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New data suggests Canada's 'gamble' on delaying, mixing and matching COVID-19 vaccines paid off – CBC.ca

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This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.


New Canadian data suggests the bold strategy to delay and mix second doses of COVID-19 vaccines led to strong protection from infection, hospitalization and death — even against the highly contagious delta variant — that could provide lessons for the world.

Preliminary data from researchers at the British Columbia Centre for Disease Control (BCCDC) and the Quebec National Institute of Public Health (INSPQ) shows the decision to vaccinate more Canadians sooner by delaying second shots by up to four months saved lives.

The researchers excluded long-term care residents from the data, who are generally at increased risk of hospitalization and death from COVID-19, in order to get a better sense of vaccine effectiveness in the general population — and the results were exceptional. 

The analysis of close to 250,000 people in B.C. from May 30 to Sept. 11 found two doses of any of the three available COVID-19 vaccines in Canada were close to 95 per cent effective against hospitalization — regardless of the approved vaccination combination

That means for every 100 unvaccinated people severely ill in Canadian hospitals, 95 of them could have been prevented by receiving two doses of either the AstraZeneca-Oxford, Pfizer-BioNTech and Moderna vaccines, or some combination of the three.

Dr. Danuta Skowronski with the B.C. Centre for Disease Control laid the groundwork for the decision to hold back second doses and says the early vaccine effectiveness data is extremely encouraging. (Harman/CBC)

Dr. Danuta Skowronski, a vaccine effectiveness expert and epidemiology lead at the BCCDC whose research laid the groundwork for the decision to hold back second doses based on the “fundamental principles of vaccinology,” says the early data is extremely encouraging. 

“We were very pleased to see during the period when the delta variant was not just circulating, but predominating, that we had such high protection nonetheless against both infection and hospitalization,” the lead researcher on the analysis told CBC News. 

“Protection was even stronger when the interval between the first and the second doses was more than six weeks apart.”

In fact, the research showed that protection against COVID-19 infection from two doses of the Pfizer vaccine rose dramatically when the first and second shots were spread out — from 82 per cent after three or four weeks, to 93 per cent after four months. 

“For those who received the AstraZeneca vaccine as their first dose, their protection against any infection was lower than for mRNA vaccine recipients, but they had comparable protection against hospitalization and that’s the main goal,” she said.

“But for those who received a first dose of AstraZeneca and a second dose as an mRNA vaccine, their protection was as good as those who had received two mRNA vaccines. So that’s also a really important finding from this analysis.”

While the work is still being finalized and has not yet been submitted as a pre-print or undergone peer review, the researchers felt it’s important to get their early data out now to inform the public and policymakers here and abroad about the positive results. 

“The mix-and-match schedules are protecting well, and my preference would be that those countries who don’t recognize that get to see our data as soon as possible,” she said, adding that the findings were sent to U.S. officials for review of international travel policies

“My hope is that when they see the evidence that they will change those policies, which are frankly inconsistent with the science.” 

Quebec data backs up findings from B.C.

In Quebec, thousands of kilometres away and with a different population, demographic makeup and early vaccine rollout approach — the results of a twin study that will be published alongside the B.C. data were astonishingly similar. 

Of the 181 people who died from COVID-19 from May 30 to Sept. 11 in Quebec, just three were fully vaccinated. Researchers say that corresponds to a vaccine effectiveness against death upwards of 97 per cent based on a population analysis of nearly 1.3 million people. 

Similar to the B.C. data, the Quebec research also showed more than 92 per cent protection from hospitalizations — with Pfizer, Moderna or AstraZeneca vaccines — against all circulating coronavirus variants of concern in Canada at that time, including delta.

“The takeaway is whatever vaccine people had, if they got two doses they should consider that they are very well protected against severe COVID-19,” said Dr. Gaston De Serres, an epidemiologist at the INSPQ. “That’s the main message.”

The analysis found Pfizer and Moderna vaccines were 90 per cent effective at preventing COVID-19 infections — either asymptomatic, symptomatic, or those needing hospital care — a protection rate equal to those with an AstraZeneca and mRNA vaccine combination.

