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The long shot: Why waiting 90 days for a second vaccine dose might be a great idea

(Evan Mitsui/CBC) The news that Public Health will delay giving the second COVID-19 vaccine dose to some New Brunswickers for as long as 90 days seemed shocking when it was revealed at Thursday’s live update. One day later, epidemiologists, researchers and even Canada’s top doctor are weighing in with new findings and factors, and suddenly it doesn’t seem so shocking anymore. In fact, some argue, it might be a very good idea. On Thursday, during the rollout of the province’s revised vaccine plan, Chief Medical Officer of Health Dr. Jennifer Russell said the next phase, in April and May, will see a range of new groups immunized. But, she said, those at low risk of severe illness may not get the second booster shot for up to 90 days. The strategy is a calculated risk that contradicts the vaccine manufacturers’ own recommendations — Pfizer-BioNTech and Moderna both recommend a second booster dose within 28 days of the first dose — and more than doubles the 42-day wait time some other provinces have moved to. Russell herself acknowledged Thursday that the approach is “not perfect” and carries some unknowns. However, she noted, in the face of limited vaccine supply and the growing threat of variants, it accomplishes a crucial goal: maximizing protection by getting first shots to as many people as possible. Dr. Jennifer Russell acknowledged Thursday that the delayed-second-shot approach is ‘not perfect’ and carries some unknowns. ‘We are facing an emergency’ That’s a compelling argument in the 90-day wait time’s favour, according to Ontario epidemiologist Raywat Deonandan. “If you’d have asked me two months ago, I would have said that this is inadvisable,” Deonandan said in an email Friday. “However, we are facing an emergency. The threat of the new variants is real. If we are to either avoid a third wave, or mitigate its impact, then we should get as much immunity into as many people … as quickly as possible.” That, he said, means using “all the doses we have available.” He also echoed Russell’s acknowledgement of “unknowns” — chiefly, slippery evidence related to the length of time a first dose would provide protection. That could be a problem if, for example, a second dose is not available for more than 90 days after the first dose was given. In that case, Deonandan said, immunity might fade and the person “would once again be susceptible and wouldn’t know it.” It could also mean the entire portion of the population that didn’t receive their second dose might need to start the two-dose regimen all over again. All things considered, that still doesn’t tip the balance against the 90-day delay. “I don’t know of any real harm in receiving a third or fourth booster,” Deonandan said. “So one can imagine a scenario where we get all the shots into many arms now and then later in the year, when the disease is not raging across the country, people can casually go to their drugstore for a quick booster.” Rodney Russell, an immunology and infectious diseases professor at Memorial University of Newfoundland, says early reports suggest that even the first dose of the vaccine is enough to keep most people from getting sick. First dose’s power might have been underestimated In Newfoundland and Labrador, which is currently in the thick of a variant-fuelled outbreak, Rodney Russell noted New Brunswick’s 90-day-delay strategy with interest. Russell, a COVID-19 antibodies researcher and professor of immunology and infectious diseases at Memorial University of Newfoundland, said there are increasing suggestions that the first vaccine dose might be a more powerful weapon than initially suspected. “The reason you give the booster is literally to boost the immunity, it gives your immune system another taste of the bug and so basically your body says, ‘OK, this is not a one-off,'” Russell said. “But the first shot will induce some immunity.” That might be really good immunity, or it might be partial immunity, he said. “But what we are seeing now … and these are very early reports … is that even the first dose is enough to keep most people from getting very sick.” Although the vaccines’ own manufacturers, Pfizer and Moderna, advise a booster shot within 28 days, Russell noted the fast-moving nature of the pandemic, and the science related to it, have already changed the landscape since the original trials. “The original trials were based on two doses, and original data indicated you’d get a much better response to vaccines after a booster,” he said. “And that’s all the time they had to try, they didn’t have an opportunity to try every possible timeframe or distance between doses.” But now that the real-time data is coming out, “and that’s what matters,” Russell said, if it increasingly proves that high percentages of people are protected with a single dose, then that changes the situation — especially if vaccines are limited. “We’re all kind of winging it and new data is coming on a global, almost daily basis,” Russell said. “I’ve never experienced science at that pace.” Chief Public Health Officer Dr. Theresa Tam said Friday that new studies suggest the initial COVID-19 dose ‘packs quite a punch.’ One might be almost as good as two: study Earlier this week, two Canadian researchers said in a letter published in the New England Journal of Medicine that a single dose of the Pfizer-BioNTech vaccine might be almost as good as two. They found that the Pfizer-BioNTech vaccine has 92.6 per cent efficacy after just one dose. Another letter to the same journal said Moderna’s first dose has 92.1 per cent efficacy. A second dose only increases Pfizer’s efficacy to 94.8 per cent, according to the researchers, Dr. Danuta Skowronski of the British Columbia Centre for Disease Control and Dr. Gaston De Serres of the Institut National de Santé Publique du Québec. “The benefits derived from a scarce supply of vaccine could be maximized by deferring second doses until all priority group members are offered at least one dose,” they wrote. The letter doesn’t mention any ideal time period for a second dose. On Friday, Canada’s top doctor said she was “very optimistic” about the findings, particularly in light of the fact that Canada’s supply of vaccines will be comparatively small over the coming months. “For the next few months, we’re not going to have a lot of people vaccinated,” Chief Public Health Officer Dr. Theresa Tam said. “That’s just a fact.” However, she said, “there are studies now beginning to emerge both abroad and in Canada that just that initial dose packs quite a punch.”

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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