This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
Canadians concerned over waning immunity from COVID-19 vaccines, breakthrough infections and the need for booster shots in the general public could benefit from a dose of some important context, experts say.
Antibodies, your first line of defence against COVID-19 infection, do decline — and may even be doing so as you’re reading this — but that’s not unexpected.
While one aspect of your vaccine-induced immunity to COVID-19 is technically “waning” in the weeks and months after vaccination, that’s not necessarily a bad thing — because it’s not your immune system’s only form of protection against the virus.
“I don’t even like the term,” said University of Toronto immunologist Jennifer Gommerman. “And the reason I don’t like the term is that it implies that the immune response in its entirety is declining.”
It’s “entirely normal” for antibody levels to drop initially after vaccination and your immune response to the virus to become “contracted” over time, she said. But your body is also creating “highly efficient” memory B cells to fight off COVID-19 long term.
B cells work quickly to generate large quantities of antibodies in the weeks after vaccination, but they typically produce more effective antibodies as time goes on, helping sharpen the long-term response to a virus.
So while reports of waning immunity may sound concerning, that initial decrease in antibody levels may also be necessary in the fight against COVID-19, as it helps fine-tune the immune system’s plan of attack.
A new study published in the journal Science found “robust cellular immune memory” from B cells for at least six months after mRNA vaccination against all circulating strains of the virus — even the highly contagious delta variant.
The researchers found those memory cells, unlike the initial wave of antibodies, continue to learn how to fend off the virus months after vaccination and are actually getting better at it over time.
“That doesn’t sound like ‘waning’ to me,” Gommerman said. “There’s a natural contraction, but waning implies that something bad is happening.”
While reports of waning immunity may sound concerning, the initial decrease in antibody levels may also be necessary in the fight against COVID-19, as it helps fine-tune the immune system’s plan of attack against the virus. (John Woods/The Canadian Press)
Breakthrough infections don’t tell the whole story
Reports of waning immunity and breakthrough infections have sporadically emerged across Canada in places like the Northwest Territories and New Brunswick, but lack important context and data on who is seriously affected and why.
The N.W.T. has been in the midst of a COVID-19 outbreak since mid-August that started in the Sahtu region before spreading to Yellowknife and its surrounding communities. It has infected 1,584 residents.
During that time, there have been 54 hospitalizations attributed to the outbreak, about 17 of which were among fully vaccinated people. A government spokesperson declined to comment on how many of the nine deaths in the territory were among those fully vaccinated.
WATCH | Concerns over waning immunity leads to expansion of boosters in N.W.T.:
N.W.T. expands COVID-19 boosters over concerns about waning immunity
5 days ago
Northwest Territories Chief Public Health Officer Dr. Kami Kandola talks about the impact of the fourth wave and why the territory is offering COVID-19 booster shots to residents as young as 50. 2:58
“New Brunswick has not identified confirmed evidence of waning immunity among COVID-19 cases,” a government spokesperson said in a statement.
In terms of national numbers, 94.7 per cent of all COVID-19 cases in Canada since Dec. 14 have been among those not fully vaccinated, as well as 95.8 per cent of hospitalizations and 94.3 per cent of deaths, according to the Public Health Agency of Canada (PHAC).
That means a total of 520 fully vaccinated Canadians have died of COVID-19 in the nearly 10 months since our vaccine rollout started, compared with 8,520 who were not considered fully vaccinated during that same time period.
“If we have 100 per cent or 95 per cent of the population vaccinated, almost all the cases that we see, including severe cases, will be in vaccinated people — just because most everyone’s vaccinated,” said Dr. Lynora Saxinger, an infectious diseases physician and associate professor at the University of Alberta.
“So that very rare outcome becomes the majority of the outcomes, and seeing an increasing number of cases in vaccinated people over time doesn’t actually mean that the vaccine works less well, necessarily.”
