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Polio Is Back. Trust the Vaccines. – The Bulwark

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A polio outbreak is upon us. How our government, public health professionals, and the media respond could lead to further politicization of vaccines, or a step toward restoring faith in public health.

First, we need to get the facts straight about the current outbreak: While just one man in Rockland Country, New York has thus far been paralyzed by the virus, this case is likely the tip of the iceberg. The reemergence of this virus, last spread in the United States in 1979, is certainly reason for worry—the virus is 2-3 times as infectious as the original strain of COVID-19 and paralyzes 1 in 200 people that it infects (about 1 in 4 will show “flu-like” symptoms). As recently as the 1940s, it disabled 35,000 Americans a year, and there is no way to cure the paralysis once someone has been infected. In especially severe cases, polio can cause death as the muscles that control breathing become paralyzed and the patient suffocates. Since this case was uncovered, wastewater testing in adjoining Orange County and New York City has demonstrated spread. (London and Jerusalem have also found evidence of the virus.)

Humankind has been dealing with poliovirus for millennia, yet the strain of this ancient virus making the rounds in New York is relatively new. The virus at issue is a mutated vaccine-derived poliovirus, meaning its ancestor is used to vaccinate people across the globe (outside the U.S.) in the form of a drink. Oral vaccination with an “attenuated” or nearly harmless virus has rare side effects (including paralysis, but at a rate of less than 1 percent of the lifetime likelihood of being struck by lightning). This vaccination technique is still used in other countries because it is cheap, easy to store and distribute, and can immunize others in the community as the attenuated virus infects and delivers immunity to unvaccinated individuals. We ceased using this very inexpensive, but effective, method in the U.S. in 2000, mostly due to these rare side effects. All U.S. polio vaccinations are now a four-shot series given to children 2 months to 6 years of age that contain only the dead (inactivated) virus with no chance of replicating or causing paralysis. It is especially important to vaccinate children, as they have the greatest risk of paralysis from the virus.

In the Rockland County case, it appears that the unlucky patient was an unvaccinated individual with recent contacts from foreign countries where the oral vaccination technique is still used. The attenuated vaccine-derived virus had spread and replicated among unvaccinated people in a country with less robust polio vaccination rates than in the United States. Somewhere in this replication, the vaccine-derived virus mutated and re-developed the ability to paralyze. The fact that its genetic material has been found on three continents suggests that it has retained its ancestors’ infectiousness.

Since the virus came about from a vaccine, why should people get vaccinated? For one, the current U.S. standard inactivated poliovirus (IPV) shot series cannot cause infection or paralysis, and is given routinely to infants across the country. Secondly, the IPV shot series protects against paralysis should an individual ever come in contact with this new virus at rates of over 99 percent. Finally, high rates of vaccination in a community can lead to herd immunity, where a virus is unable to propagate an outbreak because most people are already immune. Herd immunity is a hyper-local phenomenon and requires more than 80 percent of people in a community to be immune to prevent an outbreak. Less than half of New York counties with available data have children vaccinated at that 80 percent rate. And we have communities all across America with much lower vaccination rates—New York State’s overall polio vaccination rate is actually higher than the national average.

Somewhat understandably, it would be easy for those on either side of the political aisle to pervert the story of a vaccine-derived virus to further their own agenda. A narrative about a virus originating from a vaccine and causing harm has the potential to further mistrust, and if spun incorrectly could damage vaccination rates in this country even further. The public health community in this country must take action against this possibility with a unified, truthful, and straightforward explanation about how this infection came about and how to prevent its spread. Our vaccination rates among children have been on a downtrend since before COVID. Misinformation and disinformation during this pandemic, in no small part promoted by licensed medical professionals, may contribute to even lower rates in the future. The fields of science, public health, and medicine must act in unison and not allow this type of malicious “skepticism” about vaccines to proliferate into mainstream discourse if we wish to keep preventable infectious diseases at bay in this country.

The usefulness of childhood vaccines is a settled matter among public health experts. Vaccines save lives, and they do it at rates that easily justify their comparatively minimal costs. Even as we face this new threat, there are state legislatures that want to offer parents yet more freedom not to vaccinate their children. It is time to get our message together in a way that reflects the inestimable health benefits vaccines provide for our country every year.

Polio does not look at political affiliation before it ravages a host. It has infected Republicans as high ranking as Senate Minority Leader Mitch McConnell, and Democrats as powerful as President Franklin Delano Roosevelt. This outbreak has yet to receive the news coverage it deserves, which is a shame, but also an opportunity to get the story right: Just as with COVID, the American vaccines work superbly well, and they can save untold numbers of people from suffering and even death.

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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.

The Canadian Press. All rights reserved.

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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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