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Canada is recommending COVID boosters this fall. Who really needs one?

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Canada’s vaccine advisors are recommending a COVID-19 booster dose of yet another reformulated vaccine this fall. It may prove a tough sell.

With uptake diminishing, dose after dose, COVID vaccines may be approaching “sort of an acceptability settling point,” immunologist Dr. Matthew Tunis, executive secretary to the National Advisory Committee on Immunization (NACI), said in an interview with National Post.

Additional “promotional activities” and communication strategies may be needed, he said, “to explain and rationalize what value the vaccine program can bring.”Others also fear a lacklustre response. “My worry is that we will have very low uptake of vaccines in the fall,” said Dr. Fahad Razak, an internist with Unity Health in Toronto and a past scientific director of Ontario’s COVID-19  scientific advisory table.

However, some experts outside Canada are questioning the need for an expansive round of boosting. “I believe we should stop trying to prevent all symptomatic infections in healthy, young people by boosting them with vaccines containing mRNA strains that might disappear a few months later,” pediatrician Dr. Paul Offit, a member of the U.S. Food and Drug Administration’s vaccine advisory committee, wrote in the influential New England Journal of Medicine earlier this year.

Boosters are probably “best reserved” for high-risk groups, Offit said, like the elderly and immunocompromised. The level of neutralizing antibodies doesn’t tell the whole story, he said. Human T cell defence, cellular immunity, appears to be coping with SARS-CoV-2 mutations, Offit said in an email to the National Post.
“The good news is that the epitopes (parts of the spike protein) recognized by T cells, which are critical in protection against severe disease, have remained relatively well conserved,” Offit said.“So, even if you were only vaccinated with the original ancestral strain, protection against severe disease in those who are relatively young and healthy appears to be holding up.”

Not everyone agrees with him. SARS-CoV-2 “has evolved dramatically in the last three years,” Razak said. “The mutations that have emerged in many ways makes the virus nearly unrecognizable to the immune system, and to the protections we had in place against the original variant.”

The “who to boost” debate comes as a sizable proportion of the Canadian population already appears booster weary. While 83 per cent of the population has received at least two doses of a COVID vaccine, just over half — 51.5 per cent — are “fully vaccinated” with a third dose, according to the COVID-19 Vaccination Tracker.

Only about 26 per cent of Canadians aged five and older received one of the bivalent vaccines that rolled out last September — a 50-50 mix that contained some of the original strain, plus the then-rapidly spreading Omicron subvariants BA.4 and BA.5.Razak said that if someone is eligible for a booster — they’re six months or more out from their last vaccine or last COVID infection — “don’t go out and get vaccinated now, unless you have a specific, high-risk reason to do so.” Instead, he said people should wait until the updated shots are available in the fall, when peak circulation of the virus is expected.

The latest formulations, now under review by Health Canada, have dropped the original strain entirely, which is essentially extinct, no longer circulating in humans. They target newer Omicron subvariants, specifically the dominant circulating strain XBB.

“Individuals vaccinated with the updated formulation are expected to benefit from a better immune response against these variants compared to current vaccines,” NACI said in its latest advice.

Starting in the fall, for those previously vaccinated against COVID-19, NACI recommends a dose of the new vaccines for people in whichever age groups are ultimately authorized, if it’s been at least six months from the previous COVID vaccine or known SARS-CoV-2 infection, “whichever is later.”

Immunization is particularly important for those at increased risk of severe disease, NACI said.Immunity from even hybrid protection — vaccination plus infections — wanes with time, NACI said.

The best way to protect the vulnerable “is to have everyone boosted,” said McMaster University immunologist Dawn Bowdish.

There isn’t a health system in Canada that isn’t struggling currently, with COVID circulating at low levels, Bowdish said. “It’s imperative we get vaccinated so that during cold and flu season we don’t see the same disruptions to health care that we saw last year.”

Part of the problem is calling them “boosters,” she said, suggesting people are getting a “top up.” Like a yearly flu shot, “you can’t reasonably expect to be protected from symptomatic infections or hospitalization unless you are recently vaccinated with a matched vaccine.”

Ultimately it will be up to the provinces and territories to decide on a fall roll-out.

In Canada, rates of hospitalizations and deaths are highest for the 60 and older, and highest still among those 80 and older “and those who are unvaccinated,” NACI said. Rates are lowest for those recently vaccinated, and those with hybrid immunity (a combination of immunity from vaccinations and infections), particularly if the previous infection was with an Omicron strain.

Most Canadians have already contracted COVID. Data from blood donors suggest nearly 80 per cent of the population overall had infection-acquired antibodies in May. The vast majority were infected with Omicron.COVID isn’t the unpredictable, severe respiratory illness it once was. Overwhelming COVID pneumonias, where people rapidly deteriorated, requiring high levels of oxygen, many of them dying, “are very, very rare now,” Razak said.

Infections that don’t land people in hospital “can still be very disruptive,” he said. They can be the “tip over” event, exacerbating heart failure or other chronic illnesses. “We are trying to move towards this position of having a stable, post-pandemic period for Canada…. We want to live the healthiest, least disruptive lives possible,” Razak said.

There is “nothing that I have seen scientifically,” he said, to suggest that the immune system can become exhausted by repeated exposures to the vaccines.

There’s been a “consistent trend” of waning protection from the vaccines, Tunis said, “and we’re still early in our understanding of hybrid immunity,” including how hybrid immunity is performing in the XBB era, he said.

“We’re not at a point yet in the evolution of the science around this pandemic where we can really proclaim with certainty that hybrid immunity with a certain number of doses can protect you for X number of years,” Tunis said.

 

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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