Pharmacies prepare for 2nd doses of AstraZeneca vaccine

Four thousand doses of the AstraZeneca COVID-19 vaccine have arrived at London Drugs pharmacies across B.C. this weekend. The plan is to start getting shots into arms by the end of this week.

“Anyone who received their first doses of AstraZeneca with London Drugs, we’ll start calling them on Monday to book for their second appointment,” says Chris Chiew, general manager of pharmacy for London Drugs.

Roughly 10,000 British Columbians received their first AstraZeneca shots at London Drugs. Chiew says the process went smoothly, with customers booking appointments and filling out consent forms online, which minimized the amount of time spent at the pharmacies.

Chiew expects the drug store chain will receive another 10,000 doses this time around. However, with AstraZeneca’s vaccine being linked to rare blood clots known as vaccine-induced thrombotic thrombocytopenia (VITT), some people have concerns.

Should they get AstraZeneca again? Or should they opt instead to get Pfizer or Moderna as their second dose?

Those are the questions Ajit Johal, pharmacist and clinical director with the Immunize.io Health Association is often asked.

As for the answer, Johal says it comes down to personal preference and comfort. He points out the risk of developing the rare blood clots from AstraZeneca’s vaccine is even lower for the second dose.

“There’s more real-world evidence and more people who have gotten two doses of the AstraZeneca vaccine, which includes a large portion of the United Kingdom, so if you have two doses of AstraZeneca, you know you’ve got very good protection against severe disease,” says Johal.

When it comes to mixing and matching, immunologists say there isn’t much evidence available yet. There are two studies currently underway in the United Kingdom and Spain, and early findings suggest following up an AstraZeneca shot with a Pfizer shot is safe. Still, one epidemiologist suggests people should stick with the same vaccine for both doses whenever possible.

“All of the clinical trials were done with two shots of the same vaccine,” says Dr. Brian Conway, medical director of the Vancouver Infectious Diseases Centre. “That’s what we have the most information about in terms of how it’s tolerated, the efficacy rate and the like. So that should be the first choice.”

But, that may be easier said than done. While pharmacies are the exclusive administrator of AstraZeneca vaccines for second doses, not all pharmacies are choosing to participate. For example, CTV News Vancouver heard from a pharmacy in Delta that provided first doses, but is choosing not to provide second doses, due to staffing issues. That pharmacy’s owners said they know of seven other Metro Vancouver pharmacies opting out of administering second doses because of staff shortages as well. For some, it could spell difficulty booking a second AstraZeneca shot.

London Drugs is placing priority on people who booked first doses with them, but says it will open vaccinations to the general public if extra doses remain.

“If the first pharmacy you went to was not a London Drugs and is unable to help you, don’t hesitate to give us a call by mid-June or the end of June and we’ll see if you can help you out,” says Chiew.

Approximately 280,000 British Columbians received AstraZeneca as a first dose. What remains to be seen is how many people will choose it as their second.

“I support the decisions on both sides, and I applaud people for getting their second dose,” says Johal.