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The federal government’s decision not to provide Novavax’s COVID-19 vaccine this season is raising concerns about health care equity, experts and advocates say, as some Canadians look to the U.S. for the shot.
The Public Health Agency of Canada said it will not supply the protein-based vaccine called Nuvaxovid because the manufacturer required a minimum order that far exceeds last year’s uptake of the vaccine.
The health department said 125,000 Nuvaxovid doses were ordered in 2023, but only 5,529 were administered. This fall, it will supply only provinces and territories with the reformulated Pfizer-BioNTech and Moderna mRNA COVID-19 vaccines.
But some Canadians who say they have weakened immune systems and have had negative reactions to the mRNA vaccines are calling the decision unfair.
Among them is 64-year-old Linda Wilhelm, who has rheumatoid arthritis and takes immunosuppressants for the chronic inflammatory disease. The Bloomfield-NB resident said she received six mRNA COVID-19 vaccines over a three-year period, but her last shot caused a flare-up in her joints that lasted eight months.
Wilhelm said the flare-up was so bad that she even had trouble brushing her hair or chopping vegetables.
After searching for Nuvaxovid at several pharmacies and public health clinics, she said she finally got a dose in April at a pharmacy in Saint John, NB, and had no side effects.
“And now I have no choice again,” Wilhelm said, adding that she is considering driving across the border into Maine to get the updated Nuvaxovid shot.
Barry Hunt made the cross-border trip last month from Port Ryerse, Ontario, to a pharmacy near Buffalo, NY, where he paid $200 to get the Novavax vaccine.
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The 61-year-old, who has a persistent joint infection due to a complication of knee surgery, said he had had a six-month negative reaction to his fourth mRNA injection, which caused chest tightness and fatigue.
But he acknowledged that most people seeking Nuvaxovid don’t have the means to travel to the U.S. to obtain it.
“I think it’s unfair to people who can’t afford it. I think it’s ridiculous here in Canada to pay taxes for universal health care under the Canada Health Act and not have access to a non-mRNA vaccine,” Hunt said.
Angela Rasmussen, a virologist with the University of Saskatchewan’s Vaccine and Infectious Disease Organization, said some people may be sensitive to some components of mRNA vaccines, but they are generally safe for people with suppressed immune systems.
“It is disappointing that Novavax will not be available here, as I believe it could increase vaccine uptake just by overcoming objections to mRNA vaccines, whether they are based on truth or not,” she said in an email.
Other experts say research also shows that, except in very rare circumstances, it is safe for people taking immunosuppressants to receive an mRNA vaccine, even though some patients report flare-ups of their condition.
Specialists often ask patients with autoimmune diseases to stop taking their medications while they are being vaccinated to ensure they can mount a proper immune response, and the absence of medication may be the cause of the flare-ups rather than the mRNA vaccine itself, Dawn Bowdish said. , a professor of immunology at McMaster University in Hamilton.
Still, Nuvaxovid is “clearly less what we call reactogenic, which means you’re less likely to feel bad, have a sore arm or get any of those side effects that some people … get from vaccines,” says Bowdish, who has worked with immunocompromised people in clinical trials of mRNA vaccines.
Novavax’s vaccine, reformulated to target Omicron’s recently circulating JN.1 subvariant, was approved by Health Canada in September.
People who are concerned or have had a bad immunization experience should have access to Nuvaxovid, Bowdish said, because it is critical that they get some kind of vaccination against COVID-19, which is especially dangerous for people with weakened immune system.
The Public Health Agency of Canada said people concerned about getting an mRNA vaccine should consult their healthcare provider.
Those who are medically unable to receive an mRNA vaccine should protect themselves by practicing hand hygiene, wearing a well-fitting mask and improving indoor ventilation, the agency said.
“That response is absolutely abhorrent,” said Michelle Burleigh, co-chair of the Canadian Immunocompromised Advocacy Network, which sent a letter to the federal government in July urging it to purchase Novavax.
“It’s great if someone has the financial means and ability to travel to the US, but this raises a real health equity issue because there are many Canadians who are not in a position to pay $200 for a vaccine in the United States or the ability to get there.”
Bowdish said she is also aware of people traveling to the US to get Nuvaxovid and that is “really problematic.”
While the latest data suggests that flare-ups of certain conditions are unlikely to be a direct result of the mRNA vaccine, it is still important to accommodate patients, she said.
“If a person’s personal experience was, ‘I got vaccinated and I got a flare that kept me in bed for two months and… I missed a part of life,’ how on earth can you counter that while being respectful about their autonomy and expertise? their own body?”
This report by The Canadian Press was first published Oct. 3, 2024.
Canadian Press’ healthcare coverage is supported through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
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