Health
Could Moderna be authorized as a one-shot vaccine? Here’s what we know – Global News
The head of Ontario’s vaccine distribution task force wants Health Canada to look into allowing Moderna’s vaccine to be administered as one, less effective dose instead of two, allowing his team to ramp up their vaccination schedule across the province.
“We can’t vaccinate people any faster than we can if we don’t have the vaccines to do it,” Hillier said, speaking during a Tuesday press conference.
“I’m not asking Health Canada to change the Moderna from a two-shot vaccine to a one-shot vaccine. What I’m asking is Health Canada have a look at doing that, and saying maybe with the high efficiency that protects you in the first needle, it would be best for the entire population if we went just with a one-shot vaccination program with Moderna. I asked them to have a look at that.”
While provinces are sprinting to get needles into arms as quickly as possible, there is only so much that can be done as Canada awaits the arrival of vaccines.
Ontario came under fire for its initially slow rollout of its first vaccine shipments, but as they prepare to ramp up their vaccination schedule, Hillier says it would be worth studying whether the Moderna vaccine would be effective enough as a single dose.
There are currently two coronavirus vaccines approved for use in Canada, one of which is the Moderna vaccine. The vaccine currently requires two doses administered 28 days apart, with the initial dose providing 80 per cent protection before the second shot jolts that figure up to 95 per cent.
But one thing we don’t know is how long that initial 80 per cent effectiveness would last without a second dose.
The Pfizer-BioNTech vaccine, the only other COVID-19 vaccine currently approved for use by Health Canada, also involves two doses, taken some three weeks apart.
Both vaccines require two doses to hit around 95 per cent protection.
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And because the two dose-regimen is how both vaccines were studied and approved, this is how they must be administered, according to Dr. Zain Chagla.
“We give medications based on a monograph we give them based on how they’re dosed and how they’re studied in clinical trials,” he said.
“And so it’s very hard to then just invent a regimen, in that sense, and hope that it works based on subgroup analysis in a study or how the protocol wasn’t followed in the study.”
Moderna has only received regulatory approval in its two-dose form, meaning Hillier’s dream of a single-shot vaccine would require Moderna to submit new documents indicating the safety and efficacy of a one-dose version — a process that Moderna itself would have to be interested in undertaking.
And that’s also not a given, Chagla said.
“Taking the side of the company, they want their drug to work as best as possible,” he said.
“So I don’t think they’re particularly incentivized to also submit a regimen to Health Canada to say, well, this might work, it might be inferior – only to have their drug not work as well because they didn’t follow the optimal dosing strategy.”
Global News has reached out to Moderna for comment, but did not receive a response by the time this article was published.
Chagla also cautioned that even if Moderna wanted to submit that data, it might not actually exist. That’s because the vast majority of the vaccine recipients in the clinical trials were given two doses, not one.
“That data probably doesn’t exist significantly because, again, most of the people in the Moderna trial got both shots,” Chagla explained.
“And so there is a small subset that missed their (second) appointment…that’s probably not enough to leverage a decision that’s going to be mass vaccination campaign for the population.”
Health Canada’s chief medical adviser echoed Chagla’s comments during a press conference on Dec. 23.
“In terms of the clinical trials for the Moderna vaccine and for the Pfizer vaccine as well, they were both based on a two-dose regimen,” Dr. Supriya Sharma said.
She said that there are measurements of immunity before the second dose that, in the case of Moderna, are “quite high” — but the second dose was still eventually administered, leaving no answer as to whether that immunity drops off and how quickly that might happen.
“The question is how long does that immunity (last) and would it be lasting for that, you know, a significant period of time. So we would recommend that the second dose be given,” Sharma said.
She added that, for the Moderna and Pfizer vaccines, there can be “flexibility” in terms of when the second dose needs to be administered — but there isn’t enough evidence to say just how flexible that timeline might be.
“We haven’t seen anything in the evidence that would show that there would be a significant decrease in immunity if that is delayed for a few weeks. But again, we really don’t have the data to be able to say that, to confirm that one way or the other,” Sharma said.
Chagla said this could be an area where it would be worth investigating further. If it’s discovered that a longer delay between doses doesn’t impact the vaccine’s efficacy, it could help with the vaccine rollout logistics.
“Can we wait two weeks, four weeks and go off the monograph in that sense? Logistically, that might be a whole lot easier — to do people at eight weeks rather than four weeks,” he said.
For the time being, however, the vaccine must be administered as directed.
“The expectation is people get their second dose and…we give them their second dose,” Chagla said.
