Woman’s AstraZeneca-related death in Quebec is first in Canada

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Quebec has recorded its first death linked to complications from the AstraZeneca vaccine — a woman who developed a blood clot in her brain, public health director Dr. Horacio Arruda announced on Tuesday. Health Canada later confirmed the death is the first of its kind in Canada.

The woman was 54-year-old Francine Boyer of Saint-Rémi, who received a first dose of the AstraZeneca shot with her husband, Alain Serres, on April 9, Serres confirmed Tuesday evening.

Boyer experienced extreme fatigue and headaches for a few days after receiving the vaccine and was taken to the nearest hospital. As her condition worsened, she was transferred to the Montreal Neurological Institute and Hospital where she died of cerebral thrombosis (a blood clot) on Friday.

“Sometimes, unfortunately, there are complications,” Arruda said. “I want to present my most sincere sympathies and condolences to the family.”

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The Quebec government and experts say Boyer’s death should not discourage Quebecers from getting vaccinated given that rare cases of complications were expected based on vaccine data from elsewhere.

Boyer’s case is one of four blood clots the province has detected in people who have received the AstraZeneca vaccine so far out of more than 400,000, Health Minister Christian Dubé said. Data shows that roughly one in 100,000 people typically suffer complications, meaning Quebec’s statistics are comparable to those recorded in other places.

“We are, unfortunately, exactly within the average,” Dubé said. “It’s sad, but it’s something we were expecting.”

Two out of the four blood clot cases — including Boyer’s — have been linked directly to the vaccine, while two others are under investigation.

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The latter two cases “could be associated to the vaccine or not; there needs to be a confirmation test,” Arruda said. “It happens (that) people get vaccinated and have a blood clot but it’s not associated to this phenomenon.”

The province recently dropped the minimum age to receive the AstraZeneca vaccine from 55 to 45, sending thousands of Quebecers to walk-in clinics last week. Having been born in 1966, Boyer was eligible for the first round of walk-in AstraZeneca vaccinations in Quebec.

Guidelines around who should receive the shot have been changed several times around the world because of extremely rare cases of blood clots with low platelets. Governments and experts alike have largely maintained that the benefits of mass vaccination outweigh the risk of complications, and in Quebec, experts say that is still the case.

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“The facts have not changed, as sad as this event is,” said Dr. Alain Lamarre, a specialist in immunology and virology at the Institut national de la recherche scientifique (INRS). “I think most people should know by now that there is this risk. It’s a rare risk, it’s a low risk, but it’s there.”

Despite the risk being extremely low, Lamarre said he can understand Quebecers being worried following the death, since it’s closer to home.

“When it happens in Europe it’s one thing, but if it happens to someone in your region then it hits harder,” he said. “We always think of the greater good, but when you’re the one person in 100,000 or in one million, well, you get the effect 100 per cent.”

Dr. Jörg Fritz, an associate professor in the department of immunology and microbiology at McGill University, contextualized the risk associated to the AstraZeneca vaccine with other situations in which people can experience blood clots.

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“In a lot of people, thrombosis occurs with flying, with taking the (contraceptive) pill,” he said. “These are all things where thrombosis increasingly occurs even at higher rates than the COVID vaccine.”

Lamarre pointed out that in those cases, blood clots generally don’t appear in the brain, but that they can still be dangerous and are indeed much more frequent.

“It’s for sure higher than one in 100,000,” he said.

There have also been documented cases of blood clots in COVID long-haulers — people who experience complications months after recovering, Fritz said. And if you look at the statistics, people are more likely to die in a car accident than they are to die from complications related to the AstraZeneca vaccine, which is why Fritz said it’s all about risk assessment.

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“I know that’s not very reassuring if you think, ‘Oh, I might be the one who might have the complication,’ but just looking at the statistics, in the end, there is a risk with everything we do,” he said. “I think putting that all together, the benefits of getting the vaccine are clearly much stronger than the risks that we are facing.”

Both experts said it’s important to factor a person’s medical history into any complications and that more data is needed to understand why some have died as a result of them, including how they were treated in the hospital.

In the meantime, they said, the risks remain rare enough that the benefits outweigh them as mass vaccination is the only way out of the pandemic.

“We need to not only focus on this very sad but very rare event, but also see the big picture and see the vaccines are working, and that’s the positive side of things,” Lamarre said.

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Boyer’s family is encouraging Quebecers who get vaccinated to monitor themselves for any strange symptoms and to communicate with Info-Santé (811) immediately if they have concerns.

kthomas@postmedia.com

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