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.
Danuta Skowronski was poring over Pfizer-BioNTech vaccine data on a Friday night in mid-December when she had an “aha!” moment.
The epidemiology lead at the British Columbia Centre for Disease Control realized she could actually “correct” the data Pfizer had submitted to the U.S. Food and Drug Administration on the effectiveness of just one dose of its vaccine.
In clinical trials, Pfizer couldn’t accurately determine the efficacy of a single shot because participants had already received their second dose after three weeks, and there was no comparative one-dose study done.
Pfizer reported an efficacy of 52 per cent for one shot, compared to the more commonly cited 95 per cent after the second.
But Skowronski, who has been working on vaccine effectiveness analyses for more than 15 years, realized the company had included in its analysis the two-week time period immediately after vaccination — before the body’s immune response typically kicks in.
Dr. Danuta Skowronski with the B.C. Centre for Disease Control is in favour of delaying second doses to four months after analyzing the data Pfizer submitted to the U.S. Food and Drug Administration. (Harman/CBC)
She told CBC News vaccines are never expected to protect “instantaneously,” and that there is always a “grace period” of a couple of weeks that factors into vaccine effectiveness.
“What we found was that they were underestimating the efficacy of the first dose, and rather than the efficacy being 52 per cent, it was actually 92 per cent, ” she said. “For us, that was a game changer.”
Canada is now an outlier in the global vaccination rollout. No other country in the world has delayed second doses up to four months, and there is no evidence yet on the long-term effect it could have on immunity to COVID-19.
Some scientists say we are venturing into uncharted waters. Others are comfortable with the risk.
Why is Canada delaying second doses?
NACI says if second doses are stretched to four months across the country starting this month, close to 80 per cent of Canadians over 16 could get at least one shot of the Pfizer-BioNTech or Moderna vaccine by the end of June.
But Canada’s chief science adviser, Mona Nemer, says the decision to delay doses amounted to a “population level experiment.”
“The comment from the chief science adviser was most unfortunate,” said Skowronski. “It did not reflect the careful risk-benefit analysis that went into this decision, and frankly, that is a science and an art to be able to do that.”
But aside from a vague reference to “real-world effectiveness” from Canada and other countries in NACI’s recommendations, little evidence has been communicated to Canadians to convince them that the change in vaccine rollout strategy is the right move.
NACI says its decision to delay second doses is based on emerging real-world data from Quebec, B.C., Israel, the U.K. and the U.S. that showed “good effectiveness” of between 70 and 80 per cent from a single dose of the vaccines “for up to two months in some studies.”
But it also makes clear that these studies haven’t yet collected four months of data on the long-term effectiveness of a single dose, meaning NACI is betting on the “high levels of protection” shown so far.
“It’s shown us really good vaccine effectiveness two months after receipt of the first dose and that the effectiveness isn’t decreasing over time,” Dr. Shelley Deeks, vice-chair of NACI and a lead author of the recommendations, said in an interview.
“After looking at it from all of these angles, and given that we are in a situation of limited supply, the committee came to a strong consensus that we recommend the interval to be extended to four months.”
Deeks said NACI will continue monitoring vaccine effectiveness data as it comes out around the world to determine if it needs to further alter its recommendations — meaning another change to Canada’s vaccine rollout strategy is possible.
“If we need to reassess and revise the recommendations, we will,” she said. “But this will allow more Canadians to receive the first dose and have a vaccine in a more timely manner and will have an impact on serious disease.”
‘Not based on evidence’
The move has effectively doubled Canada’s doses of COVID-19 vaccines overnight, but some scientists are critical of the move to experiment with delaying intervals.
“The decision is not based on evidence. It’s really based on an extrapolation of the evidence,” said Brad Wouters, executive vice-president of science and research at the University Health Network in Toronto.
“We’ve only been giving this vaccine for two months, so we don’t have data out to four months — no one in the world has been waiting four months for a second dose.”
WATCH | The science behind delaying the 2nd dose of COVID-19 vaccines:
Federal government scientists have put their support behind delayed second doses of COVID-19 vaccines — which several provinces were already doing — and ongoing research shows some of the benefits of the adapted strategy. 2:04
Wouters says it’s unclear if the delay will impact the effectiveness of the second dose, and the decision comes with a lot of uncertainty in the months ahead.
