Pharmacists frustrated by vaccine shoppers
City pharmacists frustrated as patients wait for their preferred manufacturer
Dr. Nili Kaplan-Myrth had worked a long time to get doses of vaccine to offer patients in her Glebe family medicine practice.
Now she has 200 doses of AstraZeneca vaccine and is gearing up to start administering it on Monday. But she has had a hard time booking patients.
Some patients say they don't want the AstraZeneca vaccine, which has been the subject of reports of rare blood clotting events, preferring to wait until they can book for a Pfizer or Moderna vaccine.
“Literally, people are shopping for vaccine. It makes doctors feel like we're used car salesmen. I have never encountered anything like this before,” said Kaplan-Myrth.
“It's like buying tickets to a rock concert. People keep trying to get better seats.”
Of the 200 AstraZeneca doses, Kaplan-Myrth has bookings for only 39 doses so far, even after she spent two days personally calling patients over 55, then opened up her vaccine offer to the general public on Twitter.
“There are anti-vaxxers, but this is a different thing. No one had ever asked me before about the manufacturer of a vaccine,” she said.
“I've heard about this. It's a big deal,” said David Fisman, a professor epidemiology at Dalla Lana School of Public Health at the University of Toronto.
“In the short term, it's holding us back in terms of vaccine coverage. Longer term, it's not going to be an issue, as we will have increasing amounts of mRNA vaccine.”
The Ontario College of Family Physicians has posted a message to the public about waiting for a “preferred” vaccine, warning that it increases the risk of getting COVID-19.
“To best protect yourself and others, we agree that the best COVID-19 vaccine is the one that reaches your arm first.”
Vaccine shopping is real, said Dr. Elizabeth Muggah, president of the Ontario College of Family Physicians.
“People have looked at the risks, but not the benefits. This (AstraZeneca vaccine) gives 100 per cent protection against severe disease and death,” she said.
Levels of AstraZeneca hesitancy vary between communities and practices, noted Muggah, a family physician who works at the Bruyère Family Health Team in Ottawa.
The Bruyère Family Health Team received 600 doses of AstraZeneca last week and sent out emails to patients on Wednesday evening. All the appointments for Thursday and Friday were quickly booked, and vaccinations will continue over the weekend.
“One hundred per cent I would recommend this vaccine,” said Muggah. “This is the time to step up and be super-clear that we have to do this now.”
Matthew Chow, a pharmacist who works in the emergency department at Toronto General Hospital, has been working at a pharmacy in the vaccination effort.
He has reached out personally by phone to 200 people on a client list to offer them AstraZeneca appointments, but has only succeeded in booking about a dozen.
“And some required a bit of prodding,” he said.
Chow notes that there appears to be a socioeconomic divide between those who shop for vaccine and those who don't. He notes that his brother, who is a pharmacist in Scarborough, which is less affluent as well as being a COVID-19 hot spot, has had no trouble filling slots for the AstraZeneca vaccine.
Talking to people about numbers and statistics has not been an effective way to persuade people to be vaccinated with AstraZeneca, said Chow. Sometimes personal anecdotes are more persuasive.
“What has worked is saying that we gave our (61-year-old) mother AstraZeneca and she was happy to get it.”
On Wednesday, Dr. Supriya Sharma, Health Canada's chief medical adviser, said there is a very low risk that some patients could develop blood clotting with low platelets after receiving the AstraZeneca vaccine.
A Quebec woman over 55 developed clots after receiving the Covishield product, a biologically identical version of the AstraZeneca vaccine produced by the Serum Institute of India. The woman is recovering.
The risks associated with COVID-19 are much more significant than blood-clot risks, Sharma told reporters during a technical briefing. People should take whatever vaccine is offered to them first, she said.
“Get whatever vaccine is available to you. It's that simple.”
Kaplan-Myrth feels there are three factors at play in vaccine shopping. The first is that people can book vaccinations through multiple portals — and intend to cancel one or more appointments if an opportunity to get their preferred vaccine comes up. It leads to confusion and wasted vaccine.
The second factor is that multiple vaccines are available. The third is misinformation about the AstraZeneca vaccine, she said.
“This is people taking misinformation and using it as an excuse to shop around. People are being entitled and privileged. The right thing to do is to take whatever is offered to you.”
There's also a whiff of generational friction at play. Since the AstraZeneca vaccine is only available to people over 55, people in that demographic have more choice than younger people.
On March 29, the National Advisory Committee on Immunization recommended that AstraZeneca not be used for patients under 55.
That advice may be updated soon to include younger people. But as it stands, every person over 55 who delays because they want a different jab makes someone under 55 wait even longer for their chance, said Kaplan-Myrth.
“It's boomers being privileged.” It's unfair of people over 55, who often have grown children and are retired or working from home are less likely to be exposed to COVID-19 risk, to take Pfizer or Moderna if they have another choice, said Kaplan-Myrth,
“Let people who have no other options take the Pfizer. You take the AstraZeneca. They are both proven to prevent severe illness from COVID,” she said.
“People think they can pick and choose. They're just doing what suits them. It's demoralizing.”
People think they can pick and choose. They're just doing what suits them. It's demoralizing.