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Quebec to allow 90-day delay before second vaccine doses, more than double what national panel advises – CTV Montreal

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QUEBEC CITY —
Quebec public health officials said Thursday that provincial advisors have recommended a prolonged COVID-19 vaccination schedule of up to 90 days between the first and second dose — more than double what a national advisory committee recommended a day earlier.

“In our context, that is the best strategy,” said Health Minister Christian Dubé at a Thursday press conference on Quebec’s vaccination progress.

Quebec announced in late December it would be delaying second doses or “booster shots” of the vaccine, but the province hasn’t said until Thursday what kind of delay it had in mind.

Provincial officials now say the second dose should come between 42 and 90 days after the first.

Such a schedule would allow the province to give the vaccine to more people who would otherwise have to wait for their first dose, said the health officials.

A delay of 90 days is much longer than what’s been recommended by Pfizer (21 days, for its vaccine), Moderna (28 days, for its vaccine), and federal public health advisors in their recommendation on Wednesday (up to 42 days for both vaccines).

However, that national advisory panel, called NACI, said Thursday that provinces have some leeway to make their own decisions and they aren’t opposing Quebec’s 90-day timeline.

Canada’s Deputy Chief Public Health Officer, Dr. Howard Njoo, said that certain provinces’ “exceptional circumstances” may mean they need to depart from federal recommendations.

“It is sort of the interplay between the actual epidemiology, on the ground, the fact that there is a obviously increased rate of cases, hospitalizations,” said Njoo, and the vaccine guidelines.

EXTENSION BASED ON ‘EXPERIENCE,’ NOT DATA, SAYS QUEBEC

So why is the province talking about 90 days?

Health Ministry advisor Dr. Richard Massé said Quebec experts believe it’s likely that immunity will last longer than 42 days, as recommended by the NACI panel, but clinical trials have not extended past that.

What they’re relying on instead is past experience with other vaccines.

“What we have is the experience working with many vaccines,” said Massé. “Immunity is not something that is ‘on’ or ‘off.’”

While Quebec’s Ministry of Health has said that a single dose can provide up to about 90 per cent efficacy against the virus, Pfizer says that one dose alone is just 52.4 per cent effective.

Massé told reporters the discrepancy comes from different and more specific analysis of Pfizer’s trial data.

He said that Pfizer, when studying the issue, had been including people who had gotten their first dose but hadn’t had time to build up immunity.

“It takes 12 to 14 days to have immunity,” said Massé. “If you count people who get the disease two, three, five days after getting the vaccine, it’s not really a failure of vaccination because immunity [hasn’t been built up].”

One expert told CTV News this week that there are big variations in the efficacy estimates because of the small sample size of people who got only the first shot in the Pfizer trial. That expert, Dr. Donald Vinh, said that in his opinion the efficacy is likely somewhere in the range of 60 to 69 per cent.

In a statement to CTV News, Pfizer Canada spokeperson Christina Antoniou reiterated earlier statements that Pfizer has not evaluated the efficacy of its vaccine on alternative dosing schedules.

“There are no data to demonstrate that protection after the first dose is sustained after 21 days,” she said.

“We recognize that recommendations on alternative dosing intervals reside with health authorities and may include adapting public health recommendations in reaction to evolving circumstances during a pandemic,” she wrote.

But for Pfizer, “as a biopharmaceutical company working in a highly regulated industry, our position is supported by the label and indication agreed upon with Health Canada and informed by data from our Phase 3 study.”

Minister Dubé said the province has been talking to Pfizer. On Jan. 5, Pfizer told CTV News that Quebec had not informed the company before deciding to delay the second dose.

“We’ve had conversations with Pfizer,” said Dube, “to inform them as to why we were making those decisions.”

Earlier this week, Premier François Legault said that in discussions with the federal government, the province learned there may be a risk of losing Quebec’s vaccine supply if Pfizer isn’t happy with its dosing regime.

On Thursday, Pfizer’s statement said the company “remain[s] committed to our ongoing dialogue with regulators, health authorities and governments, and to our continued data-sharing efforts to help inform any public health decisions aimed at defeating this devastating pandemic.”

Both Massé and Dubé said they are hoping for an increased supply, since they would favour a shorter delay before the second dose if the province’s deliveries of vaccine increase.

“Saving lives is a moral imperative,” said Dubé.

“The more doses we have, the more we’re going to be able to decrease the time between the first and second dose.”

NEXT STEPS FOR QUEBEC’S VACCINATION

With about 65 per cent of CHSLD residents already given a first dose, Dubé said Quebec will begin vaccinating residents of private seniors’ homes (RPAs) on Jan. 25.

He said that with a prolonged schedule between the first and second doses, the province can also consider vaccinating the general senior population sooner.

With new vaccine shipments arriving in the province this week, Dubé said 115,000 people have now been vaccinated.

In total, the province has received 162,000 doses so far. Dubé says Quebec is on track to increase that total to 250,000 in February.

–With files from CTV’s Kelly Greig

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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.

The Canadian Press. All rights reserved.

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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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