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Immunocompromised young people in N.S. wonder where they stand with COVID-19 vaccinations – CBC.ca

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After more details of Nova Scotia’s COVID-19 vaccine rollout plan were released, some young people with health conditions are wondering when — and if — they will be able to get their shot.

Under the current plan, people below the age of 75 who are immunocompromised or at a high risk for COVID-19 aren’t identified as a priority group, unless they are a health-care worker or an “essential” worker, which is still being defined.

In fact, neither the Pfizer-BioNTech vaccine nor the Moderna vaccine are recommended for use on immunocompromised Canadians yet.

Anthony Ha, 36, has diffuse systemic sclerosis, an underlying autoimmune condition, and the medication he takes to manage it further compromises his immune system.

While the arrival of the first batches of the vaccine in Nova Scotia signalled a glimmer of hope, Ha said he and other people who are immunocompromised were disappointed by the details of the vaccine rollout.

“The rollout was listed in three phases, but there was almost no mention of people with chronic conditions or compromised immune systems, and it just feels like that hope was taken away from us,” he said.

“We know we’re on the list, we know that we’re going to be looked at and we’re going to be in line somewhere in there, but for them to not even mention that we exist, that just kind of ripped the heart out of us.”

Anthony Ha believes the government needs to communicate better with Canadians who are immunocompromised or have chronic conditions. (Submitted by Anthony Ha)

On its website, the National Advisory Committee on Immunization says immunocompromised Canadians have not been included in clinical trials, so there’s not enough information yet on how they might respond.

“Clinical trials assessing COVID-19 vaccines should continue to be encouraged to include individuals with potential vulnerabilities to disease … to ensure that vaccine options are informed by robust safety, immunogenicity, and efficacy data,” it said.

NACI says the vaccine “should not be routinely offered to individuals who are immunosuppressed due to disease or treatment until further evidence is available.”

“However, a complete series with a COVID-19 vaccine may be offered to individuals in the authorized age group in this population if a risk assessment deems that the benefits outweigh the potential risks for the individual, and if informed consent includes discussion about the absence of evidence on the use of COVID-19 vaccine in this population,” it said.

The website also said “there is limited evidence that immunosuppression is an independent risk factor for severe COVID-19, though evidence is evolving.”

In a statement from Nova Scotia’s Health Department, a spokesperson said older age is the main individual factor for severe COVID-19 illness. 

“There is work nationally, and here in Nova Scotia though our Clinical Advisory Group, to better understand how other medical conditions may increase the risk of severe COVID and where to prioritize these groups as we move to phase 2 and 3 of our program,” the email stated.

‘We spent the last year in our homes, alone’

Ha said he understands why older people need to be first in line for the vaccine, and that there is still work left to do to ensure the vaccine is safe for immunocompromised people — but he said he would appreciate more communication from the government and clear messaging they are working on it.

“We spent the last year in our homes, alone. What we really need is for them to reach out to us,” he said.

While the pandemic has been challenging, Ha said there is a silver lining: the broader public now has a better understanding of what immunocompromised people go through every day.

“They know that if you don’t wash your hands, if you don’t maintain your distance from sick people, it can cause harm to us,” he said. “In a weird way, it’s kind of nice that people are opening their eyes to the plight of people like me.”

Concerns of being left behind

Jillian Banfield, also 36, has rheumatoid arthritis and takes medication that suppresses her immune system. Banfield said she is privileged to be able to work from home and has a healthy partner who runs most of their errands. 

During the pandemic, “I mostly removed myself from public life,” she said. “I’ve taken all the precautions and then some.”

She said she had hoped for more details about what the vaccine rollout could look for people like her.

“I understand they may be kind of planning as they go because these things are happening very rapidly, but I would like to see a little more thought put into what’s going to happen in phases two to three,” said Banfield.

“I’m just concerned that those of us with autoimmune disorders or suppressed immune systems are going to get left behind.”

Jillian Banfield says she hopes to not have to rely on herd immunity during the pandemic. (Contributed by Jillian Banfield)

Banfield said if she is not able to get the vaccine because of her suppressed immune system, the prospect of having to rely on herd immunity is “kind of terrifying.”