A nurse tends to a patient in the intensive care unit at Scarborough Health Network’s Centenary Hospital in Toronto on Apr. 8. A total of 520 fully vaccinated Canadians have died of COVID-19 in the nearly 10 months since our vaccine rollout started, compared with 8,520 who were not considered fully vaccinated. (Evan Mitsui/CBC)
Underlying conditions key to breakthrough infections
PHAC says fully vaccinated Canadians who do get COVID-19 are also 79 per cent less likely to be hospitalized and 64 per cent less likely to die, backing up new Canadian data showing strong vaccine protection from infection, hospitalization and death.
But key information on the age, underlying health conditions or specific vaccine combination administered to those who were hospitalized or died from COVID-19 two weeks after their second shot is not available in Canada due to health privacy laws.
Older, frailer Canadians living with comorbidities in congregate settings, such as long-term care facilities, are at increased risk of breakthrough infections because their antibody levels drop “much faster” than in the general population, said Gommerman.
A recent preprint study from the Toronto-based Lunenfeld-Tanenbaum Research Institute at Sinai Health analyzed 119 Ontario long-term care residents and 78 staff over four months, finding much lower levels of neutralizing antibodies in the elderly patients.
Gommerman also stresses there’s an important difference between infections and disease.
“We expect people to get infected — even healthy people to get infected — as antibody levels decline, because the only thing that can protect you against a breakthrough infection are antibodies,” she said.
“But we have to think about who we’re looking at, and what underlying comorbidities might be there in people who experienced breakthrough disease.”
Other immunocompromised groups, such as transplant patients, have shown declining protection from COVID-19 vaccines, as evidenced in the New England Journal of Medicine from researchers at the University Health Network (UHN) in Toronto.
WATCH | NACI recommends COVID-19 booster shots for long-term care residents:
NACI recommends COVID-19 booster shots for seniors in long-term care
24 days ago
Amid a global debate over COVID-19 vaccine boosters, the National Advisory Committee on Immunization is recommending third doses for Canada’s most vulnerable, especially seniors in long-term care homes. 1:58
“If you are a healthy person and you’ve been fully vaccinated, you don’t need to worry about getting severe COVID-19,” Gommerman said.
“If you are worried about getting infected with SARS-CoV-2, you should worry because you have people around you who are not vaccinated or who are under-immune.”
Boosters for general population ‘premature’ in Canada
New data from researchers at the Institute for Clinical Evaluative Sciences (ICES) in Toronto, which has not yet been peer-reviewed, found fully vaccinated people over 16 in Ontario were highly protected against both infection and severe COVID-19 after eight months.
ICES’s vaccine estimates, which have not yet been published, show that protection against symptomatic infection does drop — from 94 per cent to 81 per cent — but protection against severe outcomes remained high, at more than 90 per cent.
“The main takeaway is that we don’t need to do boosters at this time for the general population. We can hold off and wait and see — and when we start seeing the waning, then that’s when we should use the boosters,” said Dr. Jeff Kwong, an epidemiologist and senior scientist at ICES.
“It would be premature to do it at this time and not in our best interest, because we’re allowing other variants to emerge potentially if we let the pandemic spread uncontrolled in other parts of the world [where] they’re not vaccinated.”
WATCH | PHAC reviewing data supporting COVID booster shots in Canada:
Public Health officials say they are reviewing the data supporting COVID booster shots
8 days ago
Chief Public Health Officer Dr. Theresa Tam says Canada’s Public Health Agency is reviewing the data supporting third doses of a COVID vaccine and will issue recommendations soon. 1:23
Saxinger said the vast majority of Canadians who get severely ill or hospitalized after full vaccination are the very elderly, the immunocompromised, transplant patients and people with certain types of cancers.
“That group of people, of course, they should get a third dose,” she said. “But even with a third dose, they still are going to remain vulnerable as long as we have circulating virus in the community.”
OTTAWA – Statistics Canada says wholesale sales, excluding petroleum, petroleum products, and other hydrocarbons and excluding oilseed and grain, rose 0.4 per cent to $82.7 billion in July.
The increase came as sales in the miscellaneous subsector gained three per cent to reach $10.5 billion in July, helped by strength in the agriculture supplies industry group, which rose 9.2 per cent.
