Health Canada has approved the first vaccine for respiratory syncytial virus (RSV) for adults age 60 and over, but it may only be available in “limited” quantities for this fall’s respiratory virus season.
RSV is a common but highly contagious virus that appears like a common cold for most people. In more vulnerable populations, RSV can cause bronchiolitis — the inflammation of the small airways in the lung — or pneumonia, say experts.
Health Canada approved manufacturer GSK’s new vaccine called Arexvy on Friday. In an email to CBC News, the federal health body confirmed that it anticipates a limited supply of the vaccine will be available for the upcoming RSV season.
“It will be a game changer in significantly preventing severe illness and death, especially amongst older Canadians,” said Dr. Samir Sinha, the director of geriatrics at Sinai Health and University Health Network in Toronto.
Doctors have been calling for an RSV vaccine for seniors because although the virus is common, people who are older are more likely to become severely ill and need hospitalization.
“This has been decades long in the making,” Dr. Isaac Bogoch, an infectious disease specialist with the University Health Network in Toronto, said of the vaccine’s approval.
“It’s a very tough virus, it can have negative health impacts. It [can] lead to hospitalization, intensive care unit stays, even death,” Bogoch added. “And it’s wonderful to have a vaccine that … appears to significantly reduce the risk of severe lower respiratory tract disease.”
Dr. Samir Sinha, director of geriatrics at Sinai Health System and the University Health Network in Toronto, says he will be recommending the vaccine to all of his elderly patients once its made available. (Ousama Farag/CBC)
According to Sinha, Canada isn’t properly screening for RSV and the illness itself can be hard to detect — making the exact burden unclear.
But he estimates that it can be similar to the rates of hospitalizations and death seen with influenza — if not worse as the virus can spread more rapidly and symptoms may take a few days to develop.
In this file photo, a medical staff member prepares the Pfizer-BioNTech COVID-19 vaccine at Tudor Ranch in Mecca, Calif., on Jan. 21, 2021. (Jae C. Hong/The Associated Press)
Vaccine offers more than 80% protection, says GSK
In a news release issued Friday, GSK said a randomized clinical trial showed the vaccine has an 82 per cent effectiveness at preventing lower respiratory tract disease caused by RSV, compared to seniors who got a placebo.
The company said it is 94 per cent effective in preventing the illness in seniors with underlying medical conditions.
“I think this vaccine will go a long way based on the results that are available … the vaccine appeared to be safe and appeared to provide very significant protection,” said Bogoch.
He added that if the infection spreads to the lower respiratory tract, it can make it hard for people to breathe so that they need “supplemental oxygen.” This is when people typically end up in hospital.
Dr. Isaac Bogoch is an infectious disease physician with the University Health Network in Toronto. (Maggie MacPherson/CBC)
Sinha said RSV infections can also “trigger other problems in the body,” like a bacterial or viral pneumonia.
“So it’s not necessarily that if you get RSV you’re going to die of that infection, but what you might do is trigger other heart or other lung complications that then can actually cost you your life potentially,” he said.
National guidance for the shot expected in 2024
RSV season in Canada usually starts in the late fall and lasts until spring.
Health Canada said the vaccine is a single dose injection, but it’s unclear whether people will need to get the vaccine every year or a booster.
St. Joseph’s Healthcare Hamilton infectious disease physician Dr. Zain Chagla said available data suggests that people who get the vaccine will be protected for up to two years.
But beyond that, he said further research is needed.
“Hopefully this [vaccine] gets in before RSV season, but if an older adult accesses the vaccine afterwards, they still could get a couple years benefit,” he said.
In an email to CBC News, Health Canada said that guidance from the National Advisory Committee on Immunization (NACI) on the use of the vaccine is expected next year.
It said that based on consultations with Canadian experts, NACI has “first prioritized (and is currently developing) advice for RSV products to protect infants before developing advice for older adults.”
It added that it will be up to individual provinces and territories to decide if they will work Arexvy into their existing RSV programs — and if so, it will work with them individually.
Experts like Sinha say they also hope the Canadian government considers covering the cost of the vaccine as that can often be a “barrier to access,” especially in more vulnerable populations.
Sinha said that as soon as the vaccine is made available, he’ll be recommending that all his patients get the shot.
Dr. Zain Chagla is an infectious disease specialist in Hamilton, Ont. (Craig Chivers/CBC)
In addition to seniors, infants are at a higher risk of getting very sick with RSV.
There is no RSV vaccine for children, but there are two kinds of antibody injections that can be given to high-risk babies to help prevent serious illness.
One of them, palivizumab, has often been given to babies who were born prematurely – but it needs to be injected about once a month during RSV season to stay effective.
A new antibody drug – nirsevimab, also known by the brand name Beyfortus – was approved by Health Canada in April. Nirsevimab only requires one injection to protect babies during the RSV season.
It’s not yet known how widely it will be recommended for babies in Canada this fall.
On Thursday, the Centers for Disease Control and Prevention (CDC) in the U.S. recommended that babies born just before or during the RSV season, as well as babies who are less than eight months old before the season starts, should get the nirsevimab shot.
The CDC also recommended that the shot should be given to some eight to 19-month-old babies who are at higher risk of getting seriously ill from the virus.
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.
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.
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.