“I hope the uptake will be better than the flu vaccine, for example, but it doesn’t feel great to be relying on everyone else getting the vaccine,” she said. “It’s nice to have at least a little bit of feeling of control over these things.”

Ha also expressed concerns about having to rely on herd immunity, noting the prevalence of the “anti-vaxxer” movement.

“The possibility of having to rely on herd immunity, I mean, it’s a reality, but it’s not very comforting,” he said.

He said he had to discontinue using his medication for a few weeks when he got his MMR vaccine, which was a “calculated risk.” 

Patients being ‘omitted,’ organization says

Whitney Goulstone is the executive director of the Canadian Immunodeficiencies Patient Organization, a charity that advocates for those affected by primary immunodeficiencies.

In a phone interview from Victoria, B.C., Goulstone said the organization is being inundated with questions from people across the country with primary immunodeficiencies about when they will be able to get the vaccine and if they will be able to take it.

Not being able to give them an answer, said Goulstone, is “the hardest part of my job.”

She said she hoped there will soon be a timeline about when Canadians can expect clinical trials for immunocompromised people to get underway, and is calling for them to be listed as a priority group if the vaccine is found to be safe for them.

“We need to ensure that there’s a priority so that patients can live some kind of quality of life, and we aren’t getting any kind of information about when that may happen when it comes to the vaccine rollout,” she said. 

“These patients are just being omitted, which I think is not fair to them.”

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Pfizer vaccine delay means BC is prioritizing second doses | News – Daily Hive

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BC’s top doctor says the province’s most vulnerable residents should all receive their COVID-19 vaccine by the end of March, despite Pfizer’s shipping delay.

The vaccine manufacturer is making upgrades to its European facility to increase the number of doses it can produce. But in the short term, countries receiving shipments from that facility will get fewer doses.

Such delays are to be expected in a large and global vaccine rollout, Dr. Bonnie Henry said at her Monday news conference.

“It’s a bit of a setback but is only a delay,” she said. “We are still on track to protect the most vulnerable by the end of March.”

Due to the delay, a higher proportion of vaccine doses the province has on hand will be going toward second doses and fewer will be used for first doses. BC is still confident second doses can be administered at the 35-day mark.

In the meantime, it’s important that people keep their distance, wear masks, wash their hands, and don’t participate in social gatherings, Henry said.

The most significant impact of Pfizer’s shipping delays will be felt in late January and early February.

During the week of January 25, Pfizer will only deliver one-quarter of Canada’s expected COVID-19 vaccine doses. In the first two weeks of February, the company will deliver half of the expected doses.

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Ontario's first major COVID-19 vaccination site will pause after just 5 days due to supply shortage – CTV Toronto

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TORONTO —
Toronto Fire Chief Matthew Pegg says a pilot COVID-19 vaccination clinic that just opened today at the Metro Toronto Convention Centre will have to pause vaccinations on Friday because of a shortage of vaccine supply in the province.

The proof-of-concept clinic opened Monday and is meant to help develop a blueprint for how shots should be administered in non-medical settings as soon as this spring. So far, COVID-19 vaccines have only been administered at long-term care homes and at 19 hospital sites across Ontario.

Pegg said last week the facility would be “scale-able” and capable of increasing output with little notice, with an initial target of 250 doses per day.

But at the city’s media briefing on Monday, he said the province has now asked the city to pause vaccinations at the new clinic by the end of Friday.  

“We were all disappointed to learn that the delivery of Pfizer vaccine to Canada is expected to be delayed as a result of manufacturing delays in Europe. As a result, we have now been advised by the province that we will only be able to operate this proof of concept clinic for an initial five days due to the lack of availability of COVID-19 vaccine,” Pegg said.

He said anyone with an appointment at the clinic from Jan. 23 on should expect that their appointment will be cancelled.

Peg said those who receive their first dose at the clinic this week will still be able to get their second dose within the proper timeframe.

The clinic will resume vaccinations once it gets word from the province that it may do so. In the meantime, Pegg said the city is continuing to plan for a quick rollout of the vaccine when more doses become available.

