A vial of AstraZeneca vaccine is seen at a mass COVID-19 vaccination clinic in Calgary, Alta., Thursday, April 22, 2021. Dr. Ben Chan remembers hearing the preliminary reports back in March of blood clots appearing in a handful of European recipients of the Oxford-AstraZeneca COVID-19 vaccine. THE CANADIAN PRESS/Jeff McIntosh

A vial of AstraZeneca vaccine is seen at a mass COVID-19 vaccination clinic in Calgary, Alta., Thursday, April 22, 2021. Dr. Ben Chan remembers hearing the preliminary reports back in March of blood clots appearing in a handful of European recipients of the Oxford-AstraZeneca COVID-19 vaccine. THE CANADIAN PRESS/Jeff McIntosh

Science on COVID, VITT constantly changing: A look at how doctors keep up

While VITT can represent challenges as a novel disorder, blood clots themselves are not new

Dr. Ben Chan remembers hearing the preliminary reports back in March of blood clots appearing in a handful of European recipients of the Oxford-AstraZeneca COVID-19 vaccine.

The global health expert with the University of Toronto followed the developments closely over ensuing weeks as researchers went from examining what was going on to determining how to diagnose and treat it.

The disorder, characterized by low platelet counts, is now called vaccine-induced thrombotic thrombocytopenia, or VITT. It continues to be an exceedingly rare side effect seen in a small number of recipients of adenovirus vector vaccines.

The science surrounding VITT continues to evolve quickly, and medical professionals have found themselves bombarded with developments, including changing guidance on patient care.

“In my 30-plus years working in the medical system, I don’t think I’ve ever seen such a short time period between discovering something, figuring out how to manage it, and getting the information out into the field,” says Chan.

When a time-sensitive issue like VITT arises, there are multiple ways urgent updates make their way to physicians, nurses and ER staff, note several experts who say the public can feel confident the health system has kept pace with new discoveries.

Dr. Michael Hill, a neuroscience professor at the University of Calgary, says communication varies from province to province and involves multiple avenues, but the goal is to reach hospital staff “very quickly.”

“When you try to get a message out to a huge number of people, you have to do it in a multifaceted way,” says Hill, also director of the stroke unit for the Calgary Stroke Program.

“You can’t just depend on one communication channel.”

He notes a bulletin this week from Alberta Health Services reached approximately 100,000 emergency room doctors, nurses, internists and neurologists via a system-wide email before being posted around hospitals in physical form.

In Ontario, the province’s Science Table recently shared updated guidance that included an extension of the time frame of VITT symptom onset to 4-to-28 days, a change from 4-to-20 days. Chan, who helped author the document, says the update was emailed to various groups.

Meanwhile, over at the Unity Health Network in Toronto, hospital staff use various platforms including email, meetings and WhatsApp group chats to ensure they’re up to date on the latest science, says Dr. Erin O’Connor, deputy chief of the network’s emergency department.

She says social media has also played a role as medical professionals pay closer attention than ever to what global colleagues tweet about their own research or other notable studies.

“It’s fascinating how information has been disseminated in the time of COVID,” says O’Connor. “Everything is changing so rapidly. I mean, some protocols have changed every couple of weeks as we learn more.”

Just this past Friday, an article published in the Canadian Medical Association Journal dismissed initial notions VITT affects mostly younger women and called on doctors and staff to be alert for anyone with possible symptoms.

The article highlighted the case of a 63-year-old man who developed signs 20 days after receiving his AstraZeneca vaccine.

As of Thursday, there were 18 confirmed cases of VITT in Canada — out of more than two million doses of AstraZeneca administered — with 10 more under review. Three Canadians have died.

Most provinces announced last week they’ll no longer offer AstraZeneca as a first-dose option.

Provinces have also issued guidance on symptoms to watch for — including persistent, severe headache; blurred vision; chest, back or abdominal pain; swelling in a limb and multiple bruises — along with information on how to diagnosis and treat the disorder.

At the federal level, Health Canada issues information on vaccine safety concerns, and along with the Public Health Agency of Canada, has put together “a network of clotting (and) hematology specialists across the country,” available for consultations, says chief medical adviser Dr. Supriya Sharma.

Sharma adds it’s up to provincial and territorial governments to inform front-line health professionals who could see potential VITT cases.

Keeping up with an ever-evolving scientific landscape is part of a doctor’s job.

Chan notes Canadian doctors must earn continuing education credits to remain certified with their specialty societies, with each credit roughly equivalent to an hour of lectures, reading or group study. The minimum is 50 credits per year for family doctors and 80 for specialists.

While VITT can represent challenges as a novel disorder, blood clots themselves are not new.