“We don’t stop doing it just because we want to save supply. We try to get the optimal immunity for the population.”
© 2020 Global News, a division of Corus Entertainment Inc.
British Columbia health officials announced 407 new test-positive COVID-19 cases on Tuesday, bringing the total number of recorded cases in the province to 65,234.
In a written statement, Provincial Health Officer Dr. Bonnie Henry said that broken down by health region, this equates to 124 new cases of COVID-19 in the Vancouver Coastal Health region, 169 new cases in the Fraser Health region, 22 in the Island Health region, 54 in the Interior Health region, 38 in the Northern Health region, and no new cases of people who reside outside of Canada.
There are 4,260 active cases of COVID-19 in the province. There are 313 individuals currently hospitalized with COVID-19, 71 of whom are in intensive care. The remaining people are recovering at home in self-isolation.
Currently, 6,450 people are under active public health monitoring as a result of identified exposure to known cases.
There have been 14 new COVID-19-related deaths, for a total of 1,168 deaths in British Columbia.
A total of 58,352 individuals who tested positive have now recovered, and to date, 122,359 doses of COVID-19 vaccine have been administered in BC, 4,105 of which are second doses.
“The number of new daily cases of COVID-19 is much higher than we want it to be,” said Henry. “We are asking for everyone’s help to bend our curve back down. This is especially critical with the presence of variant viruses in our province.”
Health
Additional steps Albertans can take as more cases of COVID-19 variants reported – Global News
Health officials say current public health measures around masking and distancing will protect Albertans against the new variants of the novel coronavirus, but there are some extra precautions that can be taken.
Alberta Health reported Monday that there were 20 cases of the UK variant and five cases of the South African variant in the province; while most were travel-related, there is one case that appears to be the result of community transmission.
READ MORE: U.K. variant of COVID-19 ‘may have entered the broader community’ in Alberta: Shandro
Infectious disease epidemiologist Zahid Butt of the University of Waterloo said people will need to be more vigilant now about following public health guidelines.
“We need to be more careful about distancing now. We need to be more careful about wearing masks. We should be more careful about hand sanitization and other measures,” Butt said.
The variants can transmit faster between people because of changes to the spike proteins on the virus’s surface, which allows it to enter cells more easily. Higher transmission of the virus means there is the potential for more cases and, with that, the possibility there could be more hospitalizations.
Should people wear two masks?
While some Americans are wearing two masks, Butt said he wouldn’t recommend it.
READ MORE: Officials confirm Canada’s 1st case of South African variant of COVID-19 detected in Alberta
“Currently they just recommend one mask because…it has a better fit, it’s a more comfortable fit,” Butt said, adding he recommends wearing a mask everywhere, even outdoors.
Butt also said that three layers in a mask will protect a person more than a mask with just one layer.
RELATED: COVID-19: Triple-layer masks now recommended, what does that mean for Albertans?
“Additionally if you have a mask which you can actually put in a filter, in addition to your three layers, that will protect you better,” he said.
Infectious disease physician Dr. Stephane Smith agrees, saying she doesn’t think there’s any evidence to suggest wearing two masks is more protective than wearing one.
Smith said N95 can filter small air particles but those are recommended for those working in hospital settings.
READ MORE: ‘Realistic possibility’ COVID-19 variant from U.K. could be deadlier, researchers say
“For most people in everyday settings, the surgical mask or its equivalent is effective in preventing transmission from larger droplets,” she said.
Smith said wearing masks indoors is very important and wearing masks outdoors is also important if you are going to be in close contact with someone, but she balks at wearing a mask at all times when outdoors.
“If you’re just out for a walk in your neighbourhood and you don’t actually interact with anyone then you probably don’t need to wear a mask at all,” she said.
Should people distance more than two metres?
Albertans have been told to distance two metres from people outside of their household, but Butt said people can take extra precautions and distance more than two metres to be safe.
Should people cut down the time they spend in indoor spaces?
Smith said, at this point, it isn’t clear how well established the new variants are in Alberta but she recommends curbing interactions.
“If you need to go to the grocery store, go to the grocery store but limiting the amount of time you spend there is still the best suggestion,” she said.
Butt suggests only going out for essential tasks and he also recommends reducing the time spent in closed settings.
What about travel internationally, domestically and within Alberta?
Butt said people should avoid travelling right now, saying this is one way the variant can spread.
“No travelling across provinces and also, if you’re living in an area that’s designated a high-risk area, don’t travel from your high-risk area to a low-risk area,” he said.
Smith said international travel right now is a “bad idea” and that the province should monitor what is happening in other provinces.
