Quebec announced on Tuesday it will expand access to the Oxford-AstraZeneca vaccine to those 45 and over and extend the lockdown order in three regions, including Quebec City, until at least May 3.

The decision to offer AstraZeneca to more people followed similar announcements this week by Ontario, Alberta, Manitoba and British Columbia, where the minimum age to receive that vaccine has been set at 40. 

The AstraZeneca vaccine had previously only been available to those 55 and over in Quebec because health officials were concerned about reports of rare blood blots. Premier Francois Legault told reporters the vaccine will be available to people as young as 45 starting Wednesday morning. 

Quebec's public health director, Dr. Horacio Arruda, told reporters in Quebec City the province decided to set the age at 45 because officials said the benefits of that vaccine for that age group outweigh the risks. "If things change, if our epidemiology gets worse, we could lower the age," Arruda said. 

In a report released on Tuesday afternoon, Quebec's immunization committee said that for all age groups in the province, the benefits of the Oxford-AstraZeneca vaccine outweigh the risks, but it said the benefits for people over 45 are far higher than for younger people.

The committee weighed the number of hospitalizations prevented for every 100,000 people given the AstraZeneca vaccine with the expected number of patients who would get blood clots. It found that the number of hospitalizations prevented would be higher for all adults. But the committee found that the number of ICU admissions prevented would only be significantly higher for people over 45.

Among people 45 to 54, the number of ICU admissions prevented would be at least three times as high as the number of blood clots expected, and at least six times as high among people age 55 to 59. 

Health Minister Christian Dube told reporters Tuesday there are slightly less than 200,000 doses of AstraZeneca available in the province and the decision to expand access means 600,000 more Quebecers are eligible. 

Legault said he is extending the lockdown order for Quebec City; Chaudiere-Appalaches, south of the provincial capital; and the Outaouais region in western Quebec until May 3.

"Unfortunately, the situation in hospitals in those three regions is very worrying," he said. "We have no choice but to take all measures to reduce the number of contacts."

All non-essential businesses and schools are closed in those three areas, and the nighttime curfew is maintained at 8 p.m. Legault said hospitals in those three regions are approaching their capacity and patients have already been transferred from Outaouais to a neighbouring region. 

While the situation in Montreal and its northern suburb of Laval remains stable, Legault said he doesn't plan to change the 8 p.m. curfew in those cities "for now."

"The number of cases and the number of hospitalizations are still very high," he said. "Right now, we think that the situation is too fragile to change the 8 p.m. curfew."

Dube said the province is considering giving some residents of long-term care centres who received a single dose of the Moderna vaccine a dose of the Pfizer-BioNTech vaccine as a booster shot.

Shipment delays may make it impossible to give some people a second shot of Moderna within the 112-day interval between two doses established by the province, Dube said. "We are just waiting for public health to give us the OK."

Quebec reported 1,136 new cases of COVID-19 Tuesday and 17 more deaths attributed to the novel coronavirus, including four in the previous 24 hours. Montreal reported the highest number of new cases, with 224, followed by Quebec City with 195 and the Chaudiere-Appalaches region with 140. 

Health officials said hospitalizations rose by eight, to 694, and 177 people were in intensive care, a drop of six.

The province said it administered 47,799 doses of vaccine Monday, for a total of 2,448,409; almost 30 per cent of the population has received at least one dose.

Earlier in the day, the regional health authority in south central Montreal said it is in the process of opening three vaccination sites for Indigenous people who live in the city. One site opened Monday and another two are scheduled to open within the next eight days.

The authority said the sites, which will have interpreters and other culturally sensitive resources, are intended to help prevent movement between regions. Vaccination is already open to all adults in many Indigenous communities in Quebec.

This report by The Canadian Press was first published April 20, 2021.

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This story was produced with the financial assistance of the Facebook and Canadian Press News Fellowship.

Jacob Serebrin, The Canadian Press