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Alberta doctors seek changes to COVID-19 vaccine dosing schedule for certain patients

There are growing calls for the province to reconsider the COVID-19 vaccine dosing schedule for those who are immunocompromised or elderly.

Alberta is currently spacing doses out up to 16 weeks apart, per a recommendation from the National Advisory Committee on Immunization (NACI).

READ MORE: Alberta to start extending time between COVID-19 vaccine doses as 1st variant outbreak declared

However, a professor at the University of Alberta said a network of infectious disease physicians, including himself, have reached out to the minister of health to try and modify recommendations for those who are immune-compromised, particularly transplant patients.

There are also concerns for seniors and cancer patients.

READ MORE:Provinces, territories can wait 4 months to administer 2nd COVID-19 shot, NACI says

Dr. Ilan Schwartz said the doctors are asking for the time frame to revert back to what was prescribed in the clinical trials, which is between three and four weeks.

“Collectively there has been a recognition this is something that we all feel needs to be modified within our respective provinces. We have reached out to NACI to try and urge them to reflect this with a bit more nuance in their recommendation and also within Alberta to the Minister of Health Tyler Shandro,” Schwartz said.

Click to play video: Canada’s top doctor discusses COVID-19 vaccine dose intervals following NACI recommendations

The concerns stem from growing data coming out of the United Kingdom – where both the Pfizer and AstraZeneca vaccines are being given 12 weeks apart – that suggests that the second dose is crucial to get the full benefit of the vaccine for the elderly population.

READ MORE:‘Risky’ or ‘incredible’? Experts split on delaying 2nd vaccine dose to expand coverage

Schwartz said the initial recommendation to space out doses came from real world data about antibody responses in a general pool of patients that was stretched out to as many as four months.

“Now that we have more data, we can further refine which sub populations that might not be a good idea in.

“What has been identified so far is, immune-compromised patients, particularly those that have had transplantation or otherwise have compromised immune systems, and then more recently there’s been some data to suggest elderly individuals may not have the same sustained response from the initial vaccination and may benefit from the booster dose — the second dose — happening earlier rather than waiting.”

At the time of the recommendation, NACI said extending the dosing interval will help “opportunities for protection of the entire adult population within a short timeframe.”

However, in a recent statement to Global News, Health Canada said: “NACI is monitoring the evidence on effectiveness of an extended dose interval, including in specific populations.”

In the coming weeks, the committee will review the extended interval strategy, it added.

Click to play video: Scientists question plans to delay second dose of COVID-19 vaccine

Barbara Proudfoot, 61, has interstitial lung disease and is required to take immune suppressants to maintain her level of lung function.

READ MORE: COVID-19 vaccine: Second dose delay ‘more risky’ for seniors, experts warn

She would like to see the dosing schedule changed for people identified in Phase 2B, which includes Albertans with underlying health conditions, such as herself.

“My concern is that this group of people will have a false sense of being immunized when potentially the level of immunity would not be what we believe, as well as, are we wasting valuable doses of vaccine if we’re not getting that level of immunity that we could if we did that second dose according to the manufacturer’s directions?” Proudfoot said.

Proudfoot said she has been diligent during the pandemic to protect herself, and she said she will get her vaccine when her turn comes up but she will still have questions.

“I don’t have the confidence that it will be as effective as it could be, and will I then need additional vaccines later in the fall? I think the other question becomes, how do we know if we have a level of immunity that is considered reasonable?”

On Thursday, chief medical officer of health Dr. Deena Hinshaw said the province is looking to NACI.

“We are waiting for the perspective of the National Advisory Committee on Immunization to help us understand if there are certain groups of people for whom a shorter interval would be recommended,” she said.

Hinshaw said there is real-world evidence about the effectiveness of vaccines in preventing infections, hospitalizations and deaths in older people but little data related to cancer patients.

She also emphasized that an individual is not only protected by the dose of vaccine they receive, but the doses the people around them receive.

-With files from Saba Aziz, Global News


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