Health
Moderna begins testing its COVID-19 vaccine on young children – Global News
Moderna has begun testing its COVID-19 vaccine in children between six months and 12 years old, but experts in Canada aren’t optimistic we’ll see approvals for adolescents anytime soon.
The company on Tuesday started a mid-to-late stage study of its vaccine to assess the safety and effectiveness of two doses of the shot, given 28 days apart, and intends to enroll about 6,750 children in the United States and Canada.
In a separate study, which began in December, Moderna is also testing its vaccine in adolescents between 12 and 18 years old.
Moderna’s vaccine has already been authorized in Canada and the U.S. for those who are aged 18 and older. But experts don’t expect to see any approvals for children in the near future.
When asked whether Health Canada could approve a vaccine for use in children before school begins in the fall of 2021, Dr. Supriya Sharma, the agency’s chief medical advisor, said the timeline sounded “a bit optimistic.”
“So the trials in children tend to be a bit slower to get up and running in terms of recruiting individuals,” she said earlier this month. “And then, of course, we have to conduct the trials and then take that information and assess that.”
She said it’s “not inconceivable that we might have some data in the summer.”
“And potentially by the end of this calendar year, we might have some indications in children, but … that’s still pretty optimistic.”
That appeared to be echoed by Dr. Caroline Quach, the chair of Canada’s National Advisory Committee on Immunizations, on Tuesday. She said data has so far been provided by Pfizer-BioNTech on its vaccine being tested within the 12 to 15 age group.
However, she said NACI will not make any recommendations on vaccines used in children before it has seen data from a phase three trial, she said.
“From our understanding, we should get some data in the next two to three months for at least eh 12 to 15-year-olds. Then, as data is accrued and vaccines are deemed to be safe and immunogenic, then they will decrease in age range until they go down to the younger ones,” she said.
“But we’re not expecting anything for children before the end of 2021.”
At this point in Canada, no vaccines have been approved for use in children younger than 16 years of age.
The Pfizer-BioNTech vaccine can be used in anyone 16 and older, Health Canada says, while the other three shots — Moderna, AstraZeneca, and Johnson & Johnson — have been approved for adults 18 and up.
Health Canada says it is waiting on data from the vaccine manufacturers before it approves any shot for use in children.
Sharma said Pfizer and Moderna’s clinical trials in younger-age adults are the furthest along so far, but acknowledged that Johnson & Johnson has also been given Health Canada’s seal of approval to test the safety and efficacy of its vaccine in children aged 12 to 17.
AstraZeneca has also started its own clinical trial to test its vaccine in younger age groups, though Sharma is convinced Health Canada will receive data from Pfizer and Moderna first.
Children have so far fared better than adults throughout the COVID-19 pandemic. The virus is considered far deadlier for adults — particularly seniors and those with pre-existing conditions — but has proven to be generally very mild in the young, with minimal to rare deaths.
The result has essentially put kids near the end of the line for vaccinations. It’s also sparked a debate among scientists and other officials about how important it is to get children immunized.
So far, the rollout of vaccines worldwide has prioritized older people and others at risk because of their health or occupation.
Dr. William Schaffner, an infectious diseases expert from Vanderbilt University, said it’s important vaccine makers are testing their precious drugs in children.
He put it simply: “First of all, they’re not at zero risk.”
“There have been seriously afflicted children in this country and around the world, so we want to protect them,” he said.
“Second, children can be transmitters. They can carry the virus, bring it home, and transmit it among themselves. Not as freely and exuberantly as influenza, but nonetheless, they can do that.”
Schaffner said it’s important to test the vaccines in segmented age groups — like 12 to 15 years old — because it helps “get the dose right.”
“We want to make a careful assessment of all the safety issues, as well as the effectiveness,” he said.
Schaffner believes adding childhood or student vaccination to Canada’s vaccination strategy could add confidence to school safety plans and “lower the risk even further.”
— with files from Global News’ Hannah Jackson and Reggie Cecchini
© 2021 Global News, a division of Corus Entertainment Inc.
