With the arrival of the latest COVID-19 variants within the country and the looming flu season on the horizon, many Canadians may be wondering if they should get their booster shot immediately or wait until the newest vaccine formulations arrive.
The updated booster shots are expected to roll out in the fall but are still pending approval by Health Canada. The new vaccines are also tailored to the dominant XBB.1.5 Omicron subvariants that are currently circulating in the country.
Although bivalent COVID-19 vaccines are currently available in Canada, the National Advisory Committee on Immunization (NACI) previously said in July that the fall boosters will target more recent, immune‑evasive SARS-CoV-2 variants.
Some health experts say you might be better off waiting until the updated vaccines are available, while others say not to wait. This leaves Canadians grappling with a crucial decision: whether to get their booster shot immediately or hold off.
“It is it is well and truly confusing,” Kerry Bowman, a professor of bioethics and global health at the University of Toronto, said. “I think we’re getting an incredible lack of clarity as to what should occur. I wish we had stronger guidelines from public health. I feel like we’re on our own on this one.”
Adding to the confusion, he said, is the fact that some people have said they will get both shots, one now and the reformulated version when it becomes available. However, this approach is discouraged, Bowman said, emphasizing that it is advisable to wait at least six months between vaccine shots.
Here’s what health officials are saying about the fall booster shot.
What NACI is saying
In its latest guidance on July 11, “NACI recommends a dose of the new formulation of COVID-19 vaccine for people in the authorized age groups who have previously received a COVID-19 vaccine, if it has been at least 6 months since the last COVID-19 vaccine dose or known SARS-CoV-2 infection (whichever is later).”
It noted the new formulations expected this fall should provide a better immune response to the dominant subvariants. It did not specify whether Canadians should get the current formulation of the booster if the updated version was not available by fall.
“Booster doses in the fall will be formulations updated to target more recent, immune‑evasive SARS-CoV-2 variants,” NACI said in its updated vaccine recommendations.
“Individuals vaccinated with the updated formulation are expected to benefit from a better immune response against these variants compared to current vaccines.”
It emphasized is particularly important for those at increased risk of COVID-19 infection or severe disease including those 65 and over, long-term care residents, people who are pregnant and those with underlying conditions, to get immunized.
What Health Canada is saying
In an email to Global News on Monday, a spokesperson from Health Canada said it encourages “all Canadians to make sure that their COVID-19 vaccination is up to date.”
“Vaccination is one of the most effective ways to protect against COVID-19. All approved COVID-19 vaccines used in Canada continue to be very effective at protecting against severe illness, hospitalization and death from COVID-19.”
The health agency did not specify in its response whether Canadians should wait until the updated formulations become available.
The health department’s website is in line with NACI’s guidance, stating that COVID-19 booster doses may be offered at an interval of six months after a previous COVID-19 vaccine dose (after completion of the primary series or previous booster dose) or SARS-CoV-2 infection, regardless of the product offered.
Bivalent vaccines are the preferred vaccine for booster doses among individuals in the authorized age groups, Health Canada stated on its website, in addition to containing mRNA that encodes the spike protein of the original strain, they contain mRNA that encodes the spike protein of strains of the Omicron variant of concern.
NACI’s updated guidelines have not been added to the Health Canada website.
What the WHO is saying
The World Health Organization on Thursday said it recommends getting a booster or additional dose within six to 12 months, depending on your risk category.
Those who are most at risk should get their booster right away if they are due for one, said Dr. Maria Van Kerkhove, the WHO technical lead on the COVID-19 response, during a WHO question and answer session on social media.
For those who are most at risk, it is “very critical that you get a booster, and don’t wait,” she stressed. “The big message I have for you is don’t wait for the next round of vaccines.”
Previously, on March 28, the WHO said it no longer “routinely recommends” additional COVID-19 vaccine boosters for medium or low-risk people.
The WHO recommended additional booster doses for high-priority groups such as older people, immunocompromised people of all ages, front-line health workers and pregnant people. But for those who fall under the low and medium-risk group, WHO did not recommend additional COVID-19 boosters, citing “low public health returns.”
Because of this, Bowman said part of the confusion surrounding the COVID-19 fall booster is “understandable.”
“This is a very different pandemic profile than what we’ve been dealing with in the past, and whether to get a booster now or later could depend on the risks that that you are facing,” he explained. “So the short answer is, if you have risk factors, go ahead and get it now. ”
But there’s a lot of grey area.
