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B.C. study finds low but increased risk of myocarditis after 2nd Moderna COVID shot

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A Canadian study suggests cases of heart muscle inflammation related to COVID-19 mRNA vaccines are rare but higher than expected among young men who got a second dose of Moderna compared with those who were administered Pfizer-BioNTech’s vaccine.

Lead author Dr. Naveed Janjua, an epidemiologist at the BC Centre for Disease Control, said the findings related to second doses for both vaccines show men between the ages of 18 and 29 are most at risk of myocarditis if they received Moderna’s COVID-19 vaccine.

He said the study bolsters previous research elsewhere with more robust data, which is based on hospitalizations, emergency room visits and lab tests in British Columbia after 10.2 million doses of both vaccines were administered to those aged 12 and over between December 2020 and March 2022.

The study, published this week in the Canadian Medical Association Journal, used the data to determine if people sought care for myocarditis seven and 21 days following vaccination.

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About seven million doses of Pfizer and 3.2 million doses of Moderna were administered. Nearly four million first doses were given, along with 3.8 million second doses and nearly 2.4 million third shots.

Researchers identified 99 cases of myocarditis among a total of 10.2 million doses that were administered. They expected to see about seven cases, most of them among females, based on what would have been typical. Instead, the study showed 80 males developed myocarditis, and 19 females.

Most cases were among men and after the second dose. On average, the males were younger than females, age 28 versus 45 among cases within seven days, and age 31 versus age 49 among cases within 21 days.

Out of 100,000 second doses of Moderna administered to men between the ages of 18 and 29, the study found 22 cases of myocarditis. That compares with five cases for those who received a second shot of the Pfizer vaccine per 100,000 men in that age group.

However, seven days after a third dose of Moderna, the findings show there were four cases of the heart condition per 100,000 doses in that age group, versus three cases per 100,000 doses following a booster of Pfizer.

Cases of myocarditis are typically mild for young men who seek medical help for chest pain following vaccination, Janjua said, adding treatment involves monitoring of symptoms, sometimes in hospital, as their condition may resolve with or without medication.

“When I say mild, I mean self-resolving. So, these were people who had illness for one or two days, or three days, and then they recovered. When we compare that with a COVID infection-related myocarditis, we see that (condition) stays for a very long time, that for 10 to 12 days people were admitted to hospital.”

Symptoms can include chest pain, shortness of breath or a rapid or abnormal heart rhythm.

Myocarditis can occur for various reasons, he said, including a viral infection like the flu, for example, typically among older people.

“We don’t expect any residual effects given the mildness of illness,” Janjua said of myocarditis involving mRNA vaccines administered to young men, who are otherwise not susceptible to the condition.

Authors of the study say they support the use of Pfizer for second shots among men between the ages of 18 and 29, based on their findings. That’s in keeping with the National Advisory Committee on Immunization’s recommendation last December, when it said Pfizer is preferable for first and second doses over Moderna for those between the ages of 12 and 29.

For booster shots, NACI said in a statement that Pfizer “may be preferred” for those aged 18 to 29.

Earlier this month, the agency said there is currently no evidence to suggest any meaningful difference in protection between different bivalent booster vaccines targeting the original COVID-19 strain and the Omicron subvariant, “nor any clinical trials directly comparing the Moderna (50 mcg) and Pfizer-BioNTech (30 mcg) bivalent booster products.”

Authors of the British Columbia-based study found there is little to no difference in myocarditis rates between Moderna and Pfizer-BioNTech following a third dose.

Janjua, who is also a clinical professor at the University of British Columbia’s school of population and public health, said that may be because Moderna slashed the dosage by half to 50 micrograms for the booster shot, while it remained the same for Pfizer’s booster, at 30 micrograms.

“Moderna had a better response compared to Pfizer,” Janjua said of the primary doses. “But, of course, with the higher dose, you may see some of these complications, such as myocarditis.”

Moderna did not respond to requests for comment on the study or the risk of myocarditis from second doses.

Cases of post-COVID-19 vaccination linked with myocarditis and pericarditis, inflammation of the two-layered sac surrounding the heart, have been reported internationally since 2021 among males as young as 12, prompting ongoing research.

A study published in January in the Journal of the American Medical Association with research that included the US Centers for Disease Control and Prevention was based on data seven days following a second dose of an mRNA vaccine.

For men aged 18 to 24, it reported 56 cases per million doses after the Moderna vaccine compared with 52 cases per million doses for those who received a second shot of Pfizer.

Janjua said researchers elsewhere are trying to determine why males face a higher risk of myocarditis linked to COVID-19 mRNA vaccines compared with females, but hormonal differences related to immunity are believed to be a factor.

