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Vaccinating young kids may take time but experts ready to discuss parents' concerns – cbc.ca

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With provinces and territories now rolling out plans to COVID-19 vaccinate children aged five to 11, many parents eagerly signed their children up to be among the first in line. 

But not everyone is pouncing on the opportunity. Some parents have more questions before their kids get the jab. 

Nathan Maharaj and his wife were up bright and early Tuesday registering their nine-year-old son for his first dose of a COVID-19 vaccine in Toronto.

  • Have a coronavirus question or news tip for CBC News? Email: Covid@cbc.ca or join us live in the comments now.

He’s excited Edmund can feel safer returning to karate classes, for instance, and will feel more comfortable planning visits to Ripley’s Aquarium, Ontario Science Centre or the movies.  

“It’s a threshold we needed to cross to do things that we were comfortable doing before and as things are opening up again,” Maharaj said. 

“We don’t want to be going there and then, you know, for the next 72 hours praying for no symptoms of anything to emerge and then also isolating from others because who knows what we’re carrying.”

Coquitlam, B.C., parent Mike Romaniuk, seen with his two young daughters Harper, centre, and Georgia, is still unsure about giving them the COVID-19 vaccine. He would like to review the studies that Canadian health officials reviewed when creating their recommendations for children. (Submitted by Mike Romaniuk)

In Coquitlam, B.C., Mike Romaniuk is digging through news sites and studies about how both COVID-19 and the vaccines for it are affecting children. While everyone in his family is up to date with B.C.’s recommended immunizations and received this season’s flu shot, he is still unsure about the COVID-19 vaccine for his daughters Harper and Georgia, who are respectively aged four and two.

“There’s definitely an aspect of ‘I don’t want to be first for my kids, I don’t want to risk,’ but I recognize on both sides there’s risk. Not doing it is a risk as well,” Romaniuk  said.

“The more data, the more confidence, I think, especially if it’s tabulated or presented in a way that’s easily understandable and comparable.”

He would love to be able see the studies Canadian health officials are analyzing to create their recommendations for children, for instance, saying that for him it would help instill more confidence. 

“There’s a lot of parents that I interact with that have concerns. They’re scared to ask [questions], scared to speak out. There’s quite a stigma around it,” he said.

The drive to vaccinate younger children against COVID-19 could prove tougher and perhaps take longer than earlier age groups, but medical experts say they’re ready to answer all questions and meet parents and caregivers where they’re at.

WATCH | Dr. Susy Hota answers viewer questions about the COVID-19 vaccine for kids: 

Why are COVID-19 vaccines necessary for kids? What about dosage for those almost 12?

2 days ago

Dr. Susy Hota, University Health Network’s medical director for infection prevention and control, answers questions about the first COVID-19 vaccine approved for Canadians aged 5-11. 7:33

Before the pandemic, the term vaccine hesitancy was most often discussed in the context of parental decision-making, according to medical anthropologist Ève Dubé, a researcher at the Quebec National Institute of Public Health who has studied it for more than a decade. 

She said before the pandemic about one-third of parents were vaccine hesitant.

“Not all those parents refused vaccines, but some were accepting with concerns, being unsure that this was the right decision,” said Dubé, who says education on the issue helps build trust and motivates parents to inoculate their children.

Looking at recent surveys, she says, there appears to be more hesitancy about COVID-19 vaccinations for the five-to-11 age group than for earlier cohorts. 

“For COVID, I think the situation is a bit different … because of the fact that children are less at risk of COVID, their direct benefit of vaccination is less clear than for measles or other childhood vaccinations,” she said.

‘A slower start’ predicted

Traditional mass public health campaigns with posters and fact sheets about the importance of vaccination typically work to reach the majority. Those positively discussing vaccines with fellow parents can also help, Dubé  said.

However, for those with many more concerns, health officials employing a targeted, one-on-one approach are most effective, she said. She admits it is more resource and time intensive.

“It might be a slower start of the [age 5-11 vaccination] campaign,” Dubé said. “But with time … the vaccine hesitancy may decrease. Most people never want to be the first in line to do something new.”   

A parent and child arrive an in-school clinic providing the Pfizer COVID-19 vaccine for children aged 5 to 11 in Wheeling, Ill., on Nov. 17. (Nam Y. Huh/Associated Press)

According to historian Catherine Carstairs, who has researched health and medicine, many people pointing to when “everyone rushed out to get the polio vaccine” forget that it actually took many years to achieve consistent uptake across different age groups. 

“I think we may see something similar with COVID-19,” said the University of Guelph history professor.

WATCH | It may take years for some to accept COVID-19 vaccines, says historian:

Why this history professor thinks COVID-19 vaccine uptake in kids could take time

7 hours ago

Catherine Carstairs, a history professor at the University of Guelph, notes how even with the polio vaccine in the 1950s, people choose to wait awhile before choosing to be immunized. 1:26

While many point to a discredited 1990s-era study falsely linking autism and vaccination for increased hesitancy of and opposition to vaccination in recent years, Carstairs believes there have also been many other contributors.

This includes more skepticism of the medical profession, the rise of “natural health” products and non-traditional medicine, a growing feminist health movement and a shift in parenting styles that puts “less reliance on outside expertise and more of a sense of ‘I know my child better than anyone,'” she said.

Working to address parent concerns

As a parent of a five-year-old himself, infectious diseases physician Alexander Wong empathizes with fellow parents who, given how fast the COVID-19 vaccines have rolled out, have more questions and simply want to do what’s best for their kids.

“We need to really kind of be open-minded and work really hard to address those concerns with parents so that we can get as many kids vaccinated as possible,” he said in Regina. 

