A lobbying effort from several organizations for Alberta to reduce the gap between first and second COVID-19 doses for those who are immunocompromised, cancer patients and elderly seems to have worked, for the most part.
On Thursday, Chief Medical Officer of Health Dr. Deena Hinshaw announced a change to dosing schedules for Albertans undergoing specific kinds of cancer treatments or who are on medication that results in a level of “profound immune compromise.”
Effective Friday, the following Albertans will be able to book their second dose appointments 21 to 28 days after their first dose:
- Transplant recipients, including solid organ transplants and hematopoietic stem cell transplants
- Individuals with malignant hematologic disorders and non-hematologic malignant solid tumors receiving active treatment (chemotherapy, targeted therapies, immunotherapy), excluding individuals receiving solely hormonal therapy, radiation therapy or a surgical intervention
- Individuals being treated with an anti-CD20 monoclonal antibody such as Rituximab
Individuals who meet this criteria can call 811 to book their second dose appointments; these appointments cannot be made through pharmacies or the online booking system.
Hinshaw said the change will not affect the elderly, saying real-world effectiveness data shows that those over 70 have a very good response to the first dose in protecting from severe outcomes. However, she said the same cannot be said for these vulnerable groups.
“We don’t have the same data for those with these specific medical conditions. We’re erring on the side of caution,” she said.
The province is currently spacing doses up to 16 weeks apart to try and get as many first doses into the arms of Albertans. The time period for AstraZeneca specifically is set at 12 weeks.
However, organizations such as Lymphoma Canada, Myeloma Canada, Leukemia and Lymphoma Society of Canada, Lung Cancer Canada and CLL Canada sent a letter to Health Minister Tyler Shandro on April 1 requesting that doses be spaced out according to manufacturers’ guidelines for blood cancer patients, cancer patients on active treatment and immunocompromised survivors.
The letter, signed by 27 doctors from across the country, cites research showing that the immune response in seniors and cancer patients after the first dose is reduced compared to healthy individuals but is boosted when the second dose is administered within three weeks.
Lorelei Dalrymple, interim president of the Myeloma Alberta Support Society, said earlier on Thursday that the society is in the process of starting up a letter-writing campaign to MLAs, AHS, Hinshaw and Health Minister Tyler Shandro.
“(To) hopefully capture their support in making sure vulnerable people are being put at the top of the queue for getting their second dose,” she said.
On April 20, Hinshaw had said they are closely monitoring the emerging evidence around timing of second doses for those severely immunocompromised and cancer patients. Hinshaw said that they are consulting with provincial and national partners and will update if any changes made for these groups.
Mara Erickson, 36, of Edmonton has a condition called ulcerative colitis, which is a form of irritable bowel disease. She manages the effects of it with an immunosuppressant.
Erickson said she has been able to work from home during the pandemic, which has allowed her to manage her exposure.
“I really don’t see people very often, even within the restriction. The disease itself makes me immunocompromised and then pared with the medication, it just can definitely take a toll on the system.
“COVID has really made me nervous to be out and about.”
Erickson was eligible to get a vaccine under Phase 2B, which includes people with underlying medical conditions, and was immunized in early April. Her second dose was scheduled for July.
She said earlier this week that she was worried about how well the first dose is going to work if the second dose of the vaccine is administered beyond the guidelines set by the manufacturer.
“I think waiting for this recommendation when there’s potentially data already out there that the Alberta government and the health officials in the government can draw on – I think the information is there for them to respond rather than waiting,” Erickson said.
“My fear is – I have no idea how my body reacted to that first dose, if it had a high immune response or not.”
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