The food, beverage and tobacco subsector added 1.7 per cent to total $15 billion in July.
The personal and household goods subsector fell 2.5 per cent to $12.1 billion.
In volume terms, overall wholesale sales rose 0.5 per cent in July.
Statistics Canada started including oilseed and grain as well as the petroleum and petroleum products subsector as part of wholesale trade last year, but is excluding the data from monthly analysis until there is enough historical data.
This report by The Canadian Press was first published Sept. 13, 2024.
MIAMI GARDENS, Fla. (AP) — Miami Dolphins quarterback Tua Tagovailoa sustained a concussion for the third time in his NFL career, leaving his team’s game Thursday night against Buffalo after running into defensive back Damar Hamlin and hitting the back of his head against the turf.
Tagovailoa remained down for about two minutes before getting to his feet and walking to the sideline after the play in the third quarter. He made his way to the tunnel not long afterward, looking into the stands before smiling and departing toward the locker room.
The Dolphins needed almost no time before announcing it was a concussion. The team said he had two during the 2022 season, and Tagovailoa was diagnosed with another concussion when he was a college player at Alabama.
Dolphins coach Mike McDaniel said Tagovailoa would get “proper procedural evaluation” and “appropriate care” on Friday.
“The furthest thing from my mind is, ‘What is the timeline?’ We just need to evaluate and just worry about my teammate, like the rest of the guys are,” McDaniel said. “We’ll get more information tomorrow and take it day by day from here.”
Some players saw Tagovailoa in the locker room after the game and said they were encouraged. Tagovailoa spoke with some players and then went home after the game, McDaniel said.
“I have a lot of love for Tua, built a great relationship with him,” said quarterback Skylar Thompson, who replaced Tagovailoa after the injury. “You care about the person more than the player and everybody in the organization would say the same thing. Just really praying for Tua and hopefully everything will come out all right.”
Tagovailoa signed a four-year, $212 million extension before this season — a deal that makes him one of the highest-paid players in the NFL — and was the NFL’s leading passer in Week 1 this season. Tagovailoa left with the Dolphins trailing 31-10, and that was the final score.
“If you know Tua outside of football, you can’t help but feel for him,” Bills quarterback Josh Allen said on Amazon following the game. “He’s a great football player but he’s an even greater human being. He’s one of the best humans on the planet. I’ve got a lot of love for him and I’m just praying for him and his family, hoping everything’s OK. But it’s tough, man. This game of football that we play, it’s got its highs and it’s got its lows — and this is one of the lows.”
Tagovailoa’s college years and first three NFL seasons were marred by injury, though he positioned himself for a big pay bump with an injury-free and productive 2023 as he led the Dolphins into the playoffs. He threw for 29 touchdowns and a league-best 4,624 yards last year.
When, or if, he can come back this season is anyone’s guess. Tagovailoa said in April 2023 that the concussions he had in the 2022 season left him contemplating his playing future. “I think I considered it for a time,” he said then, when asked if he considered stepping away from the game to protect himself.
McDaniel said it’s not his place to say if Tagovailoa should return to football. “He’ll be evaluated and we’ll have conversations and progress as appropriate,” McDaniel said.
Tagovailoa was hurt Thursday on a fourth-down keeper with about 4:30 left in the third. He went straight ahead into Hamlin and did not slide, leading with his right shoulder instead.
Hamlin was the player who suffered a cardiac arrest after making a tackle during a Monday night game in January 2023 at Cincinnati, causing the NFL to suspend a pivotal game that quickly lost significance in the aftermath of a scary scene that unfolded in front of a national television audience.
Tagovailoa wound up on his back, both his hands in the air and Bills players immediately pointed at him as if to suggest there was an injury. Dolphins center Aaron Brewer quickly did the same, waving to the sideline.
Tagovailoa appeared to be making a fist with his right hand as he lay on the ground. It was movement consistent with something that is referred to as the “fencing response,” which can be common after a traumatic brain injury.