Health
Nunavut sets up mobile tuberculosis clinic in Naujaat as outbreak grows
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3 have died since outbreak began, 21 diagnosed with active TB
Nunavut’s Health department has opened a community-wide mobile testing clinic in Naujaat, in the hopes of testing as many people as possible for tuberculosis.
It’s been almost a year since a TB outbreak was first declared in the community of 1,200 people on May 16, 2023.
Kevin Tegumiar, Naujaat’s mayor, said the hamlet has been asking for such a clinic for several months.
“Without accurate numbers, we’re not really sure where we are. This clinic will help clear things up,” Tegumiar said.
Tegumiar said three Naujaat residents have died since the outbreak began in the community. Nunavut’s Health department confirmed those numbers in a recent interview with CBC.
Since January 2023, 21 people in Naujaat have been diagnosed with active TB.
Another 118 others have been diagnosed with latent TB, according to the department, which is almost double the number reported in November last year.
Hundreds of tests
Health officials have set a goal to test 1,000 people in Naujaat for TB by the end of the clinic, on May 30.
“We hope that every one of them are coming and get screened during the time that we are here,” said Ekua Agyemang, Nunavut’s deputy chief public health officer. “When TB is identified early, the disease is very easy to treat in the community.”
The Health department said they will deploy a team of health-care workers, including a doctor, four nurses, an epidemiologist, a radiology technician and laboratory technician.
Canada’s chief public health officer, Dr. Theresa Tam, will also visit Naujaat this week as part of a tour alongside Nunavut Tunngavik Inc. officials and the territory’s health minister. Tam will also visit Pond Inlet and Iqaluit.
“Though TB will be a focus of the entire visit, Dr. Tam will also meet with community groups and organizations to discuss homelessness, health education, mental health, and health research initiatives in Nunavut, among other topics,” a news release from NTI said.
Agyemang said in February, the department visited schools and organized a community event to raise awareness about tuberculosis in Naujaat.
Two other outbreaks
Two other TB outbreaks are still ongoing in Pangnirtung and Pond Inlet.
A screening clinic was held in Pangnirtung last fall, which allowed about 70 per cent of the population to be tested.
“There’s definitely ongoing work that still needs to be done, but at this point in time, they’re at a good place in Pangnirtung,” Agyeman said.
Agyeman said at this point, the department does not intend to hold a clinic in Pond Inlet. She also could not provide specific information about the number of cases in the community.
Health
Experts say Canada’s cancer screening guidelines are outdated
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A group of doctors say Canadian cancer screening guidelines set by a national task force are out-of-date and putting people at risk because their cancers aren’t detected early enough.
“I’m faced with treating too many patients dying of prostate cancer on a daily basis due to delayed diagnosis,” Dr. Fred Saad, a urological oncologist and director of prostate cancer research at the Montreal Cancer Institute, said at a news conference in Ottawa on Monday.
The Canadian Task Force on Preventive Health Care, established by the Public Health Agency of Canada, sets clinical guidelines to help family doctors and nurse practitioners decide whether and when to recommend screening and other prevention and early detection health-care measures to their patients.
Its members include primary-care physicians and nurse practitioners, as well as specialists, a spokesperson for the task force said in an email Monday.
But Saad and other doctors associated with the Coalition for Responsible Healthcare Guidelines, which organized the news conference, said the task force’s screening guidelines for breast, prostate, lung and cervical cancer are largely based on older research and conflict with the opinions of specialists in those areas.
For example, the task force recommends against wide use of the prostate specific antigen test, commonly known as a PSA test, for men who haven’t already had prostate cancer. Saad called that advice, which dates back to 2014, “outdated” and “overly simplistic.”
The task force’s recommendation is based on the harms of getting false positive results that lead to unnecessary biopsies and treatment, he said.
But that reasoning falsely assumes that everyone who gets a positive PSA test will automatically get a biopsy, Saad said.
