Expert says Nova Scotia needs a plan now on expiring AstraZeneca doses

Health officials in Nova Scotia have not yet decided what to do with unused doses of the AstraZeneca-Oxford vaccine that expire at the end of June, but an expert in bioethics says there's no time to wait.

Prof. Françoise Baylis of Dalhousie University said Nova Scotia should be making plans now on whether to issue the COVID-19 vaccines as a second dose or redistribute them to countries that need them.

"For months, I have argued that we need a plan for equitable distribution of excess vaccine, and we need to start by defining excess, given that Canada does not produce vaccine," said Baylis, a professor in the faculty of medicine whose areas of research include public health.

"Vaccines we are not using sounds like a good place to start."

Nova Scotia said May 12 that it would halt rollout of the AstraZeneca vaccine out of "an abundance of caution" over a rare, but potentially fatal, blood-clotting disorder. The government also cited the fact the province has enough Pfizer-BioNTech and Moderna vaccines to go around.

More than 1,000 people scheduled to receive the AstraZeneca vaccine had cancelled their appointments leading up to the province's decision to stop distribution. 

Baylis said it's "imperative" to come up with a plan for the excess before the vaccine goes to waste.

"If we don't have a plan, then it's a very real risk, because if you're waiting and waiting and waiting, eventually they will expire, and the problem will be you need time to get them from in storage here to wherever you have decided they can be used," she said.

Dr. Robert Strang, the province's chief medical officer of health, said in a recent interview the province has about 25,000 doses that cannot be used after the end of June.

He said there's still time before having to decide what to do with them. People who received their first dose of AstraZeneca have a minimum of 12 weeks between doses, and they're not due for that just yet, Strang said.

Studies are underway now in the United Kingdom on the effectiveness and safety of taking the AstraZeneca shot as a first dose and using the Pfizer-BioNTech or Moderna vaccine as a second dose.

The results are expected in June and Canada's National Advisory Committee on Immunization will use that information to make recommendations for provincial health officials.

"We don't want to go out ahead of having that research evidence," Strang told CBC Radio's Information Morning Cape Breton on Thursday. "Fortunately nobody's due for their second dose of AstraZeneca yet, so we have time to get this research and make that decision."

Preliminary results show that for those who received AstraZeneca as a first dose, a second dose of one of the other vaccines is more effective, he said.

Other provinces stop using AZ vaccine

Nova Scotia is not the only province to stop distributing the AstraZeneca vaccine. Newfoundland and Labrador, Prince Edward Island, Ontario, Alberta and Quebec have also suspended its use.

New Brunswick has halted the first dose of AstraZeneca, but will continue to use the product for second doses.

Baylis said her biggest concern as more time passes without a plan for unused doses is possible wastage of vaccine during a pandemic.

"The only unacceptable option is to allow it to expire," she said.

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