“If it does appear there are areas of the country that have widespread transmission of the new variant then I think we would have to look at some restrictions of people coming from that particular province,” she said.
READ MORE: Albertans angry over COVID-19 travel scandal, feel consequences came too late
“There have been outbreaks in Ontario related to the new variant. I think this data is emerging. I think we’ll have to keep a close eye on the information that we get from these other provinces to determine what we should be doing about restrictions within Alberta.”
As for travel within Alberta, Smith said there is an increased risk any time you travel because there are more interactions with people that you wouldn’t normally interact with.
Smith suggests curtailing travel within the province unless it is essential.
© 2021 Global News, a division of Corus Entertainment Inc.
Ontario is reporting 1,740 new cases of the coronavirus on Tuesday, bringing the provincial total to 258,700.
Tuesday’s case count is lower than Monday’s which saw 1,958 new infections. On Sunday, 2,417 new cases were recorded and 2,359 on Saturday.
It is also the lowest increase in daily cases since Dec. 13 when 1,677 new cases were reported.
“Locally, there are 677 new cases in Toronto, 320 in Peel and 144 in York Region,” Health Minister Christine Elliott said.
The death toll in the province has risen to 5,909 after 63 more deaths were reported.
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Meanwhile, 229,755 Ontarians have recovered from COVID-19 which is about 89 per cent of known cases. Resolved cases increased by 2,261 from the previous day.
There were more resolved cases than new cases on Tuesday.
Active cases in Ontario now stand at 23,036 — down from the previous day when it was 23,620, and down from last Tuesday at 27,615.
The seven-day average has now reached 2,346, down from yesterday at 2,371 and down from last week at 2,893 — showing a downward trend in new cases.
Ontario reported 1,466 people hospitalized with COVID-19 (up by 68 from the previous day), with 383 patients in an intensive care unit (down by 14) and 298 patients in ICUs on a ventilator (up by 15).
The government said 30,717 tests were processed in the last 24 hours. There is currently a backlog of 36,405 tests awaiting results. A total of 9,375,676 tests have been completed since the start of the pandemic.
Test positivity — the percentage of tests that come back positive — for Tuesday was 5.9 per cent, up from Monday at 5.5 per cent, and down from one week ago when it was 6.8 per cent.
Ontario is reporting 1,740 cases of #COVID19 and over 30,700 tests completed. Locally, there are 677 new cases in Toronto, 320 in Peel and 144 in York Region.
As of 8:00 p.m. yesterday, 295,817 doses of the COVID-19 vaccine have been administered.
— Christine Elliott (@celliottability) January 26, 2021
As of 8 p.m. Monday, the province has administered 295,817 COVID-19 vaccine doses. There are 83,285 people fully vaccinated with two doses. Both Pfizer-BioNTech and Moderna, the only two vaccines currently approved in Canada, require two shots.
Here is a breakdown of the total cases in Ontario by gender and age:
- 126,519 people are male — an increase of 874 cases.
- 130,723 people are female — an increase of 875 cases.
- 33,791 people are 19 and under — an increase of 243 cases.
- 94,667 people are 20 to 39 — an increase of 636 cases.
- 74,605 people are 40 to 59 — an increase of 497 cases.
- 37,300 people are 60 to 79 — an increase of 252 cases.
- 18,288 people are 80 and over — an increase of 110 cases.
- The province notes that not all cases have a reported age or gender.
The province notes that the number of cases publicly reported each day may not align with case counts reported by the local public health unit on a given day. Local public health units report when they were first notified of a case, which can be updated and changed as information becomes available. Data may also be pulled at different times.
Here is a breakdown of the total deaths related to COVID-19 by age:
- Deaths reported in ages 19 and under: 2
- Deaths reported in ages 20 to 39: 22
- Deaths reported in ages 40 to 59: 222
- Deaths reported in ages 60 to 79: 1,594
- Deaths reported in ages 80 and older: 4,068
- The province notes there may be a reporting delay for deaths.
Read more:
Provinces sitting on millions in COVID-19 funds for long-term care homes: CCPA
Ontario long-term care homes
According to the Ministry of Long-Term Care, there have been 3,389 deaths reported among residents and patients in long-term care homes across Ontario which is an increase of 24 deaths. Eleven virus-related deaths in total have been reported among staff.
There are 246 current outbreaks in homes, which is a decrease of 10 from the previous day.
The ministry also indicated there are currently 1,164 active cases among long-term care residents and 1,905 active cases among staff — down by 102 cases and down by 105 cases, respectively, in the last day.
© 2021 Global News, a division of Corus Entertainment Inc.
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