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.
Despite a growing push to roll out COVID-19 vaccine boosters more widely in Canada, epidemiologists say there is currently no evidence of an urgent need for additional shots in the general population — due to the strong, ongoing protection two doses already provide.
But with the emergence of the potentially more infectious omicron variant, the holidays rapidly approaching and COVID-19 levels remaining elevated in much of the country, should Canada wait for more proof of waning immunity before expanding eligibility of boosters?
Or should we move quickly to offer up additional shots to fend off another potential surge as the U.S., the U.K. and Israel have done?
But the current case for rolling out third shots to most Canadians while much of the world remains unvaccinated and new variants continue to emerge seems weak at best.
“There is currently no evidence of widespread decreasing protection over time against severe disease in the general Canadian population who have been vaccinated,” a spokesperson for the National Advisory Committee on Immunization (NACI) told CBC News.
“NACI continues to actively review available evidence from Canada and other countries, and if needed, will update advice on booster doses as a preventive measure.”
The current case for rolling out third shots to most Canadians while much of the world remains unvaccinated and new variants continue to emerge seems weak at best. (Ben Nelms/CBC)
‘Don’t want to wait until it’s too late’
Experts are divided over the need to expand access to additional shots to more Canadians — or even to everyone over 18 — and the emergence of the omicron variant will likely only heat up the debate further until we know more about it.
“I understand that mounting pressure to give more and more doses,” said Dr. Danuta Skowronski, epidemiology lead at the British Columbia Centre for Disease Control, whose research prompted Canada’s decision to delay second doses of COVID-19 vaccines.
“But I cannot say based on the current evidence that there is a clear and present danger or need or indication for an additional dose for the general population of adults at this time.”
Skowronski said the latest data from B.C. and Quebec, released jointly as a recent preprint study that has yet to be peer reviewed, suggested mRNA vaccines were close to 95 per cent protective against hospitalization and over 80 per cent against any infection.
“Should we be attempting a preemptive strike to fend off a possible surge? Well, that kind of attitude is a slippery slope,” she said.
Rolling out boosters more widely is a “massive population-wide undertaking” that could set a bad precedent for future shots.
“We should only really make decisions ahead of the evidence if there is an urgent need to do so — otherwise we should be cautious in jumping the gun … and on what basis then do we make decisions about whether a fourth, or a fifth, or a sixth dose?”
WATCH | Growng push for Ontario to expand COVID-19 booster shot eligibility:
Calls mount for Ontario to expand COVID-19 booster shot eligibility
6 days ago
There are growing calls for Ontario to expand the eligibility for COVID-19 booster shots to include more people who are immunocompromised. It comes as Sen. Josée Forest-Niesing, who had an autoimmune disease, died shortly after being hospitalized with COVID-19 despite being fully vaccinated. 2:00
New data from Public Health Ontario shows just nine fully vaccinated people under the age of 60 have been admitted to ICU since the vaccine rollout began.
Researchers at the Institute for Clinical Evaluative Sciences (ICES) in Toronto also found most fully vaccinated people in Ontario were still highly protected against both infection and severe COVID-19 eight months after their second dose.
ICES’s vaccine estimates showed that while protection against symptoms dropped to just over 80 per cent — and to more than 70 per cent when including asymptomatic infections — prevention of hospitalizations remained high at more than 90 per cent.
“So the question is, at eight months, is a vaccine effectiveness of 70-something per cent good enough? Or is that going to open the door to disaster?” said Dr. Jeff Kwong, an epidemiologist and senior scientist at ICES.
“We’re kind of in this precarious spot where we’re probably going to need boosters at some point, but whether we need them now is debatable — but you don’t want to wait until it’s too late.”
Canada is sitting on a massive stockpile of vaccines compared to other countries — with close to six million in the national inventory according to PHAC — while over one million doses have reportedly already gone to waste since our rollout began. (Aaron Favila/The Associated Press)
Millions of unused vaccine doses sitting in freezers
Canada is also sitting on a massive stockpile of vaccines compared to other countries — with close to six million in the national inventory according to PHAC — while over one million doses have reportedly already gone to waste since the rollout began.
“Right now, we should be offering boosters to everybody five months out of the second dose,” said Raywat Deonandan, a global health epidemiologist and associate professor at the University of Ottawa.
