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Health Canada approves RSV vaccine for pregnant people

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It is the leading reason babies under six months of age land in the hospital but, until now, there have been few options to protect infants from serious RSV (respiratory syncytial virus) infections. That is changing.

Last week, Health Canada approved a new vaccine aimed at protecting two of the groups most vulnerable to serious outcomes from the common virus – infants and older adults. The Pfizer Canada vaccine, called Abrysvo, is the second approved vaccine to target seniors aged 60 and older – the first, produced by GSK, was approved by Health Canada last year.

But Abrysvo is also approved for pregnant people — the first vaccine that is aimed at protecting young babies through maternal vaccination.

“This is the first time we can help infants,” said Dr. Darine El-Chaar, a maternal-fetal medicine physician at The Ottawa Hospital. “It is exciting.”

It works the way other vaccines — including one for whooping cough — work, by passing maternal antibodies to the fetus through the placenta, something that offers protection early in the newborn’s life.

That could be a game-changer, especially in parts of Canada’s North that have among the highest rates of RSV in the world, said El-Chaar. While there is usually a specific season for RSV in southern Canada (although the pandemic has shifted it slightly), RSV can circulate throughout the year in the Far North, El-Chaar said.

“It can be quite devastating. Patients are often on oxygen support and need support for feeding. It can mean a stay in the hospital for a young family until their baby recovers from the lung infection.”

El-Chaar, who was on the advisory board for the vaccine in Canada, said she would like to see its cost covered for all pregnant people in Canada’s Far North. Some of the sickest babies from Nunavut end up hospitalized in Ottawa, which is a tertiary health centre for parts of Nunavut.

The Abrysvo vaccine has yet to be recommended by NACI (the National Advisory Committee on Immunization), a necessary step before provinces would make it available. El-Chaar said she expects it to be available well in advance of next year’s RSV season, and maybe as soon as later this month.

It is part of a revolution in the treatment of RSV, a virus many people had never heard of before 2022 when a spike in severe cases overwhelmed some pediatric hospitals and made headlines. When an adult gets RSV, they typically have a mild cold-like illness, but for babies, with tiny airways, an initial infection can be severe.

In the fall of 2022, CHEO was among hospitals overwhelmed by the number of very sick infants, which forced it to create temporary critical care units around the hospital. President and CEO Alex Munter has previously said he visited one of those pop-up critical care units and was stunned to learn that the oldest child there was just eight weeks old.

Until now, there has been one antibody treatment for babies at the highest risk of poor outcomes from RSV, including premature babies with underdeveloped lungs and children with other health issues. That treatment, Palivizumab, is a monoclonal antibody that offers short-term protection to the most vulnerable. It is injected monthly during RSV season.

Health Canada authorized another monoclonal antibody last April. Nirsevimab also offers passive immunity to babies and only needs to be given once a season, but is not yet available in Canada. In the United States, where it has been used, it is in short supply, said El-Chaar. It is both longer lasting and less expensive than Palivizumab, she said.

El-Chaar said the attention RSV has had in recent years will make it easier for her to talk to pregnant patients about getting vaccinated to protect their newborns when the vaccine is available. That is largely thanks to the recent “triple-demics” of RSV, COVID and flu in 2022, and 2023, to a lesser extent.

“We didn’t used to talk about it a lot. People only got to know about it if they had an infant infected. But last year, there was a lot of buzz about RSV because of the triple-demic. It is unfortunate we needed to go through that, though.”

Details about who will be eligible for the vaccine and who will pay for it are not yet known.

 

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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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.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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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.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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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.

The Canadian Press. All rights reserved.

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