15,000 Ottawa children missed measles vaccine during pandemic, says OPH
Thousands of children lack protection against measles and other diseases in Ottawa because they didn’t receive routine vaccinations during the pandemic, according to new data from Ottawa Public Health (OPH).
OPH gauges vaccine uptake by tracking the number of vaccine supply orders it receives from health-care providers who administer shots.
The latest data available suggest orders for the MMR vaccine that protects against measles, mumps and rubella, along with the MMR-V vaccine that protects those three diseases plus varicella (chickenpox), decreased by 30 per cent in 2020 compared to the typical number of orders in pre-pandemic years.
Orders for the measles-containing vaccine continued to slump in 2022 compared years prior to 2020 — down between 10 and 20 per cent, said OPH.
“Based on this distribution data, we estimate approximately 15,000 kids in Ottawa missed receiving a dose of MMR or MMR-V between 2020 and 2022,” said an OPH spokesperson in an email to CBC.
Measles is a highly contagious infectious disease that used to infect most children until a vaccine was introduced in the 1960s.
According to Public Health Ontario measles remains the leading global cause of death in children by a vaccine-preventable disease — an average of one to two children die for every 1,000 cases.
Two shots of the MMR vaccine provide nearly 100 per cent protection from getting measles for life.
“It’s always concerning to hear that some children may not be up to date because it means that they’re not adequately protected against disease that we have vaccines to protect them for,” said Marie-Claude Turcotte, manager of immunization at OPH.
Public health officials previously warned the drop in vaccine coverage heightens the risk of a measles outbreak in the city because measles is so contagious.
Efforts to catch up
Data for last year shows the volume of orders for all routine vaccines is still 10 per cent behind where it was before 2020, said Turcotte, though the number is better than 2020 and 2021.
According to OPH, the five-in-one vaccine (diphtheria, tetanus, pertussis, polio and haemophilus influenzae type b), usually given at a baby’s six month appointment, saw little to no changes in volumes ordered during the pandemic.
Ottawa also suspended its participation in the province’s school-age vaccine tracking program for two school years, 2020-2021 and 2021-2022.
The Panorama program prompts parents to notify OPH what vaccines their child has received as required by Ontario law. Late in 2022, the public health agency resumed the program and sent notices to more than 12,000 students who were born in 2005 and 2015.
“That’s a reminder to parents to go and get the child vaccinated,” she said.
Even ‘small’ drop makes difference: researcher
When it comes to measles and whooping cough, every new child vaccinated makes a difference, said Dr. Kumanan Wilson. He’s a professor of medicine at the University of Ottawa and the chief science officer at CANImmunize.
“These are some of our most infectious viruses so we need to have high vaccine coverage,” he said. “Even a small drop in coverage for measles can result in outbreaks.”
Wilson said CANImmunize, which runs a free app that allows parents to track their children’s vaccinations, reported a drop in new registrations during the pandemic.
“We’re still lagging somewhat,” he said earlier this week.
While Ottawa sees one to two per cent of children go without vaccines due to conscientious or religious objections, Wilson believes confusion is a large driver behind the vaccine lag.
“We like to talk a lot about vaccine hesitancy and the anti-vaccine movement but really, logistics is often at the root of a lot of these problems,” he said.
The company is currently working with CHEO to design software that will allow parents in Ottawa and four neighbouring counties to book vaccine appointments for their children online and for health units to track vaccinations if parents give consent.
It is expected to be available to parents in May, the company said. Wilson said he hopes new tools will help streamline and improve the booking process, increasing vaccine coverage.
OPH has also expanded routine vaccinations available at its family and community vaccination clinics and wellness hubs. Parents who do not have a family doctor, or another health-care provider, can book a vaccine appointment through its website at one of the clinics.
High-risk places affected by respiratory outbreaks
A respiratory virus outbreak has been declared at Southbridge Lakehead long-term care home.
The outbreak is facility-wide at the Vickers Street home. Restrictions are in place on admissions, transfers, discharges, social activities and visitation until further notice.
There are now four active respiratory outbreaks in high-risk settings in the Thunder Bay district, including at Hogarth Riverview Manor on the first floor and 2 North and on Plaza 1 at Pioneer Ridge.
A facility-wide COVID-19 outbreak is also ongoing at the Manitouwadge Hospital.
There are no active influenza outbreaks in the district.
The Thunder Bay District Health Unit reports that emergency department visits because of respiratory-related complaints have decreased and are at seasonal levels in its catchment area and the influenza A surge overall has subsided with the peak in cases and hospitalizations having taken place in November of 2022.
COVID-19 does continue to circulate with 104 new lab-confirmed cases in the last seven days.
Hospitalization numbers are stable with 23 people in the hospital with COVID in the district, including three in intensive care units.
The health unit continues to stress the importance of precautions like getting the annual flu vaccine and latest COVID booster as well as wearing a face mask, particularly indoors and crowded places. Also, stay home when sick.
