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The pros and cons of online booking portals for COVID-19 vaccines once mass immunization begins – CBC.ca

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Most provinces and territories will be using online portals to sign Canadians up for COVID-19 vaccinations as they become more widely available next month, according to a survey by CBC News.

Every province that has shared their plans will use some online sign-up, as will Yukon and the Northwest Territories. The option to book by phone will be available across Canada, and Nunavut is scheduling vaccination appointments strictly by phone.

While vaccinations started back in December 2020, what’s soon changing is the pace and distribution list — from targetted high-risk groups like seniors in long-term care, to the general population, starting with the oldest first in many jurisdictions.

“That is absolutely what we need to be doing,” said epidemiologist Kirsten Fiest, the Director of Research & Innovation in Critical Care Medicine and an assistant professor at the University of Calgary. 

“I think the efficiency piece is really the most critical.”

But, while health officials and independent experts agree online appointment booking sites will be essential to managing a mass vaccination campaign, they’ve also raised problematic questions of equity in parts of the U.S.

WATCH | Some say online vaccine portals could shut out most vulnerable:

As vaccinations ramp up in Canada, many provinces are talking about using online portals to help organize and register people for their shots. But some people worry that the Canadians who are most vulnerable and have the greatest need for the vaccine could end up getting lower priority. 2:01

Stories in the Los Angeles Times, New York Times and Washington Post have documented how online booking has prevented senior citizens, racialized individuals and poor people from getting fair access to vaccination. In some cases activists have stepped in to book shots for those who lack tech savviness, struggle with communication or cannot afford the devices, data plans or internet service.     

The problems seen south of the border concern Fiest.

“You have to worry that something similar could happen here.”  

Kirsten Fiest, an epidemiologist and assistant professor at the University of Calgary beliieves online portals to sign up for COVID-19 vaccination will be an essential part of the mass immunization effort, because they’re efficient — but not without problems. (Cumming School of Medicine, University of Calgary)

 

Cross-country picture for online portals  

While neither Newfoundland and Labrador nor New Brunswick would confirm plans for online booking options, slots for coronavirus immunizations can already be reserved through web sites in PEI, and the Northwest Territories.   

Manitoba, Saskatchewan and Alberta told CBC News they intend to offer web-based sign ups, without providing a timeline.

Quebec, Ontario, and B.C all say they’ll launch online sites for booking vaccination relatively soon.  

Quebec said its site could be online before the end of the month. 

Ontario said it has successfully tested a scheduling site it developed with three American companies in January, but the province’s Ministry of Health would only say it expected to launch it “in the coming weeks.”   

B.C. said its booking site will be launched to the public in March, and has released sample images of the COVID-19 immunization record card citizens will receive.  

British Columbia says it will have an online portal open in March for COVID-19 vaccinations for the general population. People will have the option to receive a paper record of their vaccination, like the one above, and a digital record. (Government of B.C.)

Online booking portals currently running in Yukon and Nova Scotia were built by CANImmunize, the Ottawa based tech firm co-founded by Dr. Kumanan Wilson, an internal medicine physician and senior scientist at Ottawa Hospital.

CANImmunize started out as an app for tracking vaccine records a decade ago, and was supported by the Public Health Agency of Canada.

The company has expanded its scope offering more services to help fight the pandemic because “this will be the largest mass healthcare intervention in our lifetime,” said Wilson, “and probably the most important.” 

Wilson says CANImmunize is in talks with other provinces interested in its tech, but declined to name them.

Dr. Kumanan Wilson, an internal medicine physician at Ottawa Hospital is also co-Founder of CANImmunize, the company that created online vaccine sign-up portals for Nova Scotia and Yukon. Wilson says vaccinating people for COVID-19 ‘will be the largest mass healthcare intervention in our lifetime.’ (Kim Barnhadt/CANImmunize)

 

Perpetuating the ‘digital divide’  

With millions of Canadians clamouring for COVID-19 vaccines, using technology to help facilitate booking shots will make the process more convenient for many Canadians and more efficient for health departments.  

“I think that we have a mass vaccination strategy that will work for a lot of people,” said Dr. Kwame McKenzie, a physician and the CEO of the Wellesley Institute, a non-profit group in Toronto that works in research and policy issues to improve health equity.  

“The problem is that there are some people who are at highest risk that it won’t work for at all.”

Dr. Kwame McKenzie, a psychiatrist and CEO of the Wellesley Institute, a Toronto-based think-tank that advises on policy for more equitable health care in urban communities. He’s concerned the process to sign-up for vaccines might make existing inequities worse. (Richard Agecoutay/CBC)

 

McKenzie is concerned the mass vaccination campaigns across Canada built on the power of online booking portals will perpetuate the country’s “digital divide.”  

He says the seniors, racialized groups, low income groups, and people with disabilities who have been at higher risk of getting COVID-19, are exactly the same groups who are less likely to have computers, broadband, and be “digitally savvy.”

Having call centres for phone bookings isn’t a fix-all, he said, if people using pay-as-you-go credits end up on hold for hours.  

“That could be all your credits for a week,” he said, “and the most likely scenario is that you’d use your credits before you got through. And that’s your opportunity gone.”

He also points to Statistics Canada data that shows about 20 per cent of Canadians have a mother tongue other than English or French. 

Bookings in Canada’s official languages, said McKenzie, could present challenges not just for younger  people new to Canada from places like South Asia or Africa, but also for some older Canadians from places like Italy, Portugal or Ukraine, who still function primarily in their first languages. 

Alternatives for access

McKenzie wants to see vaccination slots proactively held back for those who will struggle to book online or by phone. 

He believes community outreach for at-risk groups should be coupled with no-appointment-necessary walk-up vaccination sites in targeted areas.

In Canada, we say diversity is our strength … that means that we need a diverse vaccine roll out strategy to meet the needs of that diverse population.– Dr. Kwame McKenzie, CEO The Wellesley Institute

He also said on-the-job immunization clinics for essential workers should be part of vaccine access.        

“In Canada, we say diversity is our strength. And that’s something I believe, but that means that we need a diverse vaccine roll out strategy to meet the needs of that diverse population.”  

Several provinces have announced plans for mobile vaccination clinics, “focused immunizations teams” and community clinics set up by local public health units to reach vulnerable groups. 

Fiest believes provinces will have to be careful that “whatever system is going to be rolled out is not making health inequities worse.”  

A long process and public patience running low  

A number of questions have poured into the CBC News COVID@cbc.ca email address in recent days from Canadians anxious for specifics about when and how they can sign up for vaccination. 

Linda O’Neil of Barrie, Ont., is one of them. 

Linda O’Neil of Barrie, Ont., is concerned about when and how she’ll be able to get a COVID-19 vaccination booking for her mother, who is in her late 80s. (Submitted by Linda O’Neil)

 

She’s worried about getting a booking for her mother, who’s in her late 80s. 

“It’s just really frustrating, because my feeling is they’ve had quite a few weeks to be able to prepare this plan,” said O’Neil. 

“So I’m just looking to have it publicized now that the vaccine is starting to come in.”

While O’Neil and millions more wait for details from their provinces, Wilson sees a silver lining in COVID-19 accelerating what he sees as overdue technological change in Canada’s medical system. He acknowledges that older Canadians and others may need help figuring out how online registration works.

“In my mind for immunization, an individual, the health care provider, and the government would have the same immunization information in real time,” he said “that’s probably true for immunization, but also for all of our health care.” 

 

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 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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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

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

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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