While most cases have been mild and resolved quickly, the National Advisory Committee on Immunization strongly recommended last December that people aged 12 to 29 receive the Pfizer vaccine.

Overall, Janjua said the risk of complications from a COVID-19 infection is much higher than developing myocarditis from a Moderna vaccine, which he would advise if there is no other choice.

“Go with whatever is available to reduce your risk of getting infected.”

This report by The Canadian Press was first published Nov. 23, 2022.

This story was produced with financial assistance from the Canadian Medical Association.

Camille Bains, The Canadian Press

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Cobourg resident first at Peterborough Regional Health Centre to receive new cancer treatment

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Two years ago, Cobourg resident Stuart Morley became the first-ever patient at Peterborough Regional Health Centre (PRHC) to receive life-changing cancer treatment by interventional radiology-radiofrequency ablation for a tumour on his kidney. (Photo courtesy of PRHC Foundation)

Two years ago, a doctor looked at a CT scan of Stuart Morley’s kidney and saw a tumour. It was small — only 15 millimetres — but the Cobourg resident was over 80 years old, so major surgery wasn’t the best option for him. Instead, he was a candidate for a minimally invasive interventional radiology procedure.

Stuart became the first-ever patient at Peterborough Regional Health Centre (PRHC) to receive life-changing cancer treatment by interventional radiology-radiofrequency ablation.

The amateur photographer and retired radiographer tells how PRHC’s Dr. Kebby King put a metal probe through a small cut in his skin and, using a CT to guide her, found the tumour and dissolved it with radio waves.

Interventional radiologist Dr. Kebby King (right) and registered technologist Saara King prepare for a minimally invasive interventional radiology procedure at Peterborough Regional Health Centre (PRHC). Often described as 'the future of medicine', it's used to diagnose and treat a wide range of emergency and chronic health conditions, such as cancer and other illnesses, without the use of conventional surgery. (Photo courtesy of PRHC Foundation)
Interventional radiologist Dr. Kebby King (right) and registered technologist Saara King prepare for a minimally invasive interventional radiology procedure at Peterborough Regional Health Centre (PRHC). Often described as ‘the future of medicine’, it’s used to diagnose and treat a wide range of emergency and chronic health conditions, such as cancer and other illnesses, without the use of conventional surgery. (Photo courtesy of PRHC Foundation)

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“It was amazing,” Stuart recalls. “I felt no pain and I was able to go home later that afternoon. Now I’m back taking photos and looking forward to travelling the world again. I worked in diagnostic imaging for 12 years. But back in the ’60s, we could never have imagined the kinds of things doctors can do these days.”

Interventional radiology is often described as ‘the future of medicine’. It’s used to diagnose and treat a wide range of emergency and chronic health conditions such as cancer and other illnesses, without the use of conventional surgery and the associated pain, complications, and longer hospital stays.

For patients in the Peterborough region, this means they can go home sooner, with less pain and less risk, all without having to travel far away.

VIDEO: Interventional Radiology is helping to revolutionize cancer care at PRHC

Interventional radiologist Dr. King describes that difference as “night and day.”

It’s remarkable how many life-threatening health conditions can be diagnosed and treated with this innovative specialty. It can be used to biopsy or treat tumours like Stuart’s, put in ports for chemotherapy, or stop bleeding — in as little as an hour.

Dr. King and her colleagues already perform 6,000 interventional radiology procedures each year at PRHC, and the need for this kind of care is only growing in our region. PRHC’s interventional radiology suites are 14 years old, however, and are too small to fit new advanced technology and the staff required to use it.

Interventional radiologist Dr. Kebby King (right) and registered technologist Saara King at Peterborough Regional Health Centre (PRHC). Dr. King and her colleagues perform 6,000 interventional radiology procedures a year for patients like Stuart Morley from across the region. To meet the growing need for this service, PRHC's facilities must be upgraded with a $6 million investment. (Photo courtesy of PRHC Foundation)
Interventional radiologist Dr. Kebby King (right) and registered technologist Saara King at Peterborough Regional Health Centre (PRHC). Dr. King and her colleagues perform 6,000 interventional radiology procedures a year for patients like Stuart Morley from across the region. To meet the growing need for this service, PRHC’s facilities must be upgraded with a $6 million investment. (Photo courtesy of PRHC Foundation)

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A $6 million investment in state-of-the-art equipment, upgraded suites, and an expanded recovery room is essential to meeting the need — so more patients with more complex conditions can be diagnosed and treated close to home.

Grateful for the great care he received and determined to help pave the way for new ground-breaking therapies to be offered at PRHC in the near future, Stuart donated to the PRHC Foundation for the first time. He wants to support the interventional radiology renovation and upgrade, and he knows that the government doesn’t fund hospital equipment.

