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Health Canada approves 1st RSV vaccine for people 60 and older

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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.

This news comes after the U.S. Food and Drug Administration (FDA) gave their approval for the vaccine in May.

“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)

RSV not well-tracked in Canada: experts

It’s unclear how many people 60 and older in Canada are hospitalized or die from the illness, as experts say it’s not properly tracked.

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 Canada, 12,200 people are hospitalized and 3,500 die from influenza annually.

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)

What about kids? 

Last winter was an especially bad season of RSV in the country, specifically for young kids.

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.

 

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 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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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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