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After a year of growing vaping concerns, critics urge the federal government to take control – Ottawa Citizen

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In recent years, vaping has gone from a phenomenon to a crisis among Canadian teens and young adults, say researchers.


Vaping may be helping some adults quit smoking, but use of vaping products among young people is growing alarmingly.


Adnan Abidi / REUTERS

Fifteen years after they were introduced in Canada, e-cigarettes made headlines in 2019 with a spike in vaping-related illnesses and soaring rates of youth vaping.

If 2019 was the year of the vaping scare, observers and critics are hoping that 2020 will be the year in which Canada gains some control over the issue.

Before the year was over the federal government began taking steps in that direction by announcing a ban on promotion of vaping products in spaces where young people could see them, including on social media. It also announced that e-cigarettes must carry mandatory health warnings and must be child resistant.

Critics want to see the government go much further when it comes to reducing teen vaping.

The mandate letter to newly appointed federal Health Minister Patty Hajdu suggests the government could go further. The letter, released in mid-December, tells the health minister to “tackle the rapid increase in vaping among young people,” in collaboration with other levels of government by taking regulatory action to “reduce the promotion and appeal of vaping products to young people and by educating the public to raise awareness of health risks.”

The federal government and others have their work cut out.

In recent years, vaping has gone from a phenomenon to a crisis among Canadian teens and young adults, researchers say.

In groundbreaking research, Professor David Hammond of the University of Waterloo found that between 2017 and 2018 vaping increased by a stunning 74 per cent among Canadian teens between the ages of 16 and 19. His ongoing research suggests there has been a similar increase in youth vaping in 2019 and Hammond believes numbers of youth vaping could go higher yet.

The Canadian Student tobacco, Alcohol and Drugs survey for 2018-2019 found e-cigarette use by students doubled between 2016-17 and 2018-19. Twenty per cent of students surveyed (approximately 418,000) had used e-cigarettes in the past 30 days, an increase from 10 per cent the last time the survey was done in 2016-17.

The figures are shocking, but likely no surprising to those who have been seeing the first-hand evidence in schools and other places teenagers frequent.

In Ottawa and elsewhere, schools have taken the doors off bathrooms to try to control vaping, without much luck. Teachers report students vaping in class — exhaling into the sleeves to try to hide it and vaping wherever they can.

The huge spike in teen vaping is likely related to high rates of nicotine in Juul e-cigarettes and other popular products.

Before Juul came along, there were almost no e-cigarette brands with more than 20 mg of nicotine for each millilitre of e-liquid. That is the limit in Europe. But in North America, Juul contains 57 mg of nicotine. The federal government only limits nicotine to 66 mg or below.

The biggest change in the market, said Hammond, is that Juul designed a product that could deliver higher amounts of nicotine while remaining smooth tasting. The result has been high rates of nicotine addiction, mainly among youth.

Along with spiking teen vaping rates, dramatic and deadly cases of vaping-related illnesses have been in the news, especially in the U.S. where 52 people have died and more than 2,400 have been hospitalized. In Canada, 14 cases of vaping related illness have been reported.

The acute illnesses and deaths in the U.S. have been linked to the additive Vitamin E acetate in THC in most cases.

A study published in December, found e-cigarette users were significantly more likely to develop long-term chronic lung disease than non-smokers.

The issues have occurred against a backdrop of weak or non-existent federal regulations in Canada, which has been consulting on tougher regulations. Some provinces have toughened their laws, including a ban on the sale of flavoured vaping liquid in New Brunswick and a reduction in nicotine levels in British Columbia.

Hammond said Health Canada has failed to properly regulate the product and as a result has failed both the adult smokers who could use them to quit cigarettes and the teenagers who have become addicted to nicotine.

E-cigarettes, he noted, are less harmful than cigarettes, but they are also highly addictive: “It might not make sense to sell them beside the chips and chocolate bars.”

Related

Meanwhile, many of the adult smokers who could reduce their harm by switching to e-cigarettes are no longer interested. “Adults don’t want to go near them. Everyone sees this as something 15-year-olds grab on the way to a party.”

