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Ontario child vaccinations years behind following pandemic

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Ontario is still playing catch-up on routine vaccinations that many children missed during the pandemic and public health officials are warning that it could take years to solve the problem.

“What we see around the world is when the vaccination rates drop, you have a resurgence of vaccine preventable disease,” Dr. Anna Banerji, a Toronto-based pediatric infectious disease specialist, told CTV News Toronto.

“If someone had measles and they were with a group of unvaccinated kids, then for every person that has measles, they typically would infect about nine or 10 other kids. And so it’s extremely, extremely infectious.”

About 60 per cent of seven-year-olds are fully vaccinated against the measles—as well as other illnesses such as mumps and varicella—according to a report published by Public Health Ontario in the end of March.

This is a significant drop from coverage in 2019-2020, when those numbers were between 82 per cent and 86 per cent.

Ontario has seen a mild resurgence of the measles this year, with 13 cases identified in 2024 so far.

Of the seven children infected, five children were unvaccinated while the immunization status of two others were unknown.

Three of the adults had two doses of the vaccine while one was unvaccinated and the status of two others are unknown. All but one case has been tied to travel.

In 2023 there were seven lab-confirmed cases of measles reported in Ontario.

 

For the 2022-2023 school year, just under 60 per cent of seven-year-olds were vaccinated against diphtheria, tetanus, polio and pertussis. Immunization coverage rates were similar for 17-year-olds with the exception of the polio vaccine, which has a strong 90 per cent coverage rate.

Hepatitis B coverage among 12-year-old students stands at about 58.4 per cent for that school year, while HPV immunization coverage is at 47.8 per cent.

A spokesperson for Public Health Ontario said factors such as lack of in-person health care and delayed non-essential appointments during the COVID-19 pandemic negatively affected childhood vaccinations.

School immunization programs were also put on hold due to closures. The report noted that while in-person classes resumed for most students in 2021-2022, most public health units didn’t resume immunization programs until the following year.

“This was very disruptive to the delivery of immunizations during routine well-child visits and for adolescents needing their tetanus-diphtheria-pertussis booster at 14-16 years of age,” officials said in a statement.

“This has probably led to under-reporting of immunizations to public health, but the degree to which this under-reporting has impacted our coverage estimates is unclear.”

Some communities may also have a general difficulty accessing health care, Banerji said, adding that factors such as miscommunication with new immigrants or misinformation can also play a part.

“The reason why we’re living so long and the reason why kids aren’t dying at a young age is three things really: It’s access to clean water, sanitation and vaccination,” she added.

“I think that people forget that.”

Could take 7 years for Peel to catch up

At a meeting last week, Peel’s Medical Officer of Health Dr. Katherine Bingham said that about 50 per cent of students in the region were missing at least one mandated vaccine dose.

A report presented to Reel Region’s council noted that “multi-year strategies” are needed to address the backlog and disruptions to routine childhood immunizations.

“Without significant dedicated resources, we estimate it will take seven years to complete screen and catch-up and achieve pre-pandemic coverage rates,” Bingham said in the meeting.

In Toronto, it is unclear when immunization coverage rates will return to pre-pandemic levels.

“This is a really important question,” Dr. Vinita Dubey, Associate Medical Officer of Health, told CTV News Toronto.

According to city data, there is 57.1 per cent immunization coverage for Toronto students between grades 10 and 12 for Hepatitis B.

Coverage for the HPV vaccine is 50 per cent and the meningococcal quadrivalent vaccine is 77.5 per cent.

“Why are we 10 per cent lower when we are doing the same program that we did pre-pandemic and that’s, I think, something that we really need to pay close attention to. Is it vaccine fatigue, is it vaccine hesitancy, or is it just complacency?”

Dubey says the vaccination rates in Toronto speak to the importance of school immunization programs, especially for vaccines that require multiple doses over time.

“These vaccines can prevent cancers and it’s the kind of thing that you ideally get before you’re ever exposed to these infections. And then it will give you that protection into your life.”

‘We need to be resourced’

The COVID-19 pandemic showed that if resources are funnelled into immunization programs, they can be successful, Dubey said.

“We need to pay attention to that. We may actually need to put in more efforts to get back to where we were. It’s not just restarting what we had,” she added. “We need to be resourced accordingly.”

In November, Toronto’s Board of Health asked for $3.8 million from the Ministry of Health to support catch-up immunizations through vaccinations clinics as well as the promotion of routine vaccination.

A spokesperson for the Minister of Health said in a statement they have increased investments to public health units by an average of 16 per cent since 2018.

They also said they restored a 75-25 funding model to public health units in 2023. However the same government also slashed funding 2019 to a formula that had the province funding 70 per cent of funding and 30 per cent being contributed by municipalities.

“We are also working with PHU’s to clarify their roles and responsibilities. All changes are in direct response to the asks of Public Health Units and Municipalities across the province,” the statement says.

“Our government knows it is never too late to get caught up, and back on track with immunization schedules. That is why we are working with our partners, including public health units to catch children up on their routine vaccines. This includes memos from the Chief Medical Officer of Health communicating this focus to PHUs over the last few years. We have seen efforts remain strong across providers, including increases in school-based programs in the last two school years and we will continue to build on this progress.”

There is also a concern that some children may have received their vaccinations but that parents may not have reported it.

The data is reliant on parents and guardians submitting their children’s immunization record to public health units. Both Peel Region and Toronto officials have said it would be beneficial if physicians and clinics could input the data directly into a provincial system.

As it stands, if a child is missing a dose of a mandatory vaccine, public health units have to send parents notifications, threaten students with suspensions, and then actually suspend students if their vaccinations aren’t up to date. Dubey said the process is successful, and both Toronto data as well as numbers provided by Public Health Ontario show that immunizations are starting to slowly go up.

In Peel Region, officials have said that they are currently “mailing orders of suspension to students in Junior Kindergarten to Grade 1 who have not provided updated immunization records”

The ministry did not say if they would consider a provincial immunization registry when asked by CTV News Toronto.

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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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