“There are millions going unused, and we’re at the point where we’re struggling to get that last 20 per cent of people to even accept their first dose. So for the rest of us that have two doses, let’s maximize our immunity.”
Dr. Isaac Bogoch, an infectious diseases physician and member of Ontario’s COVID-19 vaccine task force, says it’s “well past time” to expand booster eligibility to Canadians over the age of 50 who are six months out from their second shot at the very least.
“It’s pretty fair to say that there is some degree of waning immunity against getting the infection, but most of the data we’ve seen demonstrates that two doses still provide significant protection against severe disease,” he said.
“But there is still value in reducing infection as well — it really can reduce amplification of the virus in the community, and you certainly can prevent some severe disease especially in the older cohort.”
Dr. Isaac Bogoch says it’s ‘well past time’ to expand booster eligibility to Canadians over the age of 50 who are six months out from their second shot at the very least. (Alberta Health Services)
The push for expanding boosters in Canada comes despite the World Health Organization‘s plea to wealthier countries to hit pause on widespread booster shots until at least 2022 in favour of vaccinating more of the unvaccinated world.
The omicron variant emerged in southern Africa, which has some of the lowest vaccination rates globally, highlighting a dire need for more doses on the continent.
But Bogoch says the two approaches don’t need to be mutually exclusive.
“We can align with the WHO’s request for a moratorium on population-level booster vaccines until 2022 but also simultaneously use the vaccines that we have and act in a data-driven manner by providing third doses to the 50-plus crowd,” he said.
“It was time to do this several weeks ago — if not a month or two ago — because we are headed into fall and winter months, and we know cases are going to predictably rise at this time of year.”
Boosters won’t prevent global threat of variants
Canada’s COVID-19 reproductive rate has been sitting precariously close to one for months, meaning a surge in cases due to an increase in indoor gatherings during colder weather could lead to exponential growth.
“We are all at the cusp of either growth or the decline in cases — we’re just there,” said Dr. Leyla Asadi, an infectious diseases physician at the University of Alberta in Edmonton.
“And we are kidding ourselves if we think that there isn’t going to be a significant increase in contacts over the holidays. Of course, there will be, and of course, this will mostly be inside because we are living in Canada in the winter.”
Despite the increased risk during the next few months, experts say the emergence of a new variant of concern also further highlights the need to vaccinate people in lower-income countries who have had much less access to vaccines.
“Why do we have a stockpile of vaccines when much of the world does not have access to a first dose?” said Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton and an associate professor at McMaster University.
“The reality of the situation is Canada doesn’t make vaccines, and so, every dose that shows up on our soil is a dose that was not on someone else’s soil.”
A baby cries as her mother receives the Pfizer-BioNTech COVID-19 vaccine in Diepsloot Township near Johannesburg on Oct. 21. (Denis Farrell/The Associated Press)
Canada has committed to donating 73 million more COVID-19 vaccines to the developing world, with four million doses sent to the WHO’s COVAX program earlier this month, but Chagla says giving low-risk Canadians another dose undermines that progress.
Alyson Kelvin, an assistant professor at Dalhousie University in Halifax and a virologist at the Canadian Center for Vaccinology and the Vaccine and Infectious Disease Organization in Saskatoon, says that given the global threat of variants, it would be better for Canadians to wait for a variant-specific booster.
A booster tailored to the delta, omicron or other variants that emerge in the future would likely be more useful than a third shot of a vaccine aimed at the original Wuhan strain of the coronavirus.
“We should take some of the vaccines that might come in for boosters and donate those so that we’re dividing them up more evenly and not taking everything for Canada,” she said.
“That would be a much better strategy than bringing vaccines in for boosters, when it’s not clear if it’s going to help our current pandemic situation.”
BUFFALO, N.Y. (AP) — Hearing the familiar sounds of clacking sticks and pucks banging off the boards and glass while watching Columbus Blue Jackets prospects from the stands of a cold rink on a warm late-summer afternoon was not enough to wash away the lingering residuals of grief for Don Waddell on Saturday.
That, the Blue Jackets’ general manager acknowledged, will take more time than anyone can guess — weeks, months, perhaps an entire season and beyond.
