There was a collective meltdown yesterday as the National Advisory Committee on Immunization delivered its most recent recommendations, saying that they recommended that the Johnson & Johnson vaccine be deployed for those over 30 (even though the current supply in the country is currently on hold pending a review of its quality control), and then cited that mRNA vaccines remained their preferred candidates – and everyone lost their minds.
This is not really unexpected if you have been paying attention, where the chair of the committee in particular has said that because of the “safety signal” attached to AstraZeneca related to the particular blood clots (which are very serious – there is a reasonably high fatality rate related to them) that it would be preferable to get mRNA vaccines, but if someone could not wait for them, then they should get the first available vaccine, even if it’s AstraZeneca. In their minds, it’s about being transparent around the risk factors associated, and they’re right. It’s just that this makes it harder for governments and public health officials to carry on with message that the best vaccine is the first one you are offered. Both are correct, and NACI has a lot of nuance in their guidance that is difficult for people to parse effectively, which is a problem, but it’s a question of whether the problem is NACI’s in how they communicate their guidance, or a problem in particular with media who are supposed to be able to take complex issues and translate them to the public, and yet are not very good at it (often walking away from these releases citing that they are “more confused than before,” which they shouldn’t be if they paid attention). It especially isn’t helped when certain journalists, talking heads, and especially certain MPs conflate the very different roles that NACI and Health Canada have, and try to assert that they should always be “on the same page” when they have different roles. Health Canada determines the safety of the vaccines, NACI offers guidance on the best way to deploy them, factoring in the current local epidemiology and vaccine supplies – guidance which provinces can accept or reject. It’s also why that guidance is always changing – they are reacting to current circumstances rather than just offering a simple recommendation once and being done with it, which most people are not grasping. And they have operated pretty much invisibly for decades, because there hasn’t been the kind of public attention on new vaccines up until now, which is why I really dislike the calls by people to “disband NACI” after yesterday’s press conference.
I get that people want clear binaries, and simple instructions, but that’s not NACI’s job, really, and expecting them to change their way of communicating after decades is a difficult ask. There is a lot of nuance to this conversation, and I will point you to a couple of threads – from professor Philippe Lagassé here and here about this kind of advice and how it’s communicated to the public; as well, here is hematologist Menaka Pai, who talks through NACI’s advice and what it means.
Seems the NACI is advising that all vaccines are safe, but the mNRA is their gold standard.
If you can afford to sit around and wait for the gold standard, and want to, then do!
If not, get whatever vaccine is available *right now* to keep yourself and others safe. #cdnpoli https://t.co/h0RHWXUTeH
— Alheli Picazo (@a_picazo) May 3, 2021