Canadians raced to get vaccinated against COVID-19 in the first years of the pandemic, but data suggests there’s far less of a rush to get the latest shots available this fall.
Federal figures show only 15 per cent of the population aged five and up had received an updated vaccine by Dec. 3. And while older age groups had higher uptake rates, more than half of higher-risk older adults still hadn’t gotten a dose by early December, either.
The shots, tailored to the XBB.1.5 Omicron subvariant, are meant to shore up protection against the SARS-CoV-2 descendants currently circulating.
Medical experts say seniors and other higher-risk individuals could leave themselves more vulnerable to serious illness if they skip these updated shots. Less than a third of Canadians in their 60s have had the newest vaccine, along with roughly 44 per cent of people in their 70s, and 48 per cent of those aged 80 and older.
Pandemic fatigue, muddled messaging and complex vaccination timelines might be dissuading Canadians from getting another round of vaccines, experts note.
“Why that gap exists is both an interesting and difficult question,” said Dr. Allison McGeer, an infectious diseases specialist with Sinai Health in Toronto. “I think it’s because people just aren’t getting the message about how much of a risk COVID is.”
Virus still circulating widely
Data shows SARS-CoV-2 is still circulating at high levels across much of Canada, sending hundreds of people into hospital with COVID every week. Weekly rates of hospitalizations and intensive care admissions remain highest among the oldest age groups.
The immune systems of various higher-risk groups — including seniors, pregnant women and people with other serious health issues — can be weaker than those of most healthy adults, increasing their risk of serious illness of any kind.
At the same time, a growing body of evidence suggests that immunity against this ever-evolving virus fades over time, leaving people susceptible to repeat infections.
Just this week, the World Health Organization (WHO) announced yet another variant of interest known as JN.1, an Omicron offshoot that’s rapidly spreading around the world. (WHO officials said the latest batch of vaccines are expected to maintain protection against serious illness and death from this variant as well.)
That’s why updated shots can make a difference, according to Canada’s chief public health officer, Dr. Theresa Tam.
Canada’s Chief Public Health Officer Dr. Theresa Tam speaks at a news conference in Ottawa in November 2020, during the first year of the COVID-19 pandemic. (Adrian Wyld/Canadian Press)
Tam told CBC News there’s “room for improvement” when it comes to vaccine uptake among older Canadians. “That’s the group, of course, that has the highest risk of severe outcomes,” she added.
Close to a third of the country’s older population doesn’t appear to have been infected with this virus yet either, Tam noted.
“They’ve been protecting themselves. They’ve been getting vaccinated,” she added. “But the vaccine base protection can wane over time… even protection against severe outcomes wanes over time.”
That message doesn’t seem to be reaching the public, warned McMaster University immunologist and researcher Dawn Bowdish.
Many Canadians think there’s a “magic number” of vaccine doses that will protect them long-term from COVID, but that’s incorrect, Bowdish said.
While the overall risks of SARS-CoV-2 infections may be lower now than during the early days of the pandemic, fresh shots are necessary while this virus is still “rapidly adapting.”
COVID shots don’t act like many of our childhood vaccines, she explained, since this type of virus operates in a specific way: Much like older coronaviruses known for causing the common cold, SARS-CoV-2 has a “remarkable capacity to cause repeat infections” by evolving to better dodge the frontline defences of the human immune system.
That means vulnerable individuals should treat the latest COVID vaccines like annual flu shots — not boosters — to ensure their immune system is primed to tackle new variants and avoid serious illness and lingering, life-altering health impacts, she said.
“We know that having COVID increases risks of heart attacks and other complications, especially in older adults,” Bowdish added.
“And importantly, if an older adult is hospitalized, it is very rare for them to leave the hospital and have the same level of function as they did before they went in.”
What seniors need to know about vaccines this fall
Four key vaccines are available for seniors this fall, including an updated COVID-19 shot and Canada’s first vaccine for RSV. CBC health reporter Lauren Pelley breaks down what seniors — and those who care for them — need to know.
Public, policymakers face ‘COVID fatigue’
While the vaccine guidance for higher-risk groups is fairly straightforward, McGeer, in Toronto, said younger adults in their 20s and 30s may have more to consider as they weigh the risks and benefits.
The mRNA-based vaccines from Pfizer and Moderna have been linked to higher reactogenicity — referring to expected post-vaccination reactions caused by someone’s immune response, such as a fever or a sore arm — which can discourage some people from getting another shot, McGeer said.
Novavax’s protein-based, non-mRNA vaccine is now approved as well, and doses have been delivered to the Public Health Agency of Canada for distribution to the provinces, but McGeer said it likely won’t be as widely available, making it harder to access for many Canadians who want a more traditional option.
People are also trying to navigate complex vaccination advice on how to time their next shots, she added. Guidance suggests waiting six months or so after your last vaccination or infection before getting another dose, which can complicate efforts to roll out seasonal immunization campaigns, since Canadians are operating on various schedules based on when they were last exposed to the virus.
Then there’s the simple fact that so many people are tired of getting shot after shot, four years into the COVID pandemic.
“I think everyone has a little bit of COVID fatigue, including our policymakers,” said Bowdish. “And so we haven’t been as aggressive.”
People receive a dose of the COVID-19 vaccine at a mass vaccination clinic in Toronto in June 2021. Vaccination rates have dropped steeply since the early years of the pandemic. (Cole Burston/The Canadian Press)
COVID’s long-term trajectory still an ‘open question’
The medical experts who spoke to CBC News also didn’t paint a clear picture of what the future could hold for COVID vaccination efforts.
Tam said the door is still open for another spring vaccination push, though she noted uptake last spring was also relatively low. Bowdish, the immunologist, agreed twice-annual vaccines may be appropriate given how quickly this virus is evolving.
McGeer, however, said over the long term, as more people gain repeat exposure to this virus earlier and earlier in life, the need for COVID vaccines could start to shift. A twice-annual vaccine seems unlikely, “and I’m not sure that we’re even settling into an annual vaccine,” she said.
But the world won’t know for years, perhaps even decades, how this virus will evolve, what seasonal patterns it could settle into, and how those factors might change the risks of acute illness or lasting health impacts.
“How long that trajectory is going to take, and where it’s going to stop, [is an] open question,” McGeer said.
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.
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.
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.