What mattered is how spending the weekend attending the Sabres Prospects Challenge represented a start to what Waddell called among the first steps in refocusing on hockey and the future in the aftermath of the deaths of Columbus star Johnny Gaudreau and his brother, Matthew, who were struck by a suspected drunken driver while riding bicycles on Aug 29.
“We got to play hockey,” Waddell said. “We’re not going to forget about Johnny and his family, the Gaudreau family.”
“Everybody knows that Johnny wants them to play hockey,” Waddell said. “And everybody’s rallying around that.”
The resumption of hockey in Columbus began last week, when most Blue Jackets players returned to their facility to be together and lean on each other at the urging of Waddell and team captain Boone Jenner. And it will continue on Thursday, when the team opens training camp, exactly three weeks since the Gaudreaus were killed.
“Tragic. Senseless. But now we got to focus on trying to get our team ready to play hockey this year,” Waddell said. “We all mourn and heal differently, but I think as a team being together like that is going to be critical for them to get moving forward.”
Waddell was general manager of the then-Atlanta Thrashers in 2003 when Dany Heatley lost control of his car and struck a wall, with the crash killing passenger and teammate Dan Snyder. In 2021, Blue Jackets goalie Matiss Kivlenieks died during a July Fourth fireworks accident.
Waddell placed the emphasis on himself and coach Dean Evason — both newcomers to Columbus this offseason — to guide the team through what will be an emotional season.
“Now, do I think there’s going to be some dark days? I won’t be surprised,” Waddell said.
Reminders of the Gaudreaus’ deaths remain apparent, and reflected in Buffalo on Friday night. A moment of silence was held in tribute to the brothers before the opening faceoff of a game between the Blue Jackets and Sabres.
Afterward, Columbus prospect Gavin Brindley recalled the times he spent with Johnny Gaudreau in Columbus and as teammates representing the United States at the world hockey championships in the Czech Republic in May.
“He was one of the biggest mentors for me at the world championships,” Brindley said. “I couldn’t tell you how many times we hung out with Meredith, pictures on my phone. It’s just so hard to look back and see that kind of stuff.”
The NHL and NHL Players’ Association are providing the Blue Jackets help in the form of grief counseling, crowd security at vigils and addressing hockey issues, such as potentially altering the league’s salary cap rules to provide Columbus relief from having to reach the NHL minimum payroll because of the void left by Gaudreau’s contract.
“The Blue Jackets, I don’t think anybody’s focused from an organizational standpoint, from a hockey standpoint as to what comes next, because I think everybody’s still in shock,” NHL Commissioner Gary Bettman told The Associated Press last week. “I don’t think anybody’s focused right now other than on the grieving part, which is understandable.”
Much of the burden has fallen to Waddell, who has been in discussions with the NHL and the NHLPA and dealing with outreach programs with the Blue Jackets’ partner OhioHealth, while also overseeing preparations for training camp and gauging his prospects in Buffalo.
There’s also his roster to attend to, which he said has two openings at forward, one involving Justin Danforth, who may miss the start of the season because of a wrist injury. Waddell didn’t have to mention the second opening.
Tiring and emotional as it’s been, Waddell found comfort being in his element, a rink, and looking ahead to the start of training camp.
“The guys are in really good shape. We’ve done a lot of testing already and they’re eager to get going,” Waddell said. “We have a reason to play for. And we’ll make the best of it.”
The Blue Jackets later Sunday signed veteran winger James van Riemsdyk to a one-year contract worth $900,000.
“James van Riemsdyk has been a very consistent, productive player throughout his career,” Waddell said. “Bringing him to Columbus will not only provide depth to our group up front, but also valuable leadership and another veteran presence in our dressing room.”
___
AP Hockey Writer Stephen Whyno in New York contributed to this report.
PARIS (AP) — Paris Saint-Germain defender Nuno Mendes was the target of abusive and racist comments on social media after a French league game.
The club condemned the abuse and expressed its “full support” Sunday for the Portugal left back, who was targeted following PSG’s 3-1 win against Brest on Saturday.
Mendes, who is Black, shared on his Instagram account a racist message he received.
During the match, Mendes brought down Ludovic Ajorque in the box for a penalty that Romain Del Castillo converted to give Brest the lead.
