Like a Good Canadian, I Rolled Up My Sleeve and Didn’t Ask Questions
I tried to shake off the feeling that I was about to be injected with a vaccine that had a spotty track record and was much too close to its best before date.
My cellphone lit up with yet another email from a friend containing the same urgent message, “You can get an appointment for the AstraZeneca. Go online and register.” The email then went on to set out the name of the pharmacy and a location.
My partner and I started working our phones in a frenzied effort to book appointments. Everything I had read or heard about the vaccine roll-out in Canada, led me to believe that coronavirus vaccines were not available to a retired sixty-six-year-old lawyer like myself, living in Toronto, in mid-March, 2021. But like a naive investor on the trail of a hot stock market tip, I didn’t want to get left behind. If there was any chance of me getting the vaccine, I was rolling up my sleeve.
The initial phase of Canada’s COVID-19 vaccination program has been slow and tortuous. Although the Canadian government claims to have purchased 414 million doses of vaccine, only 6.2 million doses of vaccine have been delivered. Public health authorities recently adopted a policy of using the limited supply to provide first doses of the vaccine, delaying the administration of second doses for up to four months in order to stretch the vaccine supplies over as much of the population as possible. This policy means that Canadians will wait longer between vaccine doses than the citizens of any other country.
The causes of our vaccine supply problems are not specific to Canada. Like most of the world, we are the victims of vaccine nationalism. Canada purchased vaccine from pharmaceutical companies which manufacture their product in the United States, England, the EU, and India. The United States has taken the unambiguous position that vaccine produced within its borders should be used to vaccinate its citizens. Unfortunately, the US approach has set the tone for the other countries from which Canada is receiving vaccine, leaving Canada to wonder whether the governments of our closest western allies will frustrate our vaccine suppliers in honouring their contractual commitments.
The desperation of the Canadian government to advance its vaccination program is particularly apparent in its dealings with the AstraZeneca vaccine. Health Canada approved the AstraZeneca vaccine for distribution on February 26, 2021, a few days before the arrival of half a million doses from the Serum Institute of India. The government was immediately challenged by the need to distribute the vaccine at lightning speed since two-thirds of the initial shipment was set to expire during the first week of April. This challenge was compounded by the fact that the AstraZeneca vaccine was approved for people under 60, as a result of insufficient clinical trials involving older people, like me. This complicated a rapid rollout. Its administration would require a process separate from the mass immunization system already devised for the Moderna and Pfizer vaccines, which prioritized older Canadians.
The story of the AstraZeneca vaccine in Canada became even more curious when, about two weeks after its initial approval, Health Canada removed any age restrictions attaching to its suitability. Freed from Health Canada age restrictions, it was left to the provincial governments to decide who should get the vaccine, given their existing system of vaccination priorities, the constraints of their vaccine infrastructure, and the expiry date for using the AstraZeneca vaccine. In Toronto, the AstraZeneca vaccine was made available through pharmacies by a system of appointments devised by the individual pharmacies.
Days before my AstraZeneca vaccination appointment on March 23, reports began to circulate that several European countries had suspended the use of the AstraZeneca vaccine because they were concerned about a possible connection between AstraZeneca and blood clots. At about the same time, the press reported that the anticipated approval of AstraZeneca for use in the US was not forthcoming. Approval was being withheld on the basis that the 79% efficacy rate reported by the manufacturers was based on selective data.
As I set off for my AstraZeneca vaccine appointment, I tried to shake off the feeling that I was about to be injected with a vaccine that had a spotty track record and was much too close to its best before date. I tried not to dwell on the idea that if AstraZeneca was offered in a grocery store, it would be marked down for quicker sale. Everyone I knew was clamouring to receive “the vaccine” and few of them were distinguishing between the three types of vaccine options in Canada. The entire world population was facing a dire public health crisis. This was no time to be picky.
It was an early Spring day in Toronto, almost one year to the day after the first lockdown. Walking into the pharmacy where I had booked my appointment, wearing my sweatpants and t-shirt like the uniform of a pandemic soldier, I felt the momentousness of this event. It was an old pharmacy. It had probably been around when the polio vaccine was introduced in 1955. I told myself that by getting the vaccine; I was making a contribution to the global effort to bring the pandemic under control. I felt good about adding to the herd immunity of the Canadian population.
The pharmacist and I smiled at one another over our masks. He had dark, friendly eyes. He asked me if I preferred to get the shot in my left arm and then busied himself with preparing the injection while I rolled up the sleeve of my t-shirt. I was so excited about my vaccination that I hardly felt the jab when he inserted the needle. As instructed, I took a seat in the one chair at the front of the pharmacy for a few minutes after my shot. I tried to imagine what it felt like to have a blood clot. I didn’t think I had one. Other than some soreness in my left arm where I got the injection, I felt fine.
Before I left, I was presented with a vaccination certificate bearing a large trillium beside the word “Ontario” in black bold letters. The certificate set out the important public health information relevant to my newly vaccinated status. My heart sank a little when I saw that the line of the certificate intended to set out the date for my second dose of the vaccine was left blank.
On my fifteen-minute walk back home, I texted my family and friends to let them know my good news. They responded with messages of congratulations, images of champagne glasses clinking together, sparklers and balloons. I felt like I had completed a marathon or come first on an exam. Later that afternoon, my partner and I shared a bottle of wine in our backyard. We both felt that surviving the pandemic long enough to get the vaccine was worthy of celebration. In the afterglow of the vaccine, it seemed that our post-pandemic dreams were closer to becoming reality. We would be able to see our families. We could have friends over for dinner. We could even get on a plane if we could find a safe place to visit.
Unfortunately, several days after getting the vaccine, these euphoric feelings have largely worn off and the monotony of the pandemic has enveloped me again. I am reasonably sure that the one dose of vaccine that I received will give me some protection from coronavirus. The clinical trials indicate that the incidence of severe disease among those inoculated with AstraZeneca is much reduced. I am entirely grateful to have some protection against this disease which has caused so much destruction in the world, overwhelming our hospitals with desperately ill people, killing off the old and the vulnerable among us, and wreaking havoc on our economies.
But I also have to admit that I was hoping for some more tangible and immediate improvements to my tiny pandemic lifestyle as a result of getting vaccinated. I expected that I might receive some information from the Canadian health authorities about the kinds of things that I might do as a semi-vaccinated person and soon-to-be fully vaccinated person. Apparently, I expected too much.
Canada’s Chief Public Health Officer told a press conference on March 23 that guidelines for those who have been vaccinated are under discussion but that for now, the “key message” is that everyone needs to continue with the personal protective measures that are recommended for reducing the risk of coronavirus transmission — wearing a mask, hand washing, social distancing and avoiding crowded conditions. On the same day, Health Canada announced that it would be labeling vials of the AstraZeneca vaccine with a warning regarding the risk of blood clots in those inoculated with the vaccine.
I am left with the disquieting feeling that our government doesn’t feel a high degree of accountability to me or to my fellow Canadians. For over a year, we have complied with stringent government-imposed lockdowns, including the closure of large parts of the economy, and restrictions on our ability to socialize or travel outside the country.
In the past few weeks, we have seen the government scrambling with its vaccine rollout, trying to cope with an unsteady vaccine supply and a steady flow of disturbing news about the AstraZeneca vaccine. Despite our reservations about the government’s handling of the pandemic, millions of Canadians, like me, have rolled up our sleeves to get vaccinated without asking questions.