WHO advisers to consider whether obesity medication should be added to Essential Medicines List
Advisers to the World Health Organization will consider next month whether to add liraglutide, the active ingredient in certain diabetes and obesity medications, to its list of essential medicines.
The list, which is updated every two years, includes medicines “that satisfy the priority health needs of the population,” WHO says. “They are intended to be available within the context of function health systems at all times, in adequate amounts in the appropriate dosage forms, of assured quality and at prices that individuals and the community can afford.”
The list is “a guide for the development and updating of national and institutional essential medicine lists to support the procurement and supply of medicines in the public sector, medicines reimbursement schemes, medicine donations, and local medicine production.”
The WHO Expert Committee on the Selection and Use of Essential Medicines is scheduled to meet April 24-28 to discuss revisions and updates involving dozens of medications. The request to add GLP-1 receptor agonists such as liraglutide came from four researchers at US institutions including Yale University and Brigham and Women’s Hospital.
These drugs mimic the effects of an appetite-regulating hormone, GLP-1, and stimulate the release of insulin. This helps lower blood sugar and slows the passage of food through the gut. Liraglutide was developed to treat diabetes but approved in the US as a weight-loss treatment in 2014; its more potent cousin, semaglutide, has been approved for diabetes since 2017 and as an obesity treatment in 2021.
The latter use has become well-known thanks to promotions from celebrities and on social media. It’s sold under the name Ozempic for diabetes and Wegovy for weight loss. Studies suggest that semaglutide may help people lose an average of 10% to 15% of their starting weight – significantly more than with other medications. But because of this high demand, some versions of the medication have been in shortage in the US since the middle of last year.
The US patent on liraglutide is set to expire this year, and drugmaker Novo Nordisk says generic versions could be available in June 2024.
The company has not been involved in the application to WHO, it said in a statement, but “we welcome the WHO review and look forward to the readout and decision.”
“At present, there are no medications included in the [Essential Medicines List] that specifically target weight loss for the global burden of obesity,” the researchers wrote in their request to WHO. “At this time, the EML includes mineral supplements for nutritional deficiencies yet it is also described that most of the population live in ‘countries where overweight and obesity kills more people than underweight.’ “
WHO’s advisers will make recommendations on which drugs should be included in this year’s list, expected to come in September.
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“This particular drug has a certain history, but the use of it probably has not been long enough to be able to see it on the Essential Medicines List,” Dr. Francesco Blanca, WHO director for nutrition and food safety, said at a briefing Wednesday. “There’s also issues related to the cost of the treatment. At the same time, WHO is looking at the use of drugs to reduce weight excess in the context of a systematic review for guidelines for children and adolescents. So we believe that it is a work in progress, but we’ll see what the Essential Medicines List committee is going to conclude.”
Some pediatric surgeries may be postponed as pediatric ICU faces strain: Shared Health
Re-emerging levels of respiratory illness have caused increased patient numbers at the HSC Children’s pediatric intensive care unit over the last week, and some non-urgent procedures may be postponed, Shared Health says.
On Thursday morning, there were 17 pediatric patients in the intensive care unit, and a considerable number of which were already experiencing health issues that were aggravated by respiratory illness. The unit’s normal baseline is nine, Shared Health said in a Thursday media release.
The release said patient volumes at the children’s emergency department are stable but more children with flu-like symptoms have been recorded coming in over the last two weeks, going from a low of 22 in mid-March to 47 on Wednesday.
A variety of respiratory illnesses are spreading through the community and have contributed to the increased level of patients in the pediatric intensive care unit, according to Shared Health.
Meanwhile, the number of patients in the neonatal intensive care unit was at 51 on Thursday morning, which is slightly above the unit’s normal baseline capacity of 50.
Ten staff are being temporarily reassigned to the pediatric intensive care unit to deal with the increased level of patients, the release said.
Some staff are being pulled from the pediatric surgical and recovery units, which means non-urgent procedures may be postponed due to the reassignments, Shared Health said.
Families of patients impacted by the postponements will be contacted, they said, and all urgent and life-threatening surgeries will go unhindered.
Families can protect their children from respiratory illnesses by limiting their contact with people exhibiting cold-like symptoms, washing their hands frequently and staying up to date on vaccinations, Shared Health said.
Patient volumes increased last month
While overall wait times at emergency and urgent care centres were stable in February, Shared Health said daily patient volumes in the province went up.
The daily average of patients seeking care was 750 last month, which is an increase from 730.4 in January, according to a separate Thursday news release.
The average length of stay for patients in emergency or urgent care units to be transferred to an inpatient unit went down to 21.77 hours last month, which is an improvement from 22.5 hours in January, the release said.
The overall number of people who left without being seen went down last month, from 13 per cent in January to 12.1 per cent in February, according to Shared Health. It also decreased at the HSC emergency department, from 25 per cent in January to 23.4 per cent last month.
Shared Health is reminding Manitobans to continue to call 911 in case of an emergency, and said the sickest and most injured patients will remain their priority.
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