Ottawa’s Dr. Andrew Pipe said the federal government needs to step up with tougher regulations. The existing regulations are tepid, he said, and have left a regulatory vacuum. Even the changes announced at the end of the year do not come close to what he and others want to see — notably banning flavoured e-cigarettes.

Pipe, who is considered the country’s foremost expert on smoking cessation, was instrumental in developing the Ottawa Model for Smoking Cessation at the University of Ottawa Heart Institute. He wants to see flavoured e-cigarettes banned and limits on nicotine, in addition to the restrictions on where they can be sold and mandatory health warnings, which have been announced.

One of the sad ironies of the lack of regulation, Pipe said, is that the potential of e-cigarettes to be used as harm reduction “has now essentially been squandered. No responsible clinician is now going to entertain the use of e-cigarettes as a harm reduction aid. Their potential for harm reduction has gone out the window.”

Pipe urged the new federal minister of health to act strongly to turn around soaring youth vaping rates buy using emergency powers to expedite changes while longer-term regulations are being developed.

“We are dealing with an urgent, emergent public health issue which many have labelled a crisis.”

epayne@postmedia.com

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Top commander defends military’s vaccine requirement, says ‘tweak’ in the works

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OTTAWA — Canada’s top military commander said he will “tweak” the vaccine mandate for the Armed Forces in the next few weeks but defended vaccine requirements as necessary to keep the military ready to respond to any emergency.

“This is an institution that’s unlike any other because we do have to be operationally ready, we are the nation’s insurance policy,” chief of the defence staff Gen. Wayne Eyre told The Canadian Press in an interview.

“We have to go into dangerous locations and close confined quarters, we have to deploy overseas, where there’s potentially an increased threat with the pandemic. We also don’t know the trajectory of this pandemic, where it’s going to go into the future.”

When Eyre ordered all troops vaccinated against COVID-19 last October, he said it was to both protect the force and “demonstrate leadership” as the Liberal government adopted vaccine mandates across the federal public service.

The public service vaccine mandate was suspended in June but the military one persists, a fact that has heightened criticism of the military’s policy.

The Department of National Defence said more than 98 per cent of Canadian troops complied with the order. Defence Minister Anita Anand was briefed in June that 1,137 remained unvaccinated.

Those who refuse vaccination face the risk of forced removal from the military. The department says 241 unvaccinated troops have been ousted with disciplinary measures initiated against hundreds more.

Eyre said he is trying to find the “sweet spot” between the military’s medical, legal, operational and ethical requirements.

“We need to maintain our operational viability going forward,” he said. “So over the course of the next number of weeks, we will tweak the policy, we’ll put out something amended. But we also need to realize that this is a dynamic environment, and things can change, the trajectory of the pandemic can change. So we’ve got to maintain that flexibility as well.”

He added that not only has the military been called upon to assist in communities across Canada that have been hit by the pandemic, but that vaccine requirements still exist in many allied and foreign nations and militaries.

The U.S. military still requires all troops to be vaccinated as do some NATO facilities and bases.

“There are going to be operational requirements where to operate with allies, (vaccination) is going to be essential,” he said. “But as we go forward, the options are being developed looking at those four factors that I talked about and finding the right balance.”

Eyre’s comments appear to contradict a draft copy of a revised vaccine policy obtained by the Ottawa Citizen last month, which suggested vaccine requirements for military personnel would be lifted.

The draft document, which officials say has not been approved by Eyre, said military personnel as well as new recruits would no longer have to attest to their vaccination status.

The document also noted potential legal difficulties ahead to deal with people who were kicked out of the military because of the vaccine mandate, suggesting they could be forced to apply for re-enrolment.

By contrast, other unvaccinated federal public servants were put on leave without pay but allowed to return to their jobs when the mandate was suspended.

The military mandate was unsuccessfully challenged several times in Federal Court, most recently last month.

Phillip Millar, the London, Ont.-based lawyer who appeared before the court to seek an injunction on behalf of unvaccinated service members, said the court ultimately decided it couldn’t rule on the issue until the new policy was released.