Skowronski says once good protection is established, it doesn’t suddenly disappear or “fall of a cliff.” Instead, protection against a disease wanes gradually after a vaccination, which buys researchers time to “re-evaluate the optimal timing of the second dose.”
She said that longer intervals between a first and a second dose of a vaccine are generally preferred because shorter intervals can interfere with the immune boost response and longer intervals are often associated with ultimately higher antibody levels.
Alyson Kelvin, an assistant professor at Dalhousie University in Halifax and virologist at the Canadian Center for Vaccinology, says the clinical trials on COVID-19 vaccines ran with the shortest time frame possible so they could get data out quickly, but previous studies on other vaccines show longer intervals are generally better.
Skowronski says it’s unclear why Pfizer went with a three-week interval for their clinical trials, but it may have been due to pressure to get the vaccine out or because they didn’t expect to have such good protection with the first dose.
“The only reason to go with a shorter interval is if you don’t get good protection with the first dose, and a second dose administered sooner could top it up a lot,” Skowronski said.
“That’s a scenario that we are not dealing with here. We’re getting excellent protection after the first dose, and we have a clear and present danger threat now with ongoing elevated pandemic disease risk on top of that scarcity of vaccine supply.”
Lack of clear communication for Canadians
While Skowronski is confident delaying the second dose is the right move for Canada, she and other experts feel the communication to Canadians from NACI on the decision could have been more clear.
She said it’s important to stress to Canadians that they still need a second dose eventually to have as much protection from COVID-19 as possible and that they should take any vaccine offered to them to combat its spread.
WATCH | The evidence is there for the ‘concept of further delay’ of second doses: Dr. Naylor:
Dr. David Naylor, Co-Chair of the COVID-19 Immunity Task Force, joined Power & Politics Wednesday to discuss the National Advisory Committee on Immunization’s new recommendation that second doses of COVID-19 vaccines can be administered up to four months after the first dose. 2:33
Dr. David Naylor, who co-chairs the federal government’s COVID-19 immunity task force, said the decision to delay doses is “defensible,” but agreed the decision could have been explained much more clearly to Canadians.
“There didn’t seem to be an organized communications strategy overall,” he said.
“The unhappy result is that a decision which might have been welcomed as a wider tide lifting many more boats and helping us end the epidemic more quickly has instead caused a real undercurrent of anxiety. I hope that subsequent communications will clear the air.”
Wouters says he worries about how Canadians will interpret the move to delay doses given the limited understanding the average person might have on the issue.
“There wasn’t a lot of information about why the decision was made, what the evidence was, what the process was,” he said. “There could certainly be a lot more transparency around the process and how that was done.”
Lisbeth Mendez comforts Luigini Parravano outside the Richmond Green Sports Centre, in Richmond Hill, Ont., on Monday. Parravano, along with her husband, Mario, were among the first cohort of senior citizens aged 80+ in York Region’s mass COVID-19 vaccination program. (Evan Mitsui/CBC)
Dr. Allison McGeer, a medical microbiologist and infectious disease specialist at Toronto’s Mount Sinai Hospital, says there is “overwhelming” evidence in favour of second doses.
“People who haven’t spent time in vaccination and thinking about vaccination are always really anxious about the stuff you don’t know in the future with vaccines,” she said.
“I’m comfortable with those uncertainties, and with the fact that we can deal with them when we get there. But if you’re not comfortable with that, there is a tendency to really worry about the potential consequences of doing that.”
Skowronski says Canadians should expect health experts to adapt to and absorb emerging evidence as it becomes available and incorporate that into recommendations.
“You don’t do business as usual in the midst of a crisis,” she said. “You don’t want experts that are holding steadfast to an earlier opinion or viewpoint while knowledge has amassed and moved on.
“You want your experts keeping pace with those developments and making decisions based on what is known as time evolves, especially during a dynamic crisis like an unfolding pandemic.”
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Montreal Alouettes wide receiver Tyson Philpot has announced he will be out for the rest of the CFL season.
The Delta, B.C., native posted the news on his Instagram page Thursday.
“To Be Continued. Shoutout my team, the fans of the CFL and the whole city of Montreal! I can’t wait to be back healthy and write this next chapter in 2025,” the statement read.
