Canada' National Advisory Committee on Immunization (NACI) is recommending that Johnson & Johnson's single-dose Janssen COVID-19 vaccine be offered to individuals age 30 and older, without contraindications.
Dr. Shelley Deeks, vice-chair of NACI, said that depending on how vaccines are rolled out in provinces, the COVID-19 situation in that region and each person's individuals risk, one may choose to wait to get vaccinated until an mRNA COVID-19 vaccine is available, like the Pfizer-BioNTech or Moderna vaccines.
"They need to make an informed choice as to whether they would prefer to get vaccinated sooner with a Janssen or AstraZeneca, or wait to receive the mRNA vaccine," Dr. Deeks said. "They know [their] risk tolerance for an adverse event and also know their personal situation, how much they may be able to protect themselves using public health measures."
"The mRNA vaccines are the preferred vaccine and yet, given the epidemiology, the viral vector vaccines are very effective vaccine but there is a safety signal, a safety risk...and the issues with the safety signal is that although it's very rare, it is very serious. Individuals need to have an informed choice to be vaccinated with the first vaccine that's available, or to wait for an mRNA vaccine."
On Friday, Health Canada announced that 300,000 doses of the Janssen vaccine are being held after "a drug substance" produced at the Emergent BioSolutions facility in Baltimore, Maryland, was used in the manufacturing of the vaccine doses that arrived in Canada, after a number of U.S. vaccines doses from that plant were spoiled.
Of the eight million doses of the Janssen COVID-19 vaccine administered in the U.S., there have been 17 reported cases of VITT, vaccine-induced immune thrombotic thrombocytopenia, a rare but serious blood clot event.
NACI is looking at options for "mixed schedules," someone receiving a second dose of a vaccine option different from their first shot.
"NACI will be making a recommendation about mixed schedules as soon as we see some information from some studies that are looking specifically at mixed schedules," Dr. Deeks said.
When asked about the four-month interval between the first and second dose of the Pfizer, Moderna and AstraZeneca vaccines, Dr. Deeks stressed the guidance remains that the interval can be "up to four months."
"I would suggest, given our third wave and what is being experienced across the country, trying to ensure that the majority of Canadians get their first dose fast has actually really kept us in good standing in the third wave," she said. "That is still the priority to ensure that Canadians get a first dose of COVID-19 vaccines."