“We are way beyond the era of every abnormal screening test leading to a biopsy and every biopsy leading to treatment,” he said, noting that MRIs can be used to avoid some biopsies.
“Canadian men deserve (to) have the right to decide what is important to them, and family physicians need to stop being confused by recommendations that go against logic and evidence.”
Dr. Martin Yaffe, co-director of the Imaging Research Program at the Ontario Institute for Cancer Research, raised similar concerns about the task force’s breast cancer screening guideline, which doesn’t endorse mammograms for women younger than 50.
That’s despite the fact that the U.S. task force says women 40 and older may decide to get one after discussing the risks and benefits with their primary-care provider.
The Canadian task force is due to update its guidance on breast cancer screening in the coming months, but Yaffe said he’s still concerned.
“The task force leadership demonstrates a strong bias against earlier detection of disease,” he said.
Like Saad, Yaffe believes it puts too much emphasis on the potential harm of false positive results.
“It’s very hard for us and for patients to balance this idea of being called back and being anxious transiently for a few days while things are sorted out, compared to the chance of having cancer go undetected and you end up either dying from it or being treated for very advanced disease.”
But Dr. Eddy Lang, a member of the task force, said the harms of false positives should not be underestimated.
“We’ve certainly recommended in favour of screening when the benefits clearly outweigh the harms,” said Lang, who is an emergency physician and a professor at the University of Calgary’s medical school.
“But we’re cautious and balanced and want to make sure that we consider all perspectives.”
For example, some men get prostate cancer that doesn’t progress, Lang said, but if they undergo treatments they face risks including possible urinary incontinence and erectile dysfunction.
Lang also said the task force monitors research “all the time for important studies that will change our recommendations.”
“And if one of them comes along, we prioritize the updating of that particular guideline,” he said.
The Canadian Cancer Society pulled its endorsement from the task force’s website in December 2022, saying it hadn’t acted quickly enough to review and update its breast cancer screening guidelines to consider including women between 40 and 50.
“(The Canadian Cancer Society) believes there is an obligation to ensure guidelines are keeping pace with the changing environment and new research findings to ensure people in Canada are supported with preventative health care,” it said in an emailed statement Monday evening.
Some provinces have implemented more proactive early detection programs, including screening for breast cancer at younger ages, using human papillomavirus (HPV) testing to screen for cervical cancer and implementing CT scanning to screen for lung cancer, doctors with the Coalition for Responsible Healthcare Guidelines said.
But that leads to “piecemeal” screening systems and unequal access across the country, said Dr. Shushiela Appavoo, a radiologist with the University of Alberta.
Plus, many primary-care providers rely on the national task force guidelines in their discussions with patients, she said.
“The strongest association … with a woman actually going for her breast cancer screen is whether or not her doctor recommends it to her. So if her doctor is not recommending it to her, it doesn’t matter what the provincial guideline allows,” Appavoo said.
In addition to updating its guideline for breast cancer screening this spring, the task force is due to review its guidelines for cervical cancer screening in 2025 and for lung cancer and prostate cancer screening in 2026, according to its website.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
Health
Mobile Health Clinic in Bridgewater this week
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Nova Scotia Health’s mobile primary care clinic will be retunring to Bridgewater this week for two sessions on Wednesday and Sunday.
They will be setting up at the South Shore Community Health building located at 35 North Street. On Wednesday, April 17 the clinic will be open from 5:30 p.m. until 9:00 p.m., and on Sunday, April 21 it will operate from 9:30 a.m. until 3:00 p.m,.
The clinic is intended to help those without a family doctor, or those unable to book an appointment with their family doctor for non-urgent medical issues.
Types of concerns that may be addressed at the mobile primary care clinic include:
- Prescription refills or renewals (except for controlled substances)
- Minor respiratory symptoms
- Sore throat
- Earaches
- Fever
- Headache
- Rashes
- Minor gastrointestinal concerns (vomiting and diarrhea)
- Cough, flu, or cold symptoms
- Urinary tract infections
- Muscle pain
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