“We are continuing to explore all options to accelerate our ability to administer vaccines to Toronto residents once larger quantities of vaccine are available,” he said. “This will include planning for extended hours of clinic operations, expanded clinic capacity targets and implementing innovative delivery methods that meet the needs of our city, including mobile vaccine clinics, priority neighborhood response, hospital-led clinic operations and widespread public access via pharmacies and primary care physicians.”

The site had been expected to run for at least six weeks in order to gather data about how best to host vaccination drives in larger settings.

Ontario Premier Doug Ford and Tory toured the site at MTCC’s North Building just on Sunday.

While the clinic was meant to use the Moderna vaccine, the Pfizer delays mean that some of that supply will now be redistributed to other parts of the province.

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Couche-Tard to pursue other deals after Carrefour failure – BNN

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Executives at Alimentation Couche-Tard Inc. defended a failed bid for Carrefour SA and said they would still like to buy the French grocer some day, but will turn their focus to other potential deals.

The Canadian convenience store operator made a US$20 billion offer that was shot down by French Finance Minister Bruno Le Maire on Friday. The bid caught investors off guard because Couche-Tard does not operate supermarkets.

The shares tumbled nearly 11 per cent last week. On Monday, they were up 2.4 per cent to $38.90 as of 9:36 a.m. in Toronto.

In response to criticism of the deal, Couche-Tard executive chairman Alain Bouchard said previous large deals — including the 2003 acquisition of Circle K — also surprised the market, but they worked out.

“Over the last decades while growing our business we have made many bold moves, some of which were not always obvious to our stakeholders,” Bouchard said on a conference call with investors Monday.

“Was I hoping our bold approach to Carrefour would have turned out differently? Of course. Yet I’m tremendously proud that Couche-Tard had the financial strength and acumen to make such an offer.”

The companies announced the end of negotiations on Saturday, four days after Bloomberg first reported the talks, and said they’ll work instead on a looser alliance in areas including fuel purchasing and product distribution.

Couche-Tard executives gave few details on that alliance Monday, calling the talks exploratory. Chief Executive Officer Brian Hannasch said there is a “robust” set of other acquisitions to examine as it pursues a five-year goal of doubling profit by 2023.

Hannasch said the door is open to a future Carrefour merger if the political climate in France changes.

“I’m old enough to believe there’s no such thing as permanently,” he said. “We’d love to do the transaction, so if we got signals that the environment could change or would change from the French government or the key stakeholders, we’d love the opportunity to re-engage — under the right conditions and assuming we haven’t found another way to create more value for our shareholders.”

The Laval, Quebec-based company has been making headway on its growth plans even without a major acquisition in recent years. Analysts expect adjusted earnings per share to be 16 per cent higher for the fiscal year that ends in April, according to data compiled by Bloomberg. Even so, its valuation has dipped.

The chain has been improving its coffee and adding fresh food offerings, which come with higher margins. It’s digging into analytics to improve pricing and promotions, and planning to roll out electric vehicle charging stations in North America after learning from its experience in Norway.

Couche-Tard strengthened its foothold in Asia by buying about 370 stores in Hong Kong and Macau that previously were Circle K brand licensees. But a large takeover has remained elusive since it signed a US$4 billion purchase of Texas-based CST Brands Inc. in 2016.

In April, the company walked away from a US$5.6 billion proposal for gas station chain Caltex Australia Ltd. (now known as Ampol Ltd.), citing pandemic uncertainty. And it missed out on Marathon Petroleum Corp.’s Speedway gas stations, which were scooped up in August by Japan’s Seven & i Holdings Co., the world’s largest convenience store operator, for US$21 billion.

Balance Sheet

Couche-Tard executives have scoffed at the valuation of Speedway. Addressing shareholders at the company’s annual meeting in September, Bouchard cited it as an example of the company’s discipline around acquisitions.

The balance sheet leaves it in a good place to hunt for deals. The company had about US$5.5 billion in net debt at the end of its October quarter, according to data compiled by Bloomberg. It’s earned US$3.5 billion in operating profit in the last four quarters.

Chief Financial Officer Claude Tessier told analysts in November that the current debt ratio is at half of Couche-Tard’s comfort level.

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