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The RSV vaccine: What you need to know

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Starting this fall, adults over 60 will be able to get vaccinated against the potentially deadly RSV and for the first time there’s now a tool to protect infants against RSV — an injection of monoclonal antibodies that lasts through the viral season.

RSV, which stands for respiratory syncytial virus, kills about 14,000 older adults in the United States and leads to severe disease in about 58,000 to 80,000 infants.

Unlike many other common infectious diseases, no vaccine has existed to protect against it. Until now.

Here’s what you need to know about the RSV vaccine and the new shot:

Who should get the vaccine?

The vaccine is recommended for adults over the age of 60 particularly those in communal living settings like nursing homes as well as those who have underlying health conditions, such as heart or lung disease, that put them at risk of developing severe cases of the virus. The official CDC recommendations advise doctors to discuss which their patients whether the vaccine is right for them.

How does the shot for infants work?

Nirsevimab, known as Beyfortus, contains monoclonal antibodies that protect against the virus for five months, according to the Centers for Disease Control and Prevention.

The shot is recommended for infants younger than eight months as well as children between 8 and 19 months old who are at risk of developing severe disease should they fall ill.

Dr. John Christenson, an infectious disease specialist at Riley Hospital, said the shot provides instant protection. “With this shot, you’re rock and rolling as soon as you get the shot.”

Unlike with a vaccine, where immunity can take up to two weeks to develop, nirsevimab works immediately but it cannot be used as treatment for a child who is already ill.

Ideally newborns will receive the shot before they leave the hospital just as they do the first hepatitis B shot, Christenson said.

Is this the first shot like this?

Doctors have used a similar product known as palivizumab to protect against RSV for the past 15 years or so for children younger two years old who had conditions that placed them at higher risk, such as congenital lung and neurological conditions.

Children on this therapy receive a shot every month and it is quite expensive, Christenson said, making it inefficient and not cost-effective for use in the general population.

What about a traditional vaccine for those under 60?

More than 50 years ago scientists started looking for a vaccine against RSV for children, Christenson said. They thought they were on track to find a vaccine that would work but trials showed that people who took the experimental vaccine actually developed severe RSV at a higher rate than those who had placebo.

So back to the drawing board they went. There’s hope that an effective vaccine against RSV might be on the way to protect children over the age of one as the immunity gained from nirsevimab wanes over time.

“It’s still in the works,” Christenson said of such a vaccine. “We won’t be seeing that one, at least this year.”

Another future RSV vaccine would target pregnancy. Vaccinating pregnant people would also produce antibodies in their unborn fetuses, allowing them to bring their babies into the world with protection against the virus.

 

If the shot doesn’t offer longterm protection why take it?

Infants are at the greatest risk of developing severe disease that will require hospitalization, Christenson said. Children who first get RSV when they’re over the age of one are less likely to be as seriously ill.

So the shot will target children when they have the highest risk of developing severe disease.

“You may be shifting the disease, you may be shifting the infection to an older age,” he said. “The good news is that it’s an older age, where the likelihood of them having severe cases is lower…. If you look at this monoclonal antibody, it may be a better answer to prevent RSV in infants than giving vaccine in the first year of life.”

When is RSV season typically?

Typically RSV season starts in the fall and runs through the winter. Last year, however, hospitals and doctors saw a surge in RSV in the summer that by late fall had led to crowded hospitals, a trend they attributed in part to the pandemic.

This year, so far, appears to be a more typical one, Christenson said.

Contact Shari Rudavsky at shari.rudavsky@indystar.com.

 

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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