Philpot, 24, injured his foot in a 33-23 win over the Hamilton Tiger-Cats on Aug. 10 and was placed on the six-game injured list the next week.
The six-foot-one, 195-pound receiver had 58 receptions, 779 yards and five touchdowns in nine games for the league-leading Alouettes in his third season.
Philpot scored the game-winning touchdown in Montreal’s Grey Cup win last season to punctuate a six-reception, 63-yard performance.
This report by The Canadian Press was first published Sept. 12, 2024.
MIAMI GARDENS, Fla. (AP) — Miami Dolphins quarterback Tua Tagovailoa sustained a concussion for the third time in his NFL career, leaving his team’s game Thursday night against Buffalo after running into defensive back Damar Hamlin and hitting the back of his head against the turf.
Tagovailoa remained down for about two minutes before getting to his feet and walking to the sideline after the play in the third quarter. He made his way to the tunnel not long afterward, looking into the stands before smiling and departing toward the locker room.
The Dolphins needed almost no time before announcing it was a concussion. The team said he had two during the 2022 season, and Tagovailoa was diagnosed with another concussion when he was a college player at Alabama.
Dolphins coach Mike McDaniel said Tagovailoa would get “proper procedural evaluation” and “appropriate care” on Friday.
“The furthest thing from my mind is, ‘What is the timeline?’ We just need to evaluate and just worry about my teammate, like the rest of the guys are,” McDaniel said. “We’ll get more information tomorrow and take it day by day from here.”
Some players saw Tagovailoa in the locker room after the game and said they were encouraged. Tagovailoa spoke with some players and then went home after the game, McDaniel said.
“I have a lot of love for Tua, built a great relationship with him,” said quarterback Skylar Thompson, who replaced Tagovailoa after the injury. “You care about the person more than the player and everybody in the organization would say the same thing. Just really praying for Tua and hopefully everything will come out all right.”
Tagovailoa signed a four-year, $212 million extension before this season — a deal that makes him one of the highest-paid players in the NFL — and was the NFL’s leading passer in Week 1 this season. Tagovailoa left with the Dolphins trailing 31-10, and that was the final score.
“If you know Tua outside of football, you can’t help but feel for him,” Bills quarterback Josh Allen said on Amazon following the game. “He’s a great football player but he’s an even greater human being. He’s one of the best humans on the planet. I’ve got a lot of love for him and I’m just praying for him and his family, hoping everything’s OK. But it’s tough, man. This game of football that we play, it’s got its highs and it’s got its lows — and this is one of the lows.”
Tagovailoa’s college years and first three NFL seasons were marred by injury, though he positioned himself for a big pay bump with an injury-free and productive 2023 as he led the Dolphins into the playoffs. He threw for 29 touchdowns and a league-best 4,624 yards last year.
When, or if, he can come back this season is anyone’s guess. Tagovailoa said in April 2023 that the concussions he had in the 2022 season left him contemplating his playing future. “I think I considered it for a time,” he said then, when asked if he considered stepping away from the game to protect himself.
McDaniel said it’s not his place to say if Tagovailoa should return to football. “He’ll be evaluated and we’ll have conversations and progress as appropriate,” McDaniel said.
Tagovailoa was hurt Thursday on a fourth-down keeper with about 4:30 left in the third. He went straight ahead into Hamlin and did not slide, leading with his right shoulder instead.
Hamlin was the player who suffered a cardiac arrest after making a tackle during a Monday night game in January 2023 at Cincinnati, causing the NFL to suspend a pivotal game that quickly lost significance in the aftermath of a scary scene that unfolded in front of a national television audience.
Tagovailoa wound up on his back, both his hands in the air and Bills players immediately pointed at him as if to suggest there was an injury. Dolphins center Aaron Brewer quickly did the same, waving to the sideline.
Tagovailoa appeared to be making a fist with his right hand as he lay on the ground. It was movement consistent with something that is referred to as the “fencing response,” which can be common after a traumatic brain injury.
Tagovailoa eventually got to his feet. McDaniel grabbed the side of his quarterback’s head and gave him a kiss on the cheek as Tagovailoa departed. Thompson came into the game to take Tagovailoa’s spot.
“I love Tua on and off the football field,” Bills edge Von Miller said. “I’m a huge fan of him. I can empathize and sympathize with him because I’ve been there. I wish him the best.”
