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Rollout of updated COVID-19 vaccines confusing, experts say

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A Toronto Public Health nurse draws a Pfizer dose into a syringe, at a Toronto vaccination clinic on Feb. 3, 2022.Fred Lum/the Globe and Mail

Inadequate messaging about the importance of getting an updated COVID-19 vaccine could lead to more severe outcomes this fall and winter, particularly among those who are elderly, pregnant or who have other vulnerabilities, some experts say as cases and hospitalizations creep up.

Sabina Vohra-Miller, founder of Unambiguous Science, an online platform that aims to provide important information about COVID and other health issues said she receives around 100 messages a day from people looking for information on the updated vaccine that offers protection against the subvariants that are currently dominant.

“There is a lot of confusion with the vaccine rollout this year,” said Ms. Vohra-Miller, who is also a doctoral student at the University of Toronto’s Dalla Lana School of Public Health. “Going into our third vaccine season, we should have been better prepared for all these scenarios and we’re not.”

Many of her followers have young children, and it’s been particularly challenging for them to find information or vaccine appointments because of low uptake in kids, which has led some pharmacies or doctors offices to no longer offer it: “They are eager to get the vaccine, but they don’t know where to get it.”

COVID surveillance has decreased across the country since the peak of the pandemic. But data that are collected show that, in recent weeks, there has been an increase in cases and hospitalizations. In Ontario, for instance, there were 167 new COVID hospital admissions in the week ending Oct. 14, along with 27 new deaths.

Part of the problem, according to Ms. Vohra-Miller, is the disconnect in the messaging. Health officials rarely speak about COVID now and it’s often dismissed as a minor health issue, leading some to tune out messages when new vaccines are offered, she said.

Health Canada has approved two mRNA vaccines that target the XBB.1.5 subvariant, which was dominant earlier this year. However, evidence shows the vaccine also provides strong protection against strains currently in circulation, such as EG.5. Novavax has also submitted its protein-based vaccine, which also targets XBB.1.5, to Health Canada for approval.

According to the federal department, 9.3 million doses of the Pfizer and Moderna XBB.1.5 shots have arrived in Canada, and 8.7 million of those have been delivered to provinces and territories.

Several provinces and municipal health offices declined interview requests, saying it’s too early in the season to provide a perspective on how the rollout is going.

Alex Summers, medical officer of health for the Middlesex-London Health Unit in southwestern Ontario, said in a statement that there has been “steady demand” for the XBB.1.5 shot at a number of mass vaccination clinics run there. As of last week, the health unit had administered more than 3,000 doses at its vaccine clinics, with about 85 per cent of participants opting for a flu shot at the same time, he wrote.

Dawn Bowdish, Canada Research Chair in aging and immunity at McMaster University in Hamilton, said lack of outreach from overworked family doctors or underfunded public health units means that people who are overdue for an updated shot may not even realize it, inadvertently putting them at risk this season.

“There’s a whole group of people who aren’t vaccine hesitant. It’s just no one told them they should get an update,” Dr. Bowdish said.

She highlighted the exceptional rollout of the vaccine to people living in long-term care and other high-risk groups. But noted that in order to better protect the most vulnerable, it would be ideal to keep COVID levels in the community low.

For some, actually booking an appointment has proven difficult. Dr. Bowdish recounted the story of how she and her husband tried to help some elderly family members who live in the Niagara region book their XBB.1.5 shot. According to the region’s social media pages, appointments were available, but the online booking site showed no spots. Dr. Bowdish and her husband ended up driving to the public-health office to figure out how to get their vulnerable relatives their vaccinations.

But she doesn’t blame the health unit, knowing that they are doing the best with the limited resources the province has given: “Somebody’s got to keep those websites up-to-date, and somebody’s got to answer those phones and in the funding situation they’re in, that’s just not possible.”

There have been some reports in Canada of people getting an older COVID vaccine in recent weeks, despite wanting the updated XBB shot. In the U.S., earlier versions of the COVID vaccine have been deauthorized, meaning they can no longer be given. Health Canada spokesperson Nicholas Janveau said in an e-mail that it would be up to the manufacturer to withdraw its vaccine in the market in Canada.

 

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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.

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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.

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