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Advisory body recommends 3rd COVID-19 vaccine dose for some immunocompromised Canadians – CBC.ca

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Canada’s national advisory body on vaccines now recommends giving third doses of COVID-19 vaccines to certain immunocompromised individuals, but still hasn’t reached a decision on whether to provide additional shots to the broader population.

Released on Friday, the new recommendations from the National Advisory Committee on Immunization (NACI) stipulate that moderately to severely immunocompromised Canadians should be vaccinated with a primary series of three doses of an authorized mRNA-based vaccine, which includes those from Pfizer-BioNTech and Moderna.

For those who’ve already had a two-dose series, NACI recommends providing a third dose, ideally of an mRNA vaccine — but the committee stressed this should not be considered a “booster.”

Dr. Shelley Deeks, NACI’s chair, explained in a statement that the goal is providing an extra shot to people who “may have somewhat lower responses to their first vaccinations.”

“This is not unusual for immunocompromised groups, where we often recommend different vaccine schedules to help them achieve better protection,” she continued. “This is different from a booster dose, which would be used to boost an immune response that has waned over time.”

The committee is also looking at whether additional doses might be needed for other groups, “but it is too early to comment on the state of the evidence for general boosters at this time,” Deeks said.

VIDEO | Scientists uncertain about best approach to COVID-19 booster shots:

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Some immunocompromised Canadians are already receiving COVID-19 vaccine boosters, but the science is still unclear about whether everyone should get one in the near future or wait for one designed for the new variants circulating, including delta. 1:58

Debate over offering additional shots

NACI’s recommendations come as much of the world is debating the merits of additional COVID-19 vaccine doses for various groups.

Here in Canada, some residents are already set to get third doses. Ontario and Alberta are offering additional shots for certain vulnerable populations including some transplant recipients, cancer patients, immunocompromised individuals and residents of various care homes — while Saskatchewan and Quebec are offering extra rounds of mRNA shots to people who want to travel to countries that may not recognize mixed-vaccination status.

Israel has made third doses of COVID-19 vaccine available to everyone aged 30 or older, while the U.S. plans to offer boosters to anyone eight months out from their second shot starting on Sept. 20. 

But that kind of broad approach has come under fire given the disparities in the global vaccine rollout during this pandemic.

“We’re planning to hand out extra life-jackets to people who already have life-jackets, while we’re leaving other people to drown without a single life-jacket,” Dr. Mike Ryan, the World Health Organization’s top emergencies expert, said during a recent news conference.

The European Centre for Disease Prevention and Control (ECDC) has also said there is no need to rush out booster shots for the general public because all authorized vaccines are highly protective against hospitalization, severe disease and death from COVID-19.

And other wealthy nations with ample vaccine supply have taken a slightly more nuanced approach, with France, Germany and the U.K. announcing third doses only for certain vulnerable populations.

As for the new recommendations on third doses being offered in Canada, NACI said it is referring to moderately to severely immunocompromised individuals with the following conditions:

  • Active treatment for solid tumour or hematologic malignancies.
  • Receipt of solid-organ transplant, taking immunosuppressive therapy.
  • Receipt of chimeric antigen receptor (CAR)-T-cell therapy or hematopoietic stem cell transplant (within two years of transplantation or taking immunosuppression therapy).
  • Moderate to severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome).
  • Stage 3 or advanced untreated HIV infection and those with acquired immunodeficiency syndrome.
  • Active treatment with certain immunosuppressive therapies.

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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.

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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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