For people who received two doses of AstraZeneca, the research suggests a slightly lower level of protection from infection — but one that is still remarkably high at 82 per cent. 

The research showed that protection against COVID-19 infection from two doses of the Pfizer vaccine rose dramatically when the first and second shots were spread out. (Darryl Dyck/The Canadian Press)

De Serres says the National Advisory Committee on Immunization (NACI) and the Quebec Immunization Committee (CIQ) are looking at whether additional doses may be needed for that group, but says it’s “not as pressing” given the strong protection from hospitalization. 

“For the time being, just stay put. If there is a recommendation for you to get an additional RNA dose you’ll know in time,” De Serres said. “But feel that what you’ve got is still a very good regimen to protect you against what we fear most — which is severe COVID-19.”

The NACI recommendation in March to delay second doses of all three COVID-19 vaccines by up to four months was not without controversy at the time, and no doubt led to confusion among many Canadians about whether they were adequately protected. 

Canada’s Chief Science Adviser Mona Nemer said in early March that the strategy amounted to a “population level experiment,” while at the same time health officials tried to reassure the public that the approach was safe and effective. 

Deepta Bhattacharya, an immunologist at the University of Arizona who was not involved in the study, says the results are “very encouraging” and provide evidence of “improved real world protection” from delaying second doses.

But he admits even he was initially skeptical. 

“I was uneasy about it in large part because I just wasn’t sure how well the protection would hold up in the interim,” he said. “Obviously it turned out well … but it was risky, and that gamble paid off.”

Bhattacharya says the Canadian data now provides real world evidence that vaccinated people produce more antibodies if their second shot is delayed, and the quality of those antibodies may actually improve — which could explain the better protection against delta. 

“What I’m really wondering now going forward is whether the recommendations are going to fundamentally change as to when we should get that second shot,” he said, referring to other countries around the world. “I wish I’d gotten mine later now in retrospect.” 

Keeping ‘eye on the prize’ means avoiding hospitalization

The data also has implications on whether average Canadians need booster shots, particularly given that emerging real world data in other countries like the U.S., Israel and Qatar show evidence of waning immunity that has prompted the rollout of third doses.

But experts caution that while countries reporting diminished vaccine effectiveness against COVID-19 infection may be making headlines, the more important factor is that the studies largely show the vaccines have prolonged protection against severe COVID-19 — meaning hospitalization and death.

“We really should keep our eyes on the prize, which is preserving healthcare system capacity and preventing unnecessary suffering,” said Skowronski. “We’re not going to prevent every case of COVID-19. Our goal was never to prevent the sniffles. Our goal was to prevent serious outcomes.” 

Still, the B.C. and Quebec data showed “no signs” of waning immunity in the general population four months after the second mRNA dose and strong protection against infection of more than 80 to 90 per cent maintained. The analysis doesn’t go beyond five months, but the researchers will continue monitoring vaccine effectiveness.

“We should be reassured that our vaccine effectiveness from this calculation, from what I’ve seen, will be robust with its protection,” said Alyson Kelvin, an assistant professor at Dalhousie University and virologist at the Canadian Center for Vaccinology and the Vaccine and Infectious Disease Organization in Saskatoon who was not involved in the research.

“We must continue to have public health measures in place as well as expect at some point we might need a booster, but data like this will inform when we do and right now it’s suggesting that we don’t need it yet — but we have to keep vigilant.” 

WATCH | Canada recommends COVID-19 booster shots for long-term care residents:

NACI recommends COVID-19 booster shots for seniors in long-term care

10 days ago

Amid a global debate over COVID-19 vaccine boosters, the National Advisory Committee on Immunization is recommending third doses for Canada’s most vulnerable, especially seniors in long-term care homes. 1:58

Skowronski says that while she supports giving long-term care residents and immunocompromised people third doses of COVID-19 vaccines to increase their protection based on emerging data, including from Canada, there isn’t enough evidence yet for average Canadians. 

Until then, she says Canadians should feel well protected against severe outcomes from COVID-19 in the delta-driven fourth wave if they’re fully vaccinated with any of the approved vaccine combinations in Canada. 