“Our regional hospital needs our help,” Stuart says. “I’m asking everyone to join me in donating to support the interventional radiology facilities. Pictures can save lives. I know this because medical imaging saved mine. Now, our donations will help others. Thank you for helping to give people like me a brighter future.”

Grateful for the great care he received at Peterborough Regional Health Centre (PRHC) two years ago and determined to help pave the way for new ground-breaking therapies to be offered at PRHC in the near future, Cobourg resident Stuart Morley donated to the PRHC Foundation and is encouraging others to do the same. (Photo courtesy of PRHC Foundation)
Grateful for the great care he received at Peterborough Regional Health Centre (PRHC) two years ago and determined to help pave the way for new ground-breaking therapies to be offered at PRHC in the near future, Cobourg resident Stuart Morley donated to the PRHC Foundation and is encouraging others to do the same. (Photo courtesy of PRHC Foundation)

Not only do donations fund state-of-the-art technology not funded by the government, fuel innovation, and bring new services to our region, they also help PRHC attract and retain the best and brightest healthcare professionals. Doctors, nurses and staff want to do their jobs to the best of their abilities, and advanced equipment and innovative treatments support them in doing that.

This holiday season, donors and grateful patients like Stuart can help ensure PRHC’s frontline workers have the tools they need to provide expert, compassionate care, and receive some good cheer. Tribute donations can include a message of thanks or best wishes to a hospital department or individual physician, nurse or staff member when made online at prhcfoundation.ca or by phone at 705-876-5000.

To donate, find out more about interventional radiology, or share your own PRHC grateful patient story, please visit prhcfoundation.ca or call 705-876-5000.

This branded editorial was published in partnership with the PRHC Foundation. If your organization or business is interested in a branded editorial, contact us.

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Canadians should ensure kids get routine vaccines following COVID disruptions: doctors – National | Globalnews.ca – Global News

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Preventable diseases like measles could follow trends seen elsewhere in the world and spread quickly in Canada due to a drop in routine vaccinations during the COVID-19 pandemic, say pediatricians who are urging parents to ensure their kids are fully immunized.

Provinces and territories log data on vaccinations provided in the community against infectious diseases like measles, diphtheria, polio and whooping cough, as well as vaccines against other illnesses administered in school immunization clinics.

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Although much current data doesn’t cover years beyond 2019, provinces with more recent figures are already seeing a dramatic decline in routine vaccinations.

Read more:

Measles vaccination rates in Canada have decreased, PHAC says amid global concern

Pediatricians are concerned about possible outbreaks of preventable diseases if too many children were underimmunized or not vaccinated at all while public health clinics focused on COVID-19 vaccines. Widespread school closures and vaccine disinformation that swayed some parents against immunization efforts complicated matters still further.

Recent data from Public Health Ontarioshows that for 12-year-olds, vaccination against the liver infection hepatitis B plummeted to about 17 per cent in the 2020 to 2021 school year, compared with 67 per cent in the school year ending in 2019.

For human papillomavirus, or HPV, which can cause cancer, the vaccination numbers were even lower, plunging to 0.8 per cent last year, compared with 58 per cent in 2019. For the meningococcal vaccine, which helps protect against four types of the bacteria that cause a rare disease, vaccinations fell to about 17 per cent from 80 per cent over the same time. Risks of the potentially deadly illness include meningitis, an infection of the lining of the brain and spinal cord.


Click to play video: 'Flu cases on the rise in Alberta'

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Flu cases on the rise in Alberta


“The large decline in coverage in 2019-20 and 2020-21 illustrates the impact of the COVID-19 pandemic, as there was limited capacity to deliver school-based immunization programs,” Public Health Ontario said in a statement.

It said data for uptake of vaccines aimed at protecting younger kids against measles, for example, is not available beyond 2019, and a report on later numbers is expected to be released next spring.

Dr. Monika Naus,medical director of Immunization Programs and Vaccine Preventable Diseases Service at the BC Centre for Disease Control, said in-school vaccines, starting in Grade 6, were delayed, but work is underway to return to pre-pandemic levels.

Younger children missed appointments at doctors’ offices while physicians were seeing patients virtually and public health clinics, which mostly administer routine vaccines for kids outside of the Lower Mainland region of the province, were busy with COVID-19 shots, Naus said.


Click to play video: 'Routine childhood vaccinations drop during pandemic'

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Routine childhood vaccinations drop during pandemic


Dr. Sam Wong, director of medical affairs for the Canadian Paediatric Society, said disinformation and vaccine hesitancy during the pandemic, “combined with the failure of the public health system” to provide routine vaccines, mean certain populations could be left vulnerable to highly contagious diseases like measles, which spreads through coughing and sneezing.

