Health
Do previously infected individuals still benefit from vaccination against COVID-19?
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In a recent study published in PLOS Medicine, researchers determined the vaccine effectiveness (VE) of the primary coronavirus disease 2019 (COVID-19) vaccination series. They determined VE against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection, COVID-19-related hospitalization, and mortality. In this way, the researchers assessed the effect of time since vaccination during the predominance eras of different SARS-CoV-2 variants, viz., Alpha, Delta, and Omicron.
Background
In Denmark, the government provides free COVID-19 testing, vaccines, and medical care to all its residents. They rolled out the COVID-19 vaccination program in December 2020, prioritizing the elderly and people at high risk of severe disease. Likewise, they started a booster vaccination program in September 2021.
Scientific data points to the reduced effectiveness of COVID-19 vaccines against the Omicron (B.1.1.529) variant. Studies have also shown that natural immunity more effectively protects against SARS-CoV-2 reinfections than vaccination. Thus, it is in the public health interest to examine the additional benefits of vaccination (if any) among individuals previously infected with SARS-CoV-2.
About the study
In the present study, researchers compiled data from four nationwide resources, the Danish Civil Registration System (CRS), Danish Microbiology Database (MiBa), Danish Vaccination Registry (DVR), and Danish National Patient Registry (DNPR).
Combined with a unique personal registration number of a Danish citizen, this data helped them identify people with a confirmed SARS-CoV-2 infection between 1 January 2020 and 31 January 2022. Likewise, they obtained each SARS-CoV-2 variant’s dominance periods using CSR data, defined as the period when a variant accounted for 75% or more of all whole genome sequenced reverse transcription-polymerase chain reaction (RT-PCR) tests. Additionally, the team investigated COVID-19-related hospitalization up to 14 days after or 48 hours before SARS-CoV-2 reinfection and death within 30 days of reinfection.
In statistical analyses, they included gender, comorbidity, and country of origin as categorical variables, while age and hospital stay duration as time-varying covariates. The team used a quasi-Poisson regression model to estimate crude incidence rate ratios (IRRs) and a Cox proportional hazards regression model to estimate hazard ratios (HRs) adjusted for all variables before and in the respective periods after vaccination. Finally, they calculated VE crude (VEcrude) and adjusted (VEadjusted) as a percentage using IRR and HR values.
Study findings
The study population comprised 209,814, 292,978, and 245,530 individuals infected before or during the Alpha, Delta, and Omicron predominance eras, respectively. Of these, 19.2%, 64.9%, and 64.6% of people had received their COVID-19 primary vaccination during the Alpha, Delta, and Omicron periods, respectively. The primary study finding was that previously infected individuals also benefited from COVID-19 vaccination during all three variant periods, data crucial to inform policymakers plan future vaccination strategies.
In the Alpha-dominated period, the VE was not statistically significant. It peaked at 71% at 104 days or more after vaccination with any COVID-19 vaccine type. However, the VE against reinfection was highest between 14 and 43 days after the primary vaccination series in the Delta (94%) and Omicron (60%) periods. Though lower than for other variants, the researchers noted an initial VE of 60% against reinfections even during the Omicron period. These results are consistent with findings of a Qatar study showing a VE of 55.1% against reinfection with Omicron after two doses of a COVID-19 mRNA vaccine.
Since older and more vulnerable people received SARS-CoV-2 vaccination on priority. These individuals mounted a slower immune response following vaccination, explaining why the observed VE was statistically insignificant during the Alpha period. Moreover, all 65 years or older individuals experienced more severe outcomes than SARS-CoV-2 reinfections in other age groups, overall and within the same variant period.
Another intriguing finding was that the risk of COVID-19-related hospital admission during the Alpha period was higher for vaccinated vs. unvaccinated individuals (IR: 0.002 vs. 0.001). Perhaps even before the rollout of vaccines, several long-term care facilities (LTCF) residents had already contracted SARS-CoV-2 infections. Because the hospitalization and death events due to COVID-19-induced complications were too few in the present study, the researchers could not estimate VE for the same.
The completeness of the Danish registry data likely removed all unmeasured biases that might have impacted the study results. However, studies with longer follow-up times could ascertain VE against severe COVID-19 outcomes in those with prior infection.
Health
CFIA continues surveillance for HPAI in cattle, while sticking with original name for disease – RealAgriculture
The Canada Food Inspection Agency will continue to refer to highly pathogenic avian influenza in cattle as HPAI in cattle, and not refer to it as bovine influenza A virus (BIAV), as suggested by the American Association of Bovine Practitioners earlier this month.
Dr. Martin Appelt, senior director for the Canadian Food Inspection Agency, in the interview below, says at this time Canada will stick with “HPAI in cattle” when referencing the disease that’s been confirmed in dairy cattle in multiple states in the U.S.
The CFIA’s naming policy is consistent with the agency’s U.S. counterparts’, as the U.S. Animal and Plant Health Inspection Service has also said it will continue referring to it as HPAI or H5N1.
Appelt explains how the CFIA is learning from the U.S. experience to-date, and how it is working with veterinarians across Canada to stay vigilant for signs of the disease in dairy and beef cattle.
As of April 19, there has not been a confirmed case of HPAI in cattle in Canada. Appelt says it’s too soon to say if an eventual positive case will significantly restrict animal movement, as is the case with positive poultry cases.
This is a major concern for the cattle industry, as beef cattle especially move north and south across the U.S. border by the thousands. Appelt says that CFIA will address an infection in each species differently in conjunction with how the disease is spread and the threat to neighbouring farms or livestock.
Currently, provincial dairy organizations have advised producers to postpone any non-essential tours of dairy barns, as a precaution, in addition to other biosecurity measures to reduce the risk of cattle contracting HPAI.
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Health
Toronto reports 2 more measles cases. Use our tool to check the spread in Canada – Toronto Star
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Canada has seen a concerning rise in measles cases in the first months of 2024.
By the third week of March, the country had already recorded more than three times the number of cases as all of last year. Canada had just 12 cases of measles in 2023, up from three in 2022.
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Cancer Awareness Month
Posted on: Apr 18, 2024
April is Cancer Awareness Month
As we recognize Cancer Awareness Month, we stand together to raise awareness, support those affected, advocate for prevention, early detection, and continued research towards a cure. Cancer is the leading cause of death for Métis women and the second leading cause of death for Métis men. The Otipemisiwak Métis Government of the Métis Nation Within Alberta is working hard to ensure that available supports for Métis Citizens battling cancer are culturally appropriate, comprehensive, and accessible by Métis Albertans at all stages of their cancer journey.
Receiving a cancer diagnosis, whether for yourself or a loved one, can feel overwhelming, leaving you unsure of where to turn for support. In June, our government will be launching the Cancer Supports and Navigation Program which will further support Métis Albertans and their families experiencing cancer by connecting them to OMG-specific cancer resources, external resources, and providing navigation support through the health care system. This program will also include Métis-specific peer support groups for those affected by cancer.
With funding from the Canadian Partnership Against Cancer (CPAC) we have also developed the Métis Cancer Care Course to ensure that Métis Albertans have access to culturally safe and appropriate cancer services. This course is available to cancer care professionals across the country and provides an overview of who Métis people are, our culture, our approaches to health and wellbeing, our experiences with cancer care, and our cancer journey.
Together, we can make a difference in the fight against cancer and ensure equitable access to culturally safe and appropriate care for all Métis Albertans. Please click on the links below to learn more about the supports available for Métis Albertans, including our Compassionate Care: Cancer Transportation program.
I wish you all good health and happiness!
Bobbi Paul-Alook
Secretary of Health & Seniors
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