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AstraZeneca, Moderna or Pfizer? Take whichever COVID-19 vaccine you're offered, experts say – The Globe and Mail

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A man receives his COVID-19 vaccine at a clinic at Olympic Stadium in Montreal on March 1, 2021.

Paul Chiasson/The Canadian Press

Canadians tempted to shop for a preferred COVID-19 vaccine have been given simple advice from experts who have examined the country’s three available options: Take what is offered as quickly as possible.

The vaccine study and approval processes have swamped the public with numbers about vaccine efficacy, how long immunity may last, details about the difference between innovative and traditional vaccine platforms and shifting schedules for administering doses.

The bottom line for Canadians who are accustomed to using consumer skills to find the best option is simple, according to Tania Watts, an immunologist at the University of Toronto: “I would take what is offered as it decreases your likelihood of severe disease and death.”

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While no direct head-to-head study has been conducted on the COVID-19 vaccines, current data suggest the AstraZeneca shot is just as effective as the Moderna and Pfizer-BioNTech mRNA vaccines at preventing serious illness and death. However, it may be less effective at preventing mild illness.

This difference was enough for an independent committee of experts to draw a distinction between AstraZeneca’s vaccine and the two others in recommendations that were published online Monday by the Public Health Agency of Canada.

The committee determined there were not enough data to recommend the AstraZeneca vaccine for Canadians who are 65 and older, a position also taken by some European countries.

The new recommendations also make clear that those who have previously been prioritized for vaccination, including front-line workers and Indigenous Canadians, should receive the mRNA vaccines as a first choice. In cases where an mRNA vaccine is not available, AstraZeneca should be given when “the advantages of earlier vaccination outweigh the limitations of vaccinating with a less efficacious vaccine” and when the recipient provides informed consent after a discussion about “current local vaccine options.”

When asked if the committee’s more restrictive recommendations for the AstraZeneca vaccine might prompt some people to hold off from taking it when offered, vice-chair Shelley Deeks said, “Vaccine acceptance is one consideration for the committee. … However we also need to ensure that we examine the available data and make evidence-based recommendations.”

Dr. Deeks, a physician and the surveillance medical officer of health for Nova Scotia, added the committee would continue to revise its recommendations as data become available and more vaccines are authorized. This could occur in a matter of days if the Johnson & Johnson single-dose vaccine is approved by Canadian regulators.

The Public Health Agency of Canada responded to the recommendation with a statement saying “the best vaccine for a Canadian is the one they can get.” The agency noted the AstraZeneca shot showed no safety concerns in clinical trials or among seniors already vaccinated in other countries, and is showing some benefits in older populations including reduced chance of hospitalization.

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Last month, University of Edinburgh researchers reported that the vaccination of more than 1.1 million individuals in Scotland with the AstraZeneca and Pfizer-BioNTech vaccines had reduced the risk of hospitalization because of COVID-19 by up to 94 per cent and 85 per cent, respectively.

British Columbia announced Monday it will start a second-track vaccination campaign for essential workers using the refrigerator-stable vaccines such as the AstraZeneca shot. Older and vulnerable populations will continue to receive the Moderna and Pfizer vaccines, which require deep freezing and more preparation.

Bonnie Henry, B.C.’s Provincial Health Officer, said essential workers will have the option to continue waiting their turn for mRNA vaccines if they do not want the AstraZeneca dose.

“There will be a little bit of choice but not a whole lot,” Dr. Henry said. “We encourage people to get the vaccine available to them.”

In Quebec, Daniel Paré, the head of the province’s vaccination program, said Monday that people will not get to choose which vaccine they get, although they will be informed of which dose is coming before they get the needle.

“With a global shortage of vaccine, we use the vaccine that is safe and effective and available,” Mr. Paré told Montreal radio 98.5.

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Dr. Watts at the University of Toronto said concentrating the mRNA vaccines on older and immunocompromised people may make sense because those vaccines have higher efficacy than AstraZeneca’s. People in those categories also have a weaker immune response, she said.

All three vaccines share some unknown factors, such as how long immunity lasts, how long the booster shot can wait and whether they can be used interchangeably in second doses, she said.

Jennifer Gommerman, also an immunologist at the University of Toronto, agreed mRNA vaccines “may be a better choice for groups with less immune response.”

“But for the rest of us, in the name of herd immunity, I would take what’s given as it contributes to the war on COVID,” she said. “All the vaccines prevent severe COVID requiring hospitalization. If you are offered a vaccine, you take it.”

The initial COVID-19 vaccinations in Canada and around the world raise questions about how people react to the shot, how pregnant women should approach it and how far away herd immunity may be. Globe health reporter Kelly Grant and science reporter Ivan Semeniuk discuss the answers. The Globe and Mail

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U.K. advises limiting AstraZeneca in under-30s amid clot worry

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LONDON —
British authorities recommended Wednesday that the AstraZeneca COVID-19 vaccine not be given to adults under 30 where possible because of strengthening evidence that the shot may be linked to rare blood clots.