Millar, who is also representing James Topp, an army reservist charged with publicly speaking out against federal vaccine mandates while wearing his uniform, said he was disappointed with the decision given the lack of timeline for the new policy.

“The military is deliberately dragging its feet on this new direction because it just wants to kick people out,” Millar alleged, adding: “It’s obviously a political policy, not an operational policy.”

Eyre would not say whether Armed Forces members are still being kicked out, or whether such releases have been suspended pending the results of his review.

The Defence Department says there have been more than 9,500 cases of COVID-19 among military personnel, including 113 active cases as of Aug. 1. It did not say whether there have been any deaths associated with the illness.

This report by The Canadian Press was first published Aug. 9, 2022.

 

Lee Berthiaume, The Canadian Press

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Double mRNA COVID-19 vaccination found to increase SARS-CoV-2 variant recognition – News-Medical.Net

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In a recent study posted to the bioRxiv* preprint server, researchers evaluated the impact of double BNT162b2 messenger ribonucleic acid (mRNA) vaccination in recognition of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VoCs).

Study: Double-dose mRNA vaccination to SARS-CoV-2 progressively increases recognition of variants-of-concern by Spike RBD-specific memory B cells. Image Credit: CKA/Shutterstock

Background

Studies have reported that double coronavirus disease 2019 (COVID-19) vaccinations generate high titers of SARS-CoV-2 S-targeted antibodies (Ab), Bmem and T lymphocytes; however, VoCs with SARS-CoV-2 S receptor-binding domain (RBD) mutations can evade humoral immune responses.

Booster doses have been reported to enhance VoC recognition by Abs; however, it is not clear whether VoC recognition is enhanced due to higher Ab titers or due to the increased capacity of Ab binding to S RBDs.

About the study

In the present study, researchers evaluated the benefit of double BNT162b2 vaccinations on SARS-CoV-2 VoC recognition.

Healthy and SARS-CoV-2- naïve persons (n=30) without immunological or hematological diseases were enrolled in the study to assess their peripheral blood B-lymphocyte subsets between February and June 2021.  Samples were obtained before the BNT162b2 vaccination, after three weeks of the first vaccination, and four weeks following the second vaccination.

Serum memory B lymphocytes (Bmem) counts and Ab titers were assessed using recombinant SARS-CoV-2 spike (S) protein RBDs of the Wuhan, Gamma, and Delta strains. Neutralizing Ab (NAb) titers were evaluated using 293T-ACE2 cells and SARS-CoV-2 pseudotyped viral assays. Further, the nature of RBD-targeted Bmem was examined based on the expression of cluster of differentiation (CD) 21, 27, and 71.

Enzyme-linked immunosorbent assays (ELISA) were performed to evaluate variant-specific S RBD antibody titers and the serum dilution needed for preventing 50% SARS-CoV-2 entry (ID50) values were ascertained. Flow cytometry (FC) was performed to evaluate Bmem counts. Immunoglobulin G (IgG) titers against SARS-CoV-2 nucleocapsid (N) protein RBD and S RBD were evaluated before and post the first and second BNT162b2 vaccination.

Results

In total, 28, 30, and 30 samples were obtained pre-vaccination, after three weeks of the first dose and after four weeks of the second dose, respectively. All the participants remained SARS-CoV-2-naïve throughout the study without anti-SARS-CoV-2 N antibodies. Most participants (n=22) induced NAbs after the first vaccination, and the NAb titers after the second vaccination had IC50 values >100.

Double BNT162b2 vaccination generated robust NAb responses among all study participants. Immunoglobulin G+ (IgG+) and IgM+ RBD-targeted Bmem were generated after the first vaccination, and IgG1+ Bmem counts increased after the second vaccination. Most RBD-targeted Bmem showed binding with Delta and/or Gamma VoCs, which increased significantly after the second vaccination.

The RBD-targeted Bmem compartment comprised mainly IgG1+ or IgM+ cells, and contrastingly, the total Bmem compartment comprised more IgG2+ cells and fewer IgG1+ cells compared to the RBD-targeted Bmem compartment.

After the second vaccination dose, RBD-targeted IgG1, 2 and 3-expressing Bmem populations expanded significantly, although the total Bmem lymphocyte compartment was unaltered.