“We’re going to have to learn to live with SARS-CoV-2, including in it’s very many future iterations,” she said. 

“But so long as we can prevent severe outcomes and maintain healthcare system capacity, we can come to a kind of a mutual understanding with this virus.” 

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How many lives have coronavirus vaccines saved? We used state data on deaths and vaccination rates to find out – Devdiscourse

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By Sumedha GuptaAssociate Professor of Economics, IUPUI Indianapolis, Oct 17 (The Conversation) More than 200 million US residents have gotten at least one shot of a COVID-19 vaccine with the expectation that the vaccines slow virus transmission and save lives.

Researchers know the efficacy of the vaccines from large-scale clinical trials, the gold standard for medical research. The studies found the vaccines to be very effective at preventing severe COVID–19 and especially good at preventing death. But it’s important to track any new treatment in the real world as the population-level benefits of vaccines could differ from the efficacy found in clinical trials.

For instance, some people in the US have only been getting the first shot of a two-shot vaccine and are therefore less protected than a fully vaccinated person. Alternatively, vaccinated people are much less likely to transmit COVID-19 to others, including those who are not vaccinated. This could make vaccines more effective at a population level than in the clinical trials.

I am a health economist, and my team and I have been studying the effects of public policy interventions like vaccination have had on the pandemic. We wanted to know how many lives vaccines may have saved due to the states’ COVID-19 vaccination campaigns in the US.

In March 2021, when weekly data on state COVID-19 vaccinations started to become reliably available from state agencies, my team began to analyze the association between state vaccination rates and the subsequent COVID-19 cases and deaths in each state. Our goal was to build a model that was accurate enough to measure the effect of vaccination within the complicated web of factors that influence COVID–19 deaths.

To do this, our model compares COVID-19 incidence in states with high vaccination rates against states with low vaccination rates. As part of the analysis, we controlled for things that influence the spread of the coronavirus, like state–by–state differences in weather and population density, seasonally driven changes in social behaviour and non-pharmaceutical interventions like stay-at-home orders, mask mandates and overnight business closures. We also accounted for the fact that there is a delay between when a person is first vaccinated and when their immune system has built up protection.

To check the strength of our model before playing with variables, we first compared reported deaths with an estimate that our model produced.

When we fed it all of the information available – including vaccination rates – the model calculated that by May 9, 2021, there should have been 569,193 COVID-19 deaths in the US. The reported death count by that date was 578,862, less than a 2 per cent difference from our model’s prediction.

Equipped with our well-working statistical model, we were then able to “turn off” the vaccination effect and see how much of a difference vaccines made.

Using near real-time data of state vaccination rates, coronavirus cases and deaths in our model, we found that in the absence of vaccines, 708,586 people would have died by May 9, 2021. We then compared that to our model estimate of deaths with vaccines: 569,193. The difference between those two numbers is just under 140,000. Our model suggests that vaccines saved 140,000 lives by May 9, 2021.

Our study only looked at the few months just after vaccination began. Even in that short time frame, COVID-19 vaccinations saved many thousands of lives despite vaccination rates still being fairly low in several states by the end of our study period. I can say with certainty that vaccines have since then saved many more lives – and will continue to do so as long as the coronavirus is still around.(The Conversation) RUP

(This story has not been edited by Devdiscourse staff and is auto-generated from a syndicated feed.)

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Week five without LRT service and Canada's women's soccer team plays in Ottawa: Five stories to watch this week – CTV Edmonton

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OTTAWA —
A fifth week begins without LRT service, Ottawa’s top doctor has ‘cautious optimism’ for fall during the COVID-19 pandemic, and Canada’s Olympic champion women’s soccer team takes the pitch at TD Place.

CTVNewsOttawa.ca looks at five stories to watch in Ottawa this week

ALL ABOARD? CITY REVIEWS RETURN TO SERVICE PLAN FOR LRT

Ottawa transit riders could find out this week when service will resume on the Confederation Line.

City staff spent the weekend reviewing the return-to-service plan submitted by Rideau Transit Group following the LRT car derailment near Tremblay Station on Sept. 19.

