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Ontario revises 2nd vaccine dose timeline for transplant, some cancer patients

Last Updated Mar 29, 2021 at 8:01 pm EDT

Francesca Paceri, a registered pharmacist technician carefully fills the Pfizer-BioNTech COVID-19 mRNA vaccine at a vaccine clinic during the COVID-19 pandemic in Toronto on Tuesday, December 15, 2020. THE CANADIAN PRESS/Nathan Denette

The Ontario government confirms it has revised the second vaccine dose timeline for some immunocompromised people.

The Vaccine Clinical Advisory Group advised the Ontario government to follow the recommended dose intervals for vaccines as suggested by the manufacturer — generally translating into a three-week interval between doses, for transplant and certain cancer patients.

The Advisory Group, made up of clinical and public health physicians, found that mortality rates were very high for transplant patients who were diagnosed with COVID-19. There are approximately 12,000 solid organ recipients in Ontario, but this change in timeline will also apply to certain stem cell transplant recipients as well.

Until the change, second doses were being delayed by up to four months after the first needle.

A study released earlier this month from Johns Hopkins University and published in The Journal of The American Medical Association suggests that the first dose isn’t proving effective for organ transplant recipients. It states that “patients may remain at higher early risk for COVID-19 despite vaccination.”

A second recently released study, which has yet to be peer reviewed, concludes that delaying the second booster shot of the COVID-19 vaccine could leave cancer patients “wholly or partially unprotected.”

The Vaccine Advisory Group says that individuals with certain blood cancers and those with malignant solid tumours receiving chemotherapy should also receive a second dose of vaccine within three weeks.

RELATED: NACI recommends Canada pause AstraZeneca vaccine for people under 55

Extended times between doses for older patients will remain in place.

“The Vaccine Clinical Advisory Group strongly support the evidence-based informed public health approach of delaying the administration of the second doses to maximize the number of individuals receiving a first does of vaccine at the time of constrained vaccine supply,” the report reads.

Although the panel acknowledges that age is a driving factor of mortality in COVID19 cases, “in the context of  constrained vaccine supply, the extended dose internal is believed to be appropriate for older individuals.”

The Advisory Group says it will reevaluate the interval between doses as more evidence becomes available and vaccine-supply forecasts are updated.

“This is really exciting news for us,” UHN’s Dr. Deepali Kumar told an online audience in a Monday Q&A session with transplant recipients. “This just happened on Friday at 10 p.m.,” Kumar says of the release of the Vaccine Advisory Group’s report. “Just have some patience as we work through some issues. We have to figure out how to  change the intervals in our booking systems and so on,” she warns.

The new time intervals in vaccines take effect immediately.

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