Tagovailoa’s history with concussions — and how he has since worked to avoid them — is a huge part of the story of his career, and now comes to the forefront once again.
He had at least two concussions during the 2022 season. He was hurt in a Week 3 game against Buffalo and cleared concussion protocol, though he appeared disoriented on that play but returned to the game.
The NFL later changed its concussion protocol to mandate that if a player shows possible concussion symptoms — including a lack of balance or stability — he must sit out the rest of the game.
Less than a week later, in a Thursday night game at Cincinnati, Tagovailoa was concussed on a scary hit that briefly knocked him unconscious and led to him being taken off the field on a stretcher.
His second known concussion of that season came in a December game against Green Bay, and he didn’t play for the rest of the 2022 season. After that, Tagovailoa began studying ways where he may be able to fall more safely and protect himself against further injury — including studying jiu-jitsu.
“I’m not worried about anything that’s out of my hands,” McDaniel said. “I’m just worried about the human being.”
NEW YORK (AP) — When her husband turns on the television to hear news about the upcoming presidential election, that’s often a signal for Lori Johnson Malveaux to leave the room.
It can get to be too much. Often, she’ll go to a TV in another room to watch a movie on the Hallmark Channel or BET. She craves something comforting and entertaining. And in that, she has company.
While about half of Americans say they are following political news “extremely” or “very” closely, about 6 in 10 say they need to limit how much information they consume about the government and politics to avoid feeling overloaded or fatigued, according to a new survey from the Associated Press-NORC Center for Public Affairs Research and USAFacts.
Make no mistake: Malveaux plans to vote. She always does. “I just get to the point where I don’t want to hear the rhetoric,” she said.
The 54-year-old Democrat said she’s most bothered when she hears people on the news telling her that something she saw with her own eyes — like the Jan. 6, 2021, attack on the U.S. Capitol — didn’t really happen.
“I feel like I’m being gaslit. That’s the way to put it,” she said.
Sometimes it feels like ‘a bombardment’
Caleb Pack, 23, a Republican from Ardmore, Oklahoma, who works in IT, tries to keep informed through the news feeds on his phone, which is stocked with a variety of sources, including CNN, Fox News, The Wall Street Journal and The Associated Press.
Yet sometimes, Pack says, it seems like a bombardment.
“It’s good to know what’s going on, but both sides are pulling a little bit extreme,” he said. “It just feels like it’s a conversation piece everywhere, and it’s hard to escape it.”
Media fatigue isn’t a new phenomenon. A Pew Research Center survey conducted in late 2019 found roughly two in three Americans felt worn out by the amount of news there is, about the same as in a poll taken in early 2018. During the 2016 presidential campaign, about 6 in 10 people felt overloaded by campaign news.
But it can be particularly acute with news related to politics. The AP-NORC/USAFacts poll found that half of Americans feel a need to limit their consumption of information related to crime or overseas conflicts, while only about 4 in 10 are limiting news about the economy and jobs.
It’s easy to understand, with television outlets like CNN, Fox News Channel and MSNBC full of political talk and a wide array of political news online, sometimes complicated by disinformation.
“There’s a glut of information,” said Richard Coffin, director of research and advocacy for USAFacts, “and people are having a hard time figuring out what is true or not.”
Women are more likely to feel they need to limit media
In the AP-NORC poll, about 6 in 10 men said they follow news about elections and politics at least “very” closely, compared to about half of women. For all types of news, not just politics, women are more likely than men to report the need to limit their media consumption, the survey found.
White adults are also more likely than Black or Hispanic adults to say they need to limit media consumption on politics, the poll found.
Kaleb Aravzo, 19, a Democrat, gets a baseline of news by listening to National Public Radio in the morning at home in Logan, Utah. Too much politics, particularly when he’s on social media sites like TikTok and Instagram, can trigger anxiety and depression.
“If it pops up on my page when I’m on social media,” he said, “I’ll just scroll past it.”
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Sanders reported from Washington. David Bauder writes about media for the AP. Follow him at http://x.com/dbauder.
The AP poll of 1,019 adults was conducted July 29-August 8, 2024, using a sample drawn from NORC’s probability-based AmeriSpeak Panel, which is designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 4.0 percentage points.