“You could walk into a room an hour after someone’s been in there and potentially get infected,” he said.

“We’re worried, as a group of health-care providers, that if you have lower rates of vaccinations that you’re more likely to have localized outbreaks of vaccine-preventable illnesses such as measles or mumps and chickenpox,” Wong said.

Read more:

Some childhood routine vaccines declined in Alberta over last 2 years due to COVID delays

Wong said it’s important for doctors and parents to discuss the importance of routine vaccinations that have been proven effective for decades, adding some people believe young kids’ immune systems are not ready so they’d rather wait until they’re older.

“But that’s why you want to give the vaccine, because their immune system is not able to fight off infections,” he said.

“Some parents don’t want to even have discussions with me about it. But if there is an opening, I’m happy to talk about it,” said Wong, who works in Yellowknife, Edmonton and Victoria.

The Public Health Agency of Canada said Canadian studies have found immunization coverage declined during the pandemic for the measles, mumps and rubella vaccine.


Click to play video: 'Toronto Public Health to resume in-school vaccination clinics in September'

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Toronto Public Health to resume in-school vaccination clinics in September


Quebec saw a 39 per cent drop in April 2020 compared with 2019, the agency said, with the greatest impact seen in children aged 18 months.

In Alberta, the agency said vaccination for those diseases declined by 10 per cent in April 2020 compared with the same month a year earlier. Coverage for Ontario children under two decreased by 1.7 per cent, it added.

“The Public Health Agency of Canada continues to work with provinces and territories on an ongoing basis to understand the impact of the pandemic on routine immunization coverage across Canada, and to improve the availability of high-quality data to inform immunization programs,” it said in a statement.

It is currently in discussions with all jurisdictions on ways to monitor coverage of vaccines, similar to a surveillance system used for COVID-19 vaccines, the agency said.

Nova Scotia Health said its last report on childhood vaccines was completed three years ago, and numbers have fallen during the pandemic.

“Anecdotally, we know there was a drop in childhood vaccination, but we do not have the specific numbers available at this time,” it said in a statement.

However, the school immunization program is aiming to help students catch up on vaccines that were missed early in the pandemic, mostly through doctors’ offices, it said, adding that getting an appointment was a challenge for some families.

“We know that a substantial number of Nova Scotians do not have a family doctor. Public Health often works with local primary care clinics to provide vaccines to those who do not have a family doctor and some public health offices will offer clinics to this population.”

Last week, the World Health Organization and the United States Centers for Disease Control and Prevention released a statement saying a record high of nearly 40 million children missed first and second doses of the measles vaccine in 2021 due to disruptions in immunization programs since the start of the pandemic.

The two groups said there were an estimated nine million measles cases and 128,000 related deaths worldwide in 2021, and 22 countries experienced large outbreaks.

Dr. Noni MacDonald, a professor of pediatrics and infectious diseases at Dalhousie University in Halifax, said a national registry that could quickly tell doctors which children have not been vaccinated is essential in Canada.

“I feel like I’m banging my head against a brick wall,” she said of her efforts to call for that change.

“How can we do proper health-care planning when we don’t have the data?”

Canada is an “outlier” that lags behind most European countries on the measles vaccine, she said, adding a coverage rate of 95 per cent is needed to create so-called herd immunity against the highly infectious disease.

Canada recently had 84 per cent uptake of the second dose of the measles vaccine. MacDonald said Australia, in comparison, had 94 per cent based on the most recent data from the WHO. She used the two countries as an example because they had a similar number of births _ 368,000 in Canada, and 300,000 in Australia in 2021.

“We are just not in the same league, and we should be embarrassed.”

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Flu shots are now free for everyone in Quebec due to overwhelmed hospital ERs

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While the campaign for flu shots has already been underway in Quebec for several weeks, the provincial government announced on Friday that immunization will now be free of charge for any Quebecer over the age of six months.

Previously, only people who met certain criteria (babies, seniors, the chronically ill, etc) were able to get the influenza immunization free of charge, and the vaccination sites set up for COVID-19 were only handling free flu shots. Meanwhile, the general population in Quebec was previously only able to get vaccinated at pharmacies, for a fee.

The decision was made due to the critical state of hospital ERs in the province, particularly at children’s hospitals in Montreal, where kids are being brought in by parents in larger numbers than usual due to rising rates of flu, COVID-19 and RSV infections.

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“With the trio of viruses currently circulating, the influenza vaccine is now available free of charge to all Quebecers who wish to take advantage of it. It’s one more tool to limit the pressure on our network.”

—Quebec Health Minister Christian Dubé

To schedule an appointment for a flu shot and/or a COVID-19 shot, please visit the Clic Santé website.

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