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Complex challenges mean mandatory COVID-19 vaccine unlikely: experts – Surrey Now-Leader

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While the government spends hundreds of millions of dollars to develop and test potential vaccines for COVID-19, experts say mandatory vaccination is unlikely given the difficult practical and ethical problems that would entail.

“A vaccine will be extremely important to getting back to normal,” Prime Minister Justin Trudeau said Tuesday, adding that effective treatment could help us get there too.

A recent poll conducted by Leger and the Association for Canadian Studies found 60 per cent of respondents believe people should be required to get the vaccine once it’s ready, although that is likely to be many months away.

READ MORE: Should a vaccine for COVID-19 be made mandatory in Canada, once it’s created?

It’s understandable people feel that way, said vaccine expert Dr. Noni MacDonald, but mandatory vaccines are a complicated proposition.

There are no truly mandatory vaccines in Canada. While provinces like Ontario and New Brunswick require children to be vaccinated in order to attend school, there are exemptions for medical and ideological reasons.

For adults, the only Canadian precedent for mandatory vaccines is for medical workers who must be immunized against certain diseases to protect themselves and their patients, MacDonald said.

“What’s your consequences for not doing it if you make it mandatory?” said MacDonald, a professor with the faculty of medicine at Dalhousie University. “What’s your penalty? Or what’s your incentive?”

Those questions are more complex than they appear, and can lead policy-makers down a rabbit hole.

Australia tried to convince parents to immunize their children by making certain tax benefits contingent on those vaccinations, MacDonald said.

“The group that it really harmed was the very low-income people who had to take time off work to get their child immunized,” she said. ”And they got a double whammy. They not only didn’t get their child immunized, which meant they couldn’t go to daycare or go to school, but they also didn’t get the child tax credit.”

Ethically speaking, the government would have to make sure not to unduly penalize people who don’t get the vaccine.

Policy-makers also have to worry about a backlash, said Ubaka Ogbogu, an associate professor with the University of Alberta who specializes in law and bioethics.

“The reason why we should probably not raise the question of mandatory vaccination in relation to COVID-19 is because it’s deeply controversial,” Ogbogu said.

There is usually vehement opposition to mandatory vaccination, at least by small but vocal groups who worry about the safety of vaccines and government infringement on their liberties.

Those people are likely to be even more concerned about a rapidly developed vaccine, he said.

“The last thing you want is for (a vaccine) to become available, and then we spend a lot of time fighting over whether it should be mandatory or not, when I think people are going to want it,” he said. ”I think what we’re going to have is the opposite issue.”

READ MORE: Normal life won’t fully return until COVID-19 vaccine developed, Trudeau says

The question of whether to make the vaccine mandatory assumes there will be enough to go around, which both experts agree is doubtful.

It’s difficult to know what the uptake in an eventual vaccine will be, said chief public health officer Dr. Theresa Tam.

“Sometimes it’s quite an emotional reaction,” she said Saturday.

“I recall in the last pandemic when you’d get an increase in deaths, for example, people will suddenly want to take up the vaccine very fast when you don’t have enough to go around.”

The more likely ethical quandary for policy-makers will involve figuring out how to distribute a limited supply of the vaccine in a way that is fair and effective.

That will depend on how knowledge of the vaccine and the disease develops.

Influenza, for example, spreads rampantly among kids who are in school so it’s important to boost their immunity. But it’s not clear if the same is true of COVID-19, MacDonald said. It may be that health-care workers should be the first to receive the vaccine, or people who work in long-term care homes.

To make matters more complicated, with several vaccines in development the successful candidates may be more effective in some populations than others.

Those are all factors that will have to be sorted out as the government works toward rolling out a vaccine in Canada.

The federal and provincial governments are going to have to make “extremely important decisions,” about how to achieve the optimal level of vaccination, Trudeau said Tuesday, and those decisions will be informed by research.

Laura Osman, The Canadian Press


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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.

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