The recommendation came as regulators both in the United Kingdom and the European Union emphasized that the benefits of receiving the vaccine continue to outweigh the risks for most people — even though the European Medicines Agency said it had found a “possible link” between the shot and the rare clots. British authorities recommended that people under 30 be offered alternatives to AstraZeneca. But the EMA advised no such age restrictions, leaving it up to its member-countries to decide whether to limit its use.

Several countries have already imposed limits on who can receive the vaccine, and any restrictions are closely watched since the vaccine, which is cheaper and easier to store than many others, is critical to global immunization campaigns and is a pillar of the UN-backed program known as COVAX that aims to get vaccines to some of the world’s poorest countries.

“This is a course correction, there’s no question about that,” Jonathan Van-Tam, England’s deputy chief medical officer, said during a press briefing. “But it is, in a sense, in medicine quite normal for physicians to alter their preferences for how patients are treated over time.”

Van-Tam said the effect on Britain’s vaccination timetable — one of the speediest in the world — should be “zero or negligible,” assuming the National Health Service receives expected deliveries of other vaccines, including those produced by Pfizer and Moderna.

EU and U.K. regulators held simultaneous press conferences Wednesday afternoon to announce the results of investigations into reports of blood clots that sparked concern about the rollout of the AstraZeneca vaccine.

The EU agency described the clots as “very rare” side effects. Dr Sabine Straus, chair of EMA’s Safety Committee, said the best data is coming from Germany where there is one report of the rare clots for every 100,000 doses given, although she noted far fewer reports in the U.K. Still, that’s less than the clot risk that healthy women face from birth control pills, noted another expert, Dr. Peter Arlett.

The agency said most of the cases reported have occurred in women under 60 within two weeks of vaccination — but based on the currently available evidence, it was not able to identify specific risk factors. Experts reviewed several dozen cases that came mainly from Europe and the U.K., where around 25 million people have received the AstraZeneca vaccine.

“The reported cases of unusual blood clotting following vaccination with the AstraZeneca vaccine should be listed as possible side effects of the vaccine,” said Emer Cooke, the agency’s executive director. “The risk of mortality from COVID is much greater than the risk of mortality from these side effects.”

Arlett said there is no information suggesting an increased risk from the other major COVID-19 vaccines.

The EMA’s investigation focused on unusual types of blood clots that are occurring along with low blood platelets. One rare clot type appears in multiple blood vessels and the other in veins that drain blood from the brain.

While the benefits of the vaccine still outweigh the risks, that assessment is “more finely balanced” among younger people who are less likely to become seriously ill with COVID-19, the U.K’s Van-Tam said.

“We are not advising a stop to any vaccination for any individual in any age group,” said Wei Shen Lim, who chairs Britain’s Joint Committee on Vaccination and Immunization. “We are advising a preference for one vaccine over another vaccine for a particular age group, really out of the utmost caution rather than because we have any serious safety concerns.”

In March, more than a dozen countries, mostly in Europe, suspended their use of AstraZeneca over the blood clot issue. Most restarted — some with age restrictions — after the EMA said countries should continue using the potentially life-saving vaccine.

Britain, which relies heavily on AstraZeneca, however, continued to use it.

The suspensions were seen as particularly damaging for AstraZeneca because they came after repeated missteps in how the company reported data on the vaccine’s effectiveness and concerns over how well its shot worked in older people. That has led to frequently changing advice in some countries on who can take the vaccine, raising worries that AstraZeneca’s credibility could be permanently damaged, spurring more vaccine hesitancy and prolonging the pandemic.

Dr. Peter English, who formerly chaired the British Medical Association’s Public Health Medicine Committee, said the back-and-forth over the AstraZeneca vaccine globally could have serious consequences.

“We can’t afford not to use this vaccine if we are going to end the pandemic,” he said.

In some countries, authorities have already noted hesitance toward the AstraZeneca shot.

“People come and they are reluctant to take the AstraZeneca vaccine, they ask us if we also use anything else,” said Florentina Nastase, a doctor and co-ordinator at a vaccination centre in Bucharest, Romania. “There were cases in which people (scheduled for the AstraZeneca) didn’t show up, there were cases when people came to the centre and saw that we use only AstraZeneca and refused (to be inoculated).”

Meanwhile, the governor of Italy’s northern Veneto region had said earlier Wednesday that any decision to change the guidance on AstraZeneca would cause major disruptions to immunizations — at a time when Europe is already struggling to ramp them up — and could create more confusion about the shot.

“If they do like Germany, and allow Astra Zeneca only to people over 65, that would be absurd. Before it was only for people under 55. Put yourself in the place of citizens, it is hard to understand anything,” Luca Zaia told reporters.

The latest suspension of AstraZeneca came in Spain’s Castilla y Leon region, where health chief Veronica Casado said Wednesday that “the principle of prudence” drove her to put a temporary hold on the vaccine that she still backed as being both effective and necessary.

