outweigh its risks, particularly as the risk of a vaccine-induced clot is less than one in 100,000. 

Blood specialists, infectious disease experts and the drug regulators say the risk of blood clots is vastly lower from the vaccines than from COVID-19 itself. The syndrome is treatable if caught.

Canada's chief public health officer Dr. Theresa Tam said Canadians can trust that the monitoring system for any safety concerns with the vaccines is working.

Tam got vaccinated herself Tuesday. She received the Pfizer-BioNTech vaccine.

Health Canada has added a warning about the potential risk of clots to the AstraZeneca label. The National Advisory Committee on Immunization recommended that vaccine not be used on people under 55, because most reports thus far showed patients with blood clots were younger. Health Canada is also getting a risk analysis by age and gender from AstraZeneca that could inform future decisions about the vaccine's use.

In a tweet Tuesday, Health Canada said it was also aware the U.S. had paused the use of J&J's vaccine because of clots. The U.S. has six reports out of more than 6.8 million shots given. Health Canada has asked the drug maker for more information, and is in touch with U.S. officials as well.

Dr. Anthony Fauci, the head of the U.S. National Institute of Allergy and Infectious Diseases, said the U.S. pause is out of an abundance of caution, and a desire to quickly get to the bottom of what might be going on.

Canada has approved J&J but isn't expecting any deliveries until the last week of April.

Johnson & Johnson issued a written statement Tuesday saying they are working with U.S. authorities, and have also decided to pause the rollout of their vaccine in Europe for now, as investigations on the blood clots are completed.

As of Tuesday, 20 per cent of Canadians have now received at least one dose of vaccine, and the pace of vaccinations has continued to rise. More than 336,000 vaccines were given out Monday, a new one-day record.

Canada is now giving out vaccines at a rate of almost seven per 1,000 people a day, up from five just two weeks ago, and only 2.5 a month ago.

But Prime Minister Justin Trudeau said while "everyone is working around the clock" to get vaccines out as quickly as possible, the pandemic is still raging around us.

"The situation we’re facing with COVID-19 remains extremely serious," Trudeau said Tuesday. 

Tam said over the last week, new cases are up 33 per cent, hospitalizations grew 29 per cent and the number in critical care went up 24 per cent. 

Over the last seven days, there were an average of 970 people in intensive care with COVID-19, the highest number ever, exceeding the previous seven-day high of 880 in mid-January.

Canada's new case rate is now well ahead of the United States, at 289 new cases for every million people compared to 212 in the U.S. The European average is 209.

Conservative Leader Erin O'Toole said Trudeau's "failure" to get vaccines for Canada faster led to this "catastrophic third wave."

Monday's new case reports in Ontario and Quebec were however lower than the day before. Quebec, at 1,490 new cases, is the lowest since April 6, and Ontario, at 3,670, is well below the more than 4,400 cases reported for the last two days.

Still Quebec extended lockdowns in three regions, including Quebec City and Gatineau, for another week. Saskatchewan, which added 288 new cases, is imposing a provincewide order barring gatherings with anyone you don't live with, and limiting houses of worship to a maximum of 30 people.

Prince Edward Island Premier Dennis King said plans to reopen the Atlantic bubble April 19 are in jeopardy as cases in the region aren't stable. Nova Scotia imposed new restrictions on people coming in from New Brunswick due to outbreaks of variants in the latter.

Vaccines may be providing some welcome good news in keeping deaths down. Tam reported an average of 34 deaths per day in the last week, compared to 140 when ICU numbers were similar in January. 

She said getting vaccines to the most vulnerable person has had an impact.

In Saskatchewan, the province is tightening restrictions provincewide on group sizes and how many people can attend worship services as the number of COVID-19 cases continues to surge. 

Effective Tuesday, only people living under the same roof are to be present in a home. 

As of Friday, church gatherings will be restricted to no more than 30 people. 

Alberta’s chief medical officer of health said new public-health restrictions might be needed if high daily COVID-19 case counts continue.

Dr. Deena Hinshaw reported 1,081 new cases on Tuesday, the seventh consecutive day of counts above 1,000. 

The rise is being driven by more contagious variants, which now make up 52 per cent of the province's 15,087 active cases.

In B.C., Premier John Horgan said further COVID-19 restrictions may be on the way. 

He said he expected his cabinet will consider travel restrictions and those talks will also likely examine the status of visitor bookings for hotels, bed and breakfasts and campsites.  

This report by The Canadian Press was first published April 13, 2021.

— with files from James McCarten in Washington, D.C.

Mia Rabson, The Canadian Press

Note to readers: This is a corrected story. A previous version incorrectly reported there has been 700,000 doses of the Oxford-AstraZeneca vaccine administered in Canada as of April 3. It also said Dr. Anthony Fauci is the head of the U.S. Institutes of Health and Infectious Diseases.

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