“Paris Saint-Germain doesn’t tolerate racism, antisemitism or any other form of discrimination,” the club said. “The racial insults directed at Nuno Mendes are totally unacceptable … we are working with the relevant authorities and associations to ensure those responsible are held accountable for their actions.”
MONTREAL – Tadej Pogacar was so dominant on Sunday, Canada’s Michael Woods called it a race for second.
Pogacar, a three-time Tour de France champion from Slovenia, pedalled to a resounding victory at the Grand Prix Cycliste de Montreal.
The UAE Team Emirates leader crossed the finish line 24 seconds ahead of Spain’s Pello Bilbao of Bahrain — Victorious to win the demanding 209.1-kilometre race on a sunny, 28 C day in Montreal. France’s Julian Alaphilippe of Soudal Quick-Step was third.
“He’s the greatest rider of all time, he’s a formidable opponent,” said Woods, who finished 45 seconds behind the leader in eighth. “If you’re not at your very, very best, then you can forget racing with him, and today was kind of representative of that.
“He’s at such a different level that if you follow him, it can be lights out.”
Pogacar slowed down before the last turn to celebrate with the crowd, high-five fans on Avenue du Parc and cruise past the finish line with his arms in the air after more than five hours on the bike.
The 25-year-old joined Belgium’s Greg Van Avermaet as the only multi-time winners in Montreal after claiming the race in 2022. He also redeemed a seventh-place finish at the Quebec City Grand Prix on Friday.
“I was disappointed, because I had such good legs that I didn’t do better than seventh,” Pogacar said. “To bounce back after seventh to victory here, it’s just an incredible feeling.”
It’s Pogacar’s latest win in a dominant year that includes victories at the Tour de France and Giro d’Italia.
Ottawa’s Woods (Israel Premier-Tech) tied a career-best in front of the home crowd in Montreal, but hoped for more after claiming a stage at the Spanish Vuelta two weeks ago.
“I wanted a better result,” the 37-year-old rider said. “My goal was a podium, but at the same time I’m happy with the performance. In bike racing, you can’t always get the result you want and I felt like I raced really well, I animated the race, I felt like I was up there.”
Pogacar completed the 17 climbs up and down Mount Royal near downtown in five hours 28 minutes 15 seconds.
He made his move with 23.3 kilometres to go, leaving the peloton in his dust as he pedalled into the lead — one he never relinquished.
Bilbao, Alaphilippe, Alex Aranburu (Movistar Team) and Bart Lemmen (Visma–Lease) chased in a group behind him, with Bilbao ultimately separating himself from the pack. But he never came close to catching Pogacar, who built a 35-second lead with one lap left to go.
“It was still a really hard race today, but the team was on point,” Pogacar said. “We did really how we planned, and the race situation was good for us. We make it hard in the last final laps, and they set me up for a (takeover) two laps to go, and it was all perfect.”
Ottawa’s Derek Gee, who placed ninth in this year’s Tour de France, finished 48th in Montreal, and called it a “hard day” in the heat.
“I think everyone knows when you see Tadej on the start line that it’s just going to be full gas,” Gee said.
Israel Premier-Tech teammate Hugo Houle of Sainte-Perpétue, Que., was 51st.
Houle said he heard Pogacar inform his teammates on the radio that he was ready to attack with two laps left in the race.
“I said then, well, clearly it’s over for me,” Houle said. “You see, cycling isn’t that complicated.”
Australia’s Michael Matthews won the Quebec City GP for a record third time on Friday, but did not finish in Montreal. The two races are the only North American events on the UCI World Tour.
Michael Leonard of Oakville, Ont., and Gil Gelders and Dries De Bondt of Belgium broke away from the peloton during the second lap. Leonard led the majority of the race before losing pace with 45 kilometres to go.
Only 89 of 169 riders from 24 teams — including the Canadian national team — completed the gruelling race that features 4,573 metres in total altitude.
Next up, the riders will head to the world championships in Zurich, Switzerland from Sept. 21 to 29.
Pogacar will try to join Eddy Merckx (1974) and Stephen Roche (1987) as the only men to win three major titles in a season — known as the Triple Crown.
“Today gave me a lot of confidence, motivation,” Pogacar said. “I think we are ready for world championships.”
This report by The Canadian Press was first published Sept. 15, 2024.
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