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

Festivals Kelowna president Richard Groves and executive director Renata Mills wrap themselves in the flag during the announcement of preparations for the 2018 Canada Day festival. (Alistair Waters/Capital News)
Festivals Kelowna cancels Canada Day celebrations for second year in a row

The group cited logistic issues in their announcement

Central Okanagan Public Schools is assisting with the distribution of a donation of $500 to every Grade 12 graduating student in the school district. (File photo)
Central Okanagan Grade 12 grads get $500 surprise

Anonymous donor gifts $500 to every Grade 12 student

A vehicle was fully engulfed in flames before around 11:10 p.m. Wednesday, June 16, 2021. (Kerry Hutter - contributed)
UPDATE: Kelowna man cuffed after carjacking in Vernon

Crime spree: Man robs couple at Coldstream lookout at gunpoint, sets a vehicle ablaze

Lady Dia, pictured with her son Glory, is a Kelowna artist. She recently received $10,000 in funding for her podcast MoM:ents. (Twila Amato - Black Press Media)
Lady Dia selected as City of Kelowna’s artist in residence

Dia will release a project designed to discuss and shape the future of a more inclusive Kelowna

A Sycamore Road home in Kelowna has been cordoned as police conduct an investigation after a man was found dead at the residence at around 1:30 a.m. on June 17. (Aaron Hemens/Capital News)
Kelowna RCMP investigate death at ‘house from hell’

RCMP said that the incident is isolated in nature

Bear wanders Kelowna on June 15. (Michelle Wallace/Facebook)
Bear climbs fence, uses crosswalk in Kelowna

The bear was spotted on Baron Road Wednesday evening

Jeanette Megens
KCR: Volunteering is sharing your story

Kelowna Community Resources shares stories of its volunteers in a weekly column

201 First Street West 1980s. Prior revitalization. (Photo from Revelstoke Museum and Archives)
Man who redesigned downtown Revelstoke honoured with lifetime achievement award

Robert Inwood has worked on historical projects across the province

Provincial health officer Dr. Bonnie Henry outlines B.C.’s COVID-19 restart plan, May 25, 2021, including larger gatherings and a possible easing of mandatory masks on July 1. (B.C. government photo)
B.C. records 120 new COVID-19 cases, second vaccines accelerating

Lower Pfizer deliveries for early July, Moderna shipments up

Cannabis bought in British Columbia (Ashley Wadhwani/Black Press Media)
Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

The weekly COVID-19 map for June 6 to 12. (BC CDC)
South Okanagan sees only 5 new cases in last week

The Similkameen Valley went a second week without any new cases

A heart of ribbons is seen on the fence of Highroad Academy along Chilliwack Central Road on Friday, June 4, 2021. (Jenna Hauck/ Chilliwack Progress)
Orange Heart Memorial campaign launches in Vernon on National Indigenous Peoples Day

North Okanagan Friendship Center raising funds for bench, mural memorializing 215 discovered in Kamloops

A Heffley Creek peacock caught not one - but two - lifts on a logging truck this month. (Photo submitted)
Heffley Creek-area peacock hops logging trucks in search of love

Peacock hitched two lifts in the past month

Most Read