For example, he said if someone is a healthy 25-year-old, but is living with a person who has advanced cancer and is going through chemotherapy, this creates uncertainty.
“We’re getting an incredible lack of clarity as to what should occur,” he said, adding that because there are new variants circulating, the level of risk and appropriate precautions have become even more challenging to determine.
With so much uncertainty, Bowman argued now is not the time for public health to go quiet, but instead, it’s a time for more guidance.
“I think most of us understand it’s no longer one size fits all, but we still need a lot more help with it than what we’re getting,” he said.
Dawn Bowdish, an immunologist at McMaster University in Hamilton, told the Canadian Press the mutating virus puts vulnerable populations, including the elderly, most at risk of infection.
Anyone starting chemotherapy or having major surgery may consider getting a booster before the reformulated vaccines are available but it’s otherwise best to wait, Bowden stressed.
However, for most people, “waiting for that new formulation of a booster dose in the fall will be the way to go because they already have enough immunity by having COVID-19 or having all of their complete vaccine doses and they’re otherwise healthy,” explained University of Saskatchewan epidemiologist Dr. Nazeem Muhajarine.
For those who are at higher risk, he said to get a booster shot as soon as possible.
Dr. Gerald Evans, an infectious disease specialist at Queen’s University in Kingston, Ont., said it would be ideal if XBB vaccines were available now before the flu season began.
“It would be great to have it as early as possible,” he said. “Once Health Canada says ‘yes we approve,’ then the manufacturer is the part that creates a bit of a delay. My hope is that delay will be extremely short-lived as there are a lot of people who are due for boosters now, including young, healthy people, where we say just get it once a year.”
He added that if “we can get those out and into people’s arms in September,” it could potentially help curb the ongoing surge in COVID-19 cases.
What is the status of the fall COVID-19 booster?
Health Canada is currently reviewing three new vaccine vaccines containing the XBB.1.5 Omicron subvariant, for those six months and older. It is reviewing submissions from Pfizer-BioNtech, Moderna and Novavax.
While no specific rollout date has been established, it is anticipated that Pfizer and Moderna vaccines will likely receive approval in the fall, with the Novavax shot following at a later date, Health Canada said in an email Monday.
“The authorization and availability of new vaccines will depend on many factors including the submission date, the review timelines, the acceptability of the information submitted and the supply of the vaccine by the manufacturer. If authorized, Canada will have ample supply of the new formulation of mRNA vaccines available in Fall 2023,” the spokesperson stated.
Canada will also have access to non-mRNA vaccine (Novavax) for those who are unwilling or unable to receive an mRNA shot, Health Canada said.
“We are anticipating it will be available later this year, pending a submission to, and authorization by, Health Canada.”
Public Services and Procurement Canada told Global News in an email Monday that it has agreements in place to procure the latest COVID-19 vaccines, ensuring Canada has the right quantity of doses it needs for 2023 to 2024.
“This includes agreements with Pfizer, Moderna and Novavax, currently allowing for up to 33 million doses that will be manufactured from their respective off-shore facilities and delivered in the fall/winter 2023, pending Health Canada regulatory approvals,” the spokesperson said.
Where do other countries stand on COVID-19 boosters?
Like Canada, the rollout of the COVID-19 booster shots in the United States is expected in the fall, according to the U.S. Food and Drug Administration (FDA).
The updated booster is expected to be cleared by the FDA ahead of a Centers for Disease Control and Prevention (CDC) vaccine advisory panel, which is scheduled to meet on Sept. 12 to vote on whether to recommend the updated vaccines, NBC News reported.
In England health officials on Wednesday said vaccinations will be available starting Sept. 11 (rather than the original October release date) as a precautionary measure intended to protect the most vulnerable as the winter months approach.
MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.
There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.
The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.
Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.
Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.
Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.
“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.
Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.
But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.
That includes his own teenage daughter.
“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.
It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.
“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”
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AP data journalist Kasturi Pananjady contributed to this report.
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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
How a sperm and egg fuse together has long been a mystery.
New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.
“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.
The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.
Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.
It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.
Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.
Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.
The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.
The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.
The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.
The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.
The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.
“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.
When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.
“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.
“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.
The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.
Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.
The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.
“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.
They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.
“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”
This report by The Canadian Press was first published Oct. 17, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