Tagovailoa eventually got to his feet. McDaniel grabbed the side of his quarterback’s head and gave him a kiss on the cheek as Tagovailoa departed. Thompson came into the game to take Tagovailoa’s spot.
“I love Tua on and off the football field,” Bills edge Von Miller said. “I’m a huge fan of him. I can empathize and sympathize with him because I’ve been there. I wish him the best.”
Tagovailoa’s history with concussions — and how he has since worked to avoid them — is a huge part of the story of his career, and now comes to the forefront once again.
He had at least two concussions during the 2022 season. He was hurt in a Week 3 game against Buffalo and cleared concussion protocol, though he appeared disoriented on that play but returned to the game.
The NFL later changed its concussion protocol to mandate that if a player shows possible concussion symptoms — including a lack of balance or stability — he must sit out the rest of the game.
Less than a week later, in a Thursday night game at Cincinnati, Tagovailoa was concussed on a scary hit that briefly knocked him unconscious and led to him being taken off the field on a stretcher.
His second known concussion of that season came in a December game against Green Bay, and he didn’t play for the rest of the 2022 season. After that, Tagovailoa began studying ways where he may be able to fall more safely and protect himself against further injury — including studying jiu-jitsu.
“I’m not worried about anything that’s out of my hands,” McDaniel said. “I’m just worried about the human being.”
TORSBY, Sweden (AP) — David Beckham and former England coach Roy Hodgson were among the soccer dignitaries who attended the funeral of Sven-Goran Eriksson on Friday in the Swedish manager’s small hometown of Torsby.
Eriksson’s wooden coffin was covered in white flowers and surrounded by six tall candles and other floral wreaths as the ceremony began inside the 600-seat Fryksande church.
“It is a day of grief but also a day of thankfulness,” the priest, Ingela Älvskog, told those in attendance.
Beckham, who arrived by private jet on Thursday, greeted Eriksson’s 95-year-old father Sven and other family members with hugs inside the church before the funeral started.
Eriksson became England’s first foreign-born coach when he led the national team from 2001-06, and made Beckham his captain.
Eriksson, who also won trophies at club level in Italy, Portugal and Sweden, died on Aug. 26 at the age of 76, eight months after he revealed he had been diagnosed with pancreatic cancer and had at most one year to live.
Some 200 seats in the neo-Gothic church from 1898 were reserved for his family, friends and players from his career in the football world, according to his agent. The remaining seats were open for the public, according to Eriksson’s wish, with a big screen set up outside the church where hundreds more gathered to watch the ceremony. The funeral was also broadcast live on some Swedish media websites.
The wooden coffin was wheeled in by pallbearers at the church Friday morning as fog wrapped Torsby — a town of about 4,000 people located about 310 kilometers (193 miles) west of Stockholm. Next to the casket was a photo of Eriksson on a small table. The floral wreaths included ones sent by FIFA and Lazio, the Italian team that Eriksson led to the Serie A title in 2000.
The ceremony began with somber piano and organ music, but later took on a more upbeat note with Swedish singer Charlotta Birgersson performing Elton John’s song “Candle In The Wind” and then “My Way” in a duet with Johan Birgersson, who later intoned the popular Italian song “Volare” after the family had gathered around the casket to lay flowers.
Beckham also visited Eriksson in Sweden in June to say goodbye. Others attending the funeral included the Swedish coach’s longtime partner Nancy Dell’Olio. Eriksson’s agent had said that guests from England, Italy and Spain were expected.
After the funeral, the casket was carried out of the church by eight men to the hearse. The guests then walked in a procession accompanying the coffin to a nearby museum where speeches and eulogies to the coach fondly known as “Svennis” were planned on an outdoor stage. A brass band played during the procession through Torsby, including the tune “You never walk alone” from the musical “Carousel” which has become the anthem of Liverpool, the club Eriksson supported since childhood.
The local soccer club Torsby IF, where Eriksson started his career in the 1960s, wrote on its webpage that “you also showed your greatness by always being yourself, the caring Svennis who talked to everyone and took the time, for big and small, asking how things were and how the football was going. We will miss you.”
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