Sources tell CTV News Ottawa the RTM return to service plan has a specific date, but staff must review the entire plan to assess if it’s possible. Officials expect that when the trains resume, it will be a gradual return to service.

City Manager Steve Kanellakos told council last week that Rideau Transit Group has identified a loose gearbox as the issue that caused the derailment.

The Transit Commission is scheduled to receive an update on the Confederation Line on Wednesday, which could include details on the derailment and return to service plan.

Meantime, the new boss of OC Transpo arrives on Monday.

Renee Amilcar replaces John Manconi as Transportation Services General Manager after Manconi retired last month. Amilcar worked with Montreal’s transit system as the director of bus maintenance.

QR CODES FOR COVID-19 VACCINE PASSPORT

Ontario’s new COVID-19 vaccine verification app and QR code system will roll out this week for people to access non-essential restaurants and services.

Individuals can download their QR codes through the Ontario government’s website, while businesses can download an app to check a vaccination status.

When a proof of vaccination QR code is scanned in the app, it will respond with either a green check, yellow caution sign or a red “X,” which means the certificate is invalid.

The yellow caution sign could be issued because the vaccine certificate being scanned was issued outside of Canada, the app says.

You will still need to show a piece of ID with the QR code.

Verify Ontario app

‘CAUTIOUS OPTIMSIM’ ON COVID-19 SITUATION IN OTTAWA

With Ottawa approaching a first dose vaccination rate of 90 per cent, medical officer of health Dr. Vera Etches says her outlook for fall is “one of cautious optimism.”

However, Dr. Etches is concerned about the number of close contacts unvaccinated children under 12 currently have.

“The most common source of COVID-19 infections for children and youth are household members.”

Etches is asking parents to limit extra curricular activities, sleepovers and other social activities outside of school for unvaccinated school to limit cases and help keep schools open.

Currently 89 per cent of Ottawa residents 12 and older have received one dose of a COVID-19 vaccine, while 85 per cent of residents are fully vaccinated. Dr. Etches has set a goal of over 90 per cent of residents fully vaccinated to limit the spread of the virus.

As of Sunday, there are five outbreaks in Ottawa elementary schools. The number of active cases is at 258, and hospitalizations remain low.

COVID-19 vaccine in Ottawa

MORE MONEY FOR THE OTTAWA PUBLIC LIBRARY

Ottawa’s finance and economic development committee and the Ottawa Public Library Board will vote Tuesday on spending more money to build the new super-library at LeBreton Flats.

The price-tag for the new joint library between the Ottawa Public Library and Library and Archives Canada jumped by $131 million, plus another $10 million for the parking garage.

A report says the increase from the initial estimate of $193 million (including the parking garage) to $334 million can be directly attributed to an escalation in the construction market.

“Canada is experiencing a significant increase in construction costs due to COVID-19 impacts,” said staff. “A combination of material shortages and commodity escalation, supply chain slowdowns and pressures, labour implications and a superheated construction market, have all been described by the Ottawa Construction Association and observed in recent city tenders.”

The city of Ottawa must spend an extra $65 million for the new super library, which will be covered through borrowing, using surplus funds and development charges.

Ottawa Public Library

CANADA’S WOMEN’S SOCCER TEAM PLAYS IN OTTAWA

Canada’s Olympic champion women’s soccer team will play in Ottawa next weekend, the first match since winning a historic Gold medal at the Summer Games in Tokyo.

Canada faces New Zealand at TD Place as part of the Women’s National Team Celebration Tour.  Game time 3 p.m. Saturday.

The team includes Ottawa’s Vanessa Gilles, who scored the decisive penalty shootout goal for Canada in the quarterfinals against Brazil.

For tickets, visit canadasoccer.com

canada women's soccer

EVENTS HAPPENING IN OTTAWA THIS WEEK

Tuesday

Ottawa Finance and Economic Development Committee meeting – 9 a.m.

Standing Committee on Environmental Protection, Water and Waste Management meeting – 1 p.m.

Ottawa Public Library Board meeting – 5 p.m.

Wednesday

Ottawa Transit Commission meeting – 9:30 a.m.