The number of RBD-targeted IgG+ Bmem correlated positively with RBD-targeted serum IgG post first and second vaccinations. While two subsets of IgM+ Bmem lymphocytes (CD27+ IgM+ and CD27+ IgM+ IgD+) proportionally decreased after the second vaccination dose, the absolute cell counts were identical to those observed post the first vaccine dose. Taken together, BNT162b2 vaccinations particularly affected the antigen-targeted Bmem lymphocyte counts, and the production of IgG1-expressing Bmem lymphocytes was boosted after the second BNT162b2 vaccination.

CD27 was expressed by 95% of anti-RBD and IgG-expressing Bmem lymphocytes, the proportion of which did not differ between the initial and subsequent BNT162b2 vaccination. After the first vaccine dose, 15% of anti-RBD Bmem lymphocytes were CD21lo, the proportion of which was marginally but significantly lower (reduced to 10%) after four weeks of the second vaccination.

CD71 was expressed by 10% of anti-RBD Bmem lymphocytes after the first and second vaccination. In the total population of Bmem lymphocytes, the results after the first and second vaccination did not differ significantly, denoting the Bmem compartment stability. After four weeks of vaccination, anti-RBD Bmem lymphocytes exhibited a nature and resting Bmem lymphocyte immunophenotype.

Anti-Wuhan S RBD- IgG titers exhibited partial recognition of the Beta, Gamma and Delta VoCs with more prominent reductions for Gamma and Beta VoCs than for the Delta VoC. The second vaccine BNT162b2 dose significantly enhanced anti-Wuhan RBD antibody binding to Gamma and Beta VoCs; however, the neutralization potency of vaccine-induced NAbs against Gamma and Beta was lesser than for Delta.

Delta RBD and Gamma RBD were recognized by 50% and 70% of RBD-targeted Bmem lymphocytes after the first and second vaccinations, respectively, and the increase in VoC-recognizing Bmem counts was largely due to elevated IgG1+ Bmem counts.

Conclusion

Overall, the study findings showed that the second BNT162b2 vaccination elevated NAb titers and SARS-CoV-2 RBD-targeted Bmem counts and that double BNT162b2 vaccination was especially needed for Delta and Gamma VoC recognition. The findings indicated that the second vaccine dose improved S RBD-targeted Bmem counts and the Bmem affinity to overcome VoC mutations.

*Important notice

bioRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:

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First West Nile virus-positive mosquitoes of the year confirmed in Peel Region – CP24

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Mississauga, Brampton, and Caledon residents are being reminded to protect themselves from mosquito bites and remove any standing water from their property after the first West Nile virus-positive mosquitoes of the year were confirmed in Peel Region.

The infected insects were recently collected from three traps in Brampton, near the intersections of Chinguacousy Road and Williams Parkway, Hurontario Street and Steeles Avenue, and The Gore Road and Cottrelle Boulevard.

Peel’s public health unit monitors West Nile virus activity through 33 mosquito traps set across the region. Trapped mosquitoes are collected and tested weekly from late June to September.

The health unit also surveys public areas for stagnant water that could serve as breeding sites for mosquitoes. Identified locations are treated with larvicide, they said in an Aug. 9 news release.

So far this year, there are no confirmed human cases of the mosquito-borne illness, which is passed to humans through the bite of an infected mosquito, in the Region of Peel.

While the risk of acquiring the virus is low, the Region of Peel is urging people to protect themselves against mosquito bites by applying a Health Canada approved insect repellent containing an ingredient effective against mosquitoes, like as DEET or icaridin, to exposed skin and clothing.

They’re also advising people to wear light-colored, tightly woven, loose-fitting clothing like long pants, a long-sleeved shirt, shoes, and socks to protect exposed skin and avoid shaded or wooded areas with high mosquito populations, especially at dusk and dawn when mosquitoes are most active.

Residents should also ensure all windows and door screens fit securely and are free of tears and holes.

Further, people can help prevent mosquito bites by removing stagnant water or draining items on their property. Water stagnant for more than seven days is an ideal breeding site for mosquitoes, the region noted.

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