O’Connor says triage nurses — a patient’s first point of contact in an emergency room — have been trained to spot potential clot symptoms long before VITT emerged.

Hill says the difference now is they’ll ask patients whether they’ve received the AstraZeneca vaccine when presenting with possible VITT signs.

Concerns arose last week when a woman with VITT symptoms was reportedly turned away from an emergency room in Edmonton. The woman went to another hospital, where a CT scan revealed a blood clot, and she died shortly after.

Chan, who didn’t know the specific context of the woman’s case, says human error does sometimes happen in medicine. But, he adds the public should feel confident health professionals know what to look for.

“It’s important that patients who have symptoms like severe headache or bleeding after vaccination seek care immediately and ask that VITT be ruled out,” he says.

— With files from Mia Rabson in Ottawa

Melissa Couto Zuber, The Canadian Press

Coronavirusvaccines

Just Posted

A conceptual rendering of the commercial plaza at 1130 Rocky Creek Road. (Town of Ladysmith/June 15 Council Agenda)
Rocky Creek commercial plaza passes public hearing

The proposed plaza at 1130 Rocky Creek Road would bring commercial activity to Ladysmith’s north end

Kate Cram and her team at Old Town Ice Cream are thrilled to be open for business. (Cole Schisler photo)
Old Town Ice Cream opens up right on time for summer

Located at 539 1st Avenue, Old Time Ice Cream is open from 10 a.m. to 7 p.m. daily

Things are looking up for Vancouver Island as zero COVID-19 cases have been reported for the first time since October. THE CANADIAN PRESS/Darryl Dyck
Island records zero new COVID-19 cases for the first time since October

For the first time since October, the province is reporting zero new… Continue reading

Black Press file photo
RCMP seek suspect in Vancouver Island-wide crime spree

Crimes stretched from Deep Bay to Qualicum, Ladysmith, Chemainus and Youbou

Volunteers Alex Cook, Ron Dashwood, and Bill Drysdale have been hard at work restoring the old Ladysmith train station. (Cole Schisler photo)
Train station restoration on track for future community open house

Community is asked to give feedback on what they think the best use is for the station

A small pod of Pacific white-sided dolphins pass by close to shore in Campbell River June 16, 2021. Still capture from video courtesy of Kimberly Hart
VIDEO: Dolphin sunset captured from Vancouver Island shore

Spectacular setting for view of travelling pod of Pacific white-sided dolphins

Bruce Springsteen performs at the 13th annual Stand Up For Heroes benefit concert in support of the Bob Woodruff Foundation in New York on Nov. 4, 2019. (Greg Allen/Invision/AP)
Canadians who got AstraZeneca shot can now see ‘Springsteen on Broadway’

B.C. mayor David Screech who received his second AstraZeneca dose last week can now attend the show

New research suggests wolves can be steered away from the endangered caribou herds they prey on by making the man-made trails they use to hunt harder to move along. THE CANADIAN PRESS/Nathan Denette
Culling cutlines, not B.C. wolves, key to preserving caribou herds: researcher

The government has turned to killing hundreds of wolves in an effort to keep caribou around

Gary Abbott (left) and Louis De Jaeger were two of the organizers for the 2014 Spirit of the People Powwow in Chilliwack. Monday, June 21, 2021 is Indigenous Peoples Day. (Jenna Hauck/ Chilliwack Progress file)
Unofficial holidays: Here’s what people are celebrating for the week of June 20 to 26

Indigenous Peoples Day, Take Your Dog to Work Day, Onion Rings Day all coming up this week

Gwen Spencer Hethey with her uncle and mentor Major Frederick Richardson. (Courtesy of Greater Victoria Sports Hall of Fame)
‘She was a killer’: The B.C. woman who pioneered female sharpshooting

Gwen Spencer Hethey made military men ‘look like turkeys’ says her son

Central Okanagan Grade 12 grads are set to get $500 each after a more than $1 million donation from a Kelowna couple. (File photo)
B.C. couple donating $500 to every Grade 12 student in the Okanagan

Anonymous donors identified as Kelowna entrepreneurs Lance and Tammy Torgerson

Rita Coolidge played the main stage at Vancouver Island Musicfest in 2017. (Black Press file photo)
This year’s Vancouver Island MusicFest to virtually showcase beauty of Comox Valley

Returning July 9 through 11 with more than 25 hours of music performances

British Columbia’s premier says he’s received a second dose of the Oxford-AstraZeneca COVID-19 vaccine. (Twitter/John Horgan)
B.C. premier gets 2nd dose of AstraZeneca COVID-19 vaccine

John Horgan shared a photo of himself on social media Friday afternoon holding a completed vaccination card

Most Read