French health authorities had said they, too, were awaiting EMA’s conclusions, as were some officials in Asia.

On Wednesday, South Korea said it would temporarily suspend the use of AstraZeneca’s vaccine in people 60 and younger. In that age group, the country is only currently vaccinating health workers and people in long-term care settings.

The Korea Disease Control and Prevention Agency said it would also pause a vaccine rollout to school nurses and teachers that was to begin on Thursday, while awaiting the outcome of the EMA’s review.

But some experts urged perspective. Prof Anthony Harnden, the deputy chair of Britain’s vaccination committee, said that the program has saved at least 6,000 lives in the first three months and will help pave the way back to normal life.

“What is clear it that for the vast majority of people the benefits of the Oxford AZ vaccine far outweigh any extremely small risk,” he said. “And the Oxford AZ vaccine will continue to save many from suffering the devastating effects that can result from a COVID infection.”

Source: – CTV News

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Facebook downplays ‘old’ breach exposing info on 533 million users

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Facebook is downplaying the significance of a data breach that saw the personal information of 533 million of its users accessed online, saying the information is old and the vulnerability that was exploited was closed almost two years ago.

Over the weekend, Business Insider reported that personal information of Facebook users in 106 countries was found on a low-level hacking forum, free of charge. Cybercrime intelligence firm Hudson Rock calculated that almost 3.5 million Canadians were included.

Information included names, phone numbers, locations, birth dates, email addresses and other identifying details. No financial or payment information was accessed, Facebook said.

In a statement on its website Tuesday the social media giant said the information was gathered via a vulnerability the company fixed almost two years ago, and disputed that it was a hack.

Data scraped, not hacked: Facebook

“It is important to understand that malicious actors obtained this data not through hacking our systems but by scraping it from our platform prior to September 2019,” said product management director Mike Clark.

Scraping refers to the act of gathering information that is already out there but somewhat hidden on public databases.

The company said whoever collected and assembled the data did so by abusing the contact importing service, which allows users to find other people in their network on Facebook.

Facebook said whoever did it seems to have uploaded a large set of phone numbers to see which ones matched Facebook users.

David Masson, director of enterprise security at cybersecurity firm Darktrace, says the information has likely been out there and spread widely for a while, before being outed recently.

“It’s been on the Web for quite a while, probably for sale to people,” he said. “But now somebody’s just offered it up for free.”

Building a profile

Greg Wolfond, CEO of data security firm SecureKey, said that in a vacuum, much of the information taken can seem innocuous and harmless, but when taken together can be very dangerous.

“What the hackers do is they try and get little bits of data about you in this case something like your phone number,” he told CBC News in an interview. They can then combine that with other bits of information — an address, a full name — and start building a profile.

What’s most dangerous is once they have gathered enough to attempt to gain access to a cellphone account. With the right combination of information, a telecom company may allow someone walking in to port the account number to a new phone.

 

Cybersecurity expert David Masson with Darktrace says Facebook users shouldn’t assume the company’s size and scope make them better at fending off attacks. (Darktrace)

 

“They take over your phone, and within minutes of taking over your phone, they’re trying to get into your bank account, to get into your Facebook account, your Google account, whatever you use that phone as your recovery for,” he said.

Typically, consumers are urged to fight data theft by doing things like changing passwords frequently, and making the complex. But those things are of little use when companies claim the right to reams of data about their users, and promise to keep it safe.

“Empowering individuals to share their data and putting a responsibility on parties that have the data to keep it secure,
is super important,” he said.

Not Facebook’s first user-info incident

Although the company is downplayed in the incident, it is far from the company’s first misstep with user info.

In 2018, the social media giant disabled a feature that allowed users to search for one another via phone number following revelations that the political firm Cambridge Analytica had accessed information on up to 87 million Facebook users without their knowledge or consent.

In December 2019, a Ukrainian security researcher reported finding a database with the names, phone numbers and unique user IDs of more than 267 million Facebook users — nearly all U.S.-based — on the open internet.

Spark15:32Digital security expert shares tips on how to protect your data while working remotely 

During the COVID-19 pandemic, we are spending more of our time at home online than ever before – and according to Citizen Lab’s John Scott-Railton, this makes us vulnerable to privacy and security threats. 15:32

Facebook says it will “continue aggressively go after malicious actors who misuse our tools,” and touted its dedicated team focused on this work” but  Masson says users shouldn’t make the mistake of assuming that the company’s size and scope somehow make them better equipped to keep user data safe.

“It doesn’t matter how big or sophisticated you are, they can be attacked,” he said.

Like many breaches, this one was only discovered long after the fact, and that’s because the technology company’s use isn’t keeping up with the ones the hackers are using.

“There are better technologies that actually work on what happens once the bad guys get inside your network rather than when they’re banging on the door outside. So people [have] got to realize this will happen again.

Source: – CBC.ca

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