Atletico Ottawa vs. Valour FC. 7 p.m. at TD Place (TSN 1200)

Thursday

Ottawa Community and Protective Services Committee meeting – 9:30 a.m.

Ottawa Senators vs. San Jose Sharks. 7 p.m. at Canadian Tire Centre (TSN 1200 and TSN 5)

Saturday

Ottawa Senators vs New York Rangers. 1 p.m. at Canadian Tire Centre (TSN 5 and TSN 1200)

Canada’s women’s soccer team vs. New Zealand. 3 p.m. at TD Place

Ottawa Redblacks at Hamilton. 4 p.m. (TSN 1200 and TSN)

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Three more COVID-19 related deaths, 58 new cases, in New Brunswick Sunday – CTV News Atlantic

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New Brunswick is reporting three more COVID-19 related deaths on Sunday, bringing the total number in the province to 90. 

All three deaths occurred in Zone 5 (Campbellton region). Two people were aged 40-49 and one person was aged 80-89.

“My thoughts are with the loved ones of the people who have passed away today,”Premier Blaine Higgs said in a release.

“We all have a role to play in slowing the spread of the virus. I want to thank the businesses that have taken steps to motivate employees to get vaccinated and I encourage other businesses to do the same. COVID-19 can pose a serious risk in the workplace and may impact a business’s operations, especially if an unvaccinated employee contracts the disease.”

There are 57 people hospitalized due to the virus, with 18 in an intensive care unit.

“Of the 18 in an intensive care unit, none are fully vaccinated (16 are unvaccinated and two are partially vaccinated). Of the total of all hospitalized, 29 are unvaccinated, six are partially vaccinated and 22 are fully vaccinated,” says the release.

58 NEW CASES

Public health is also reporting 58 new cases of COVID-19 Sunday and 117 recoveries, dropping the number of active cases to 935.

Of the new cases, 35 – or 60 per cent – are unvaccinated, five – or nine per cent – are partially vaccinated, and 20 – or 34 per cent – are fully vaccinated.

RAPID-TESTING PROGRAM EXPANDS

Beginning Monday, Oct. 18, people who are not a positive COVID-19 case will be able to pick up free rapid-test kits which they can administer at home.

Public Health has doubled the number of rapid test kits for each pick-up location Monday and throughout this week to help meet the initial high demand.

All the pick-up centres will be open during their scheduled hours or until the daily supply has been given out.

“We’re grateful for the high interest in these tests as people clearly want to do what they can to help fight the COVID-19 virus,” Dr. Jennifer Russell, chief medical officer of health, said in a release.

“Thank you for your patience with staff at the centres as they work as quickly as possible to distribute the tests.”

The kits will be available to the public at large at the following locations provincewide:

  • Moncton: Greater Moncton Health Centre, 150 Edmonton Ave., (3 p.m. to 9 p.m. Monday to Thursday, 1 p.m. to 5 p.m. Friday, and 9 a.m. to noon Saturday)
  • Cocagne: Cocagne Health Clinic, 4813 Rte. 134, (8 a.m. to 10 a.m. and 2 p.m. to 4 p.m. Monday to Thursday, and 8 a.m. to noon Friday)
  • Moncton: 380 MacNaughton Ave. (10 a.m. to 6 p.m. Monday to Friday)
  • Edmundston: Edmundston Regional Hospital, 275 Hébert Blvd., (2 p.m. to 4 p.m. Monday to Friday)
  • Clair: Haut-Madawaska Medical Clinic, 809 Principale St., (1 p.m. to 3:30 p.m. Tuesday, Wednesday and Thursday)
  • Grand Falls: Grand Falls General Hospital, 625 Everard H. Daigle Blvd., (8 a.m. to 4 p.m. Monday to Friday)
  • Saint-Quentin: Hôtel-Dieu Saint-Joseph de Saint-Quentin, 21 Canada St., (2 p.m. to 5 p.m. daily)
  • Campbellton: E.L. Murray Medical Clinic, 3 Stanley St., (2 p.m. to 4 p.m. Monday to Friday)
  • Dalhousie: St. Joseph Community Health Centre, 280 Victoria St., (noon to 3 p.m. Monday to Friday)
  • Shediac: Shediac Regional Medical Centre, 419 Main St., (8:30 a.m. to 4:30 p.m. Monday to Friday)
  • Belledune: Jacquet River Health Centre, 41 Mack St., (1 p.m. to 3:30 p.m. Monday to Friday)
  • Bathurst: Chaleur Regional Hospital, 1750 Sunset Blvd., (12:30 p.m. to 1:30 p.m. Monday to Saturday)
  • Caraquet: Enfant-Jésus RHSJ Hospital, 1 Saint-Pierre Blvd. W., (1 p.m. to 4 p.m. Monday to Friday)
  • Tracadie: Tracadie Hospital, 400 Des Hospitalières St., (1 p.m. to 3 p.m. daily)
  • Lamèque: Lamèque Hospital and Community Health Centre, 29 De l’Hôpital St., (noon to 3 p.m. Monday to Friday)
  • Paquetville: Paquetville Health Centre, 1096 Du Parc St., (8 a.m. to 4 p.m. Monday, Tuesday, Thursday and Friday, 1 p.m. to 4 p.m. Wednesday)
  • Saint-Isidore: Saint-Isidore Community Health Centre, 3973-1 Des Fondateurs Blvd., (12:30 p.m. to 3 p.m. Monday to Friday)
  • Saint John: Diamond Jubilee Cruise Terminal, (10 a.m. to 6 p.m. Monday to Friday)
  • Fredericton: Exhibition Grounds, 361 Smythe St., (10 a.m. to 6 p.m. Monday to Friday)
  • Miramichi: 365 Wellington St. (10 a.m. to 6 p.m. Monday to Friday)

The rapid test screening program is aimed at people two and older who are not a confirmed positive COVID-19 case. A kit has five tests to be used over a 10-day period. People 16 and under must be accompanied by an adult to acquire a testing kit.

VACCINATION UPDATE

Public Health reported today that 82.4 per cent of eligible New Brunswickers are fully vaccinated against COVID-19 and 91.5 per cent have received their first dose of a vaccine.

All eligible New Brunswickers can book their second-dose appointments for a date that is at least 28 days after their first dose.

Those attending a vaccination clinic are asked to bring their Medicare card, a signed consent form and, for those receiving their second dose, a copy of the record of immunization provided after receiving their first dose.

REGIONAL BREAKDOWN OF NEW CASES

The 15 new cases in Zone 1 (Moncton region) are as follows:

  • four people 19 and under;
  • four people 20-29;
  • two people 30-39;
  • two people 40-49;
  • one person 60-69;
  • one person 70-79; and
  • one person 80-89.

Thirteen cases are under investigation and two cases are contacts of previously confirmed cases.

The three new cases in Zone 2 (Saint John region) are as follows:

  • a person 20-29; and
  • two people 50-59.

All three cases are under investigation.

The ten new cases in Zone 3 (Fredericton region) are as follows:

  • one person 19 and under;
  • a person 20-29;
  • two people 30-39;
  • a person 40-49;
  • a person 50-59; and
  • four people 60-69.

All ten cases are under investigation.

The 13 new cases in Zone 4 (Edmundston region) are as follows:

  • five people 19 and under;
  • three people 20-29
  • a person 30-39;
  • a person 40-49;
  • a person 60-69; and
  • two people 70-79.

Twelve cases are under investigation and one case is a contact of previously confirmed cases.

The 14 new cases in Zone 5 (Campbellton region) are as follows:

  • four people 19 and under;
  • three people 30-39;
  • three people 40-49;
  • two people 50-59;
  • a person 70-79; and
  • a person 80-89.

Twelve cases are under investigation and two cases are contacts of previously confirmed cases.

The two cases in Zone 6 (Bathurst region) are as follows:

  • a person 50-59; and
  • a person 60-69.

Both cases are under investigation.

The one new case in Zone 7 (Miramichi region) is a person 80-89 and the case is under investigation.

Additional information is available on the COVID-19 dashboard.

POTENTIAL PUBLIC EXPOSURES

Anyone with symptoms of the virus, as well as anyone who has been at the site of a possible public exposure, is urged to request a test online to get an appointment.

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