WATCH | This infectious diseases doctor shares advice for parents with concerns:

Infectious diseases doctor and parent shares advice for fellow parents with vaccine questions

7 hours ago

Dr. Alex Wong outlines a few important points about COVID-19 vaccines for parents of younger children. 2:14

A question Wong hears regularly is that if COVID-19 has caused relatively few kids to become severely ill, hospitalized or die than adult populations, why do we need to vaccinate? 

His response: “No kid should get sick or, God forbid, die as a result of a preventable illness.… We vaccinate for things like measles, rubella, mumps, norovirus, all these other things without thinking twice. And the number of deaths caused by those types of disease conditions pre-vaccine were far, far lower than what we’re seeing with COVID.”  

More practically, he added, vaccination will minimize the intense disruptions kids and families have faced throughout the pandemic at school, with extracurricular activities and time spent with extended family and friends.

Another thing he highlights for parents is that real-world data is coming from the U.S., which approved the vaccine for children aged five to 11 in early November. Wong notes that about three million Americans kids have had one dose thus far with no major flags about side effects.

“That’s a reassuring safety signal,”  he said. “Everybody is scrutinizing this vaccine unlike anything else probably in history quite frankly.”

Leah Lefkove, 9, shows off her vaccination sticker in Decatur, Ga., on Nov. 3. It was the first day COVID-19 vaccinations were available for U.S. children from 5 to 11. (Ben Gray/The Associated Press)

Paul Offit, a professor of pediatrics and member of the Advisory Committee on Immunization Practices that authorized the COVID-19 vaccine for children in the United States, empathizes with those who feel there hasn’t been enough data gathered on this young cohort.

Yet there has never been this abundance of real-word data on teen and adult populations that can be applied to children, he told CBC Radio’s The Sunday Magazine.

Offit says contracting COVID-19 is a much riskier proposition than potential vaccine side effects. One risk of natural infection is myocarditis, or an inflammation of the heart muscle.

He said the risk of myocarditis is roughly one in 45 people who contract COVID-19, compared with roughly one in 50,000 among people who get the vaccine.

“And it’s much more severe [with infection],” Offit added.

He also pointed out that young kids who contract COVID-19 are at higher risk of a condition called Multisystem Inflammatory Syndrome in Children (MIS-C), “where myocarditis occurs 50 to 75 per cent of the time.”

LISTEN | Decision to approve COVID-19 vaccine for kids ‘nerve-wracking’ says U.S. doctor:  

The Sunday Magazine24:13Decision to approve COVID-19 vaccine for kids ‘nerve-wracking’ says American doctor

Canadian kids aged five to 11 are up next for COVID-19 shots, after Health Canada’s decision Friday to approve the Pfizer vaccine for them. Dr. Paul Offit is a member of the vaccine advisory committee that made the same recommendation in the United States earlier this month, a decision he describes as “nerve-wracking,” because he knows there’s some risk involved for young kids. But, as he writes in his new book, You Bet Your Life: From Blood Transfusions to Mass Vaccination, the Long and Risky History of Medical Innovation, all medical breakthroughs involve risk… and not getting the shot is not a risk-free choice. 24:13

In the past 200 years, any side effects associated with vaccines invariably arise within six weeks of the dose, says Offit, who is also director of the Vaccine Education Center at the Children’s Hospital of Philadelphia.

“It’s perfectly reasonable to be skeptical… You should have questions and you should have those questions answered,” he said.

“There’s a line though between that and someone who [doesn’t] trust the pharmaceutical industry, they don’t trust the medical community, they don’t trust the government and it doesn’t matter what you say, they’re simply not going to get a vaccine.

“That to me is not a vaccine skeptic. That’s a vaccine cynic.”


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Trans Mountain Pipeline restarts after three-week pause due to B.C. floods – Globalnews.ca

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The Trans Mountain Pipeline has restarted “safely,” said the company, after a three-week pause due to safety risks posed by widespread flooding in B.C.

On Sunday, Trans Mountain confirmed it has completed “all necessary assessments, repairs, and construction of protective earthworks” needed to turn the taps back on.

“As part of this process Trans Mountain will monitor the line on the ground, by air and through our technology systems operated by our control centre,” it said on its website.

Read more:

B.C. gas supply: Trans Mountain Pipeline plans to restart Sunday

The pipeline was shut down as a precaution on Nov. 14, amid record-breaking rainfall that caused catastrophic flooding and mudslides across southern B.C.

It was the first of four major storms to strike the province last month.

Trans Mountain said Saturday there’s no evidence of “serious damage” to the pipeline, or the release of any product in the aftermath of the extreme weather.


Click to play video: 'B.C.’s fight for fuel: Trans Mountain hopes to restart pipeline at reduced capacity in days'



2:09
B.C.’s fight for fuel: Trans Mountain hopes to restart pipeline at reduced capacity in days


B.C.’s fight for fuel: Trans Mountain hopes to restart pipeline at reduced capacity in days – Nov 26, 2021

The 1,150-kilometre Trans Mountain Pipeline ships roughly 300,000 barrels of oil per day to terminals in B.C. from Edmonton. It also supplies fuel to Washington.

With the pipeline shut down, the B.C. government issued an emergency order on Nov. 19 limiting consumers in storm-stricken parts of the province to 30 litres of gasoline in a single fill-up.

On Nov. 29, it extended gas-rationing to Dec. 14. The fuel conservation measures apply to residents of the Lower Mainland to Hope, Sea to Sky, Sunshine Coast, Gulf Islands and Vancouver Island.

Essential vehicles remain exempt.

© 2021 Global News, a division of Corus Entertainment Inc.

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China Evergrande shares plunge as it teeters on brink of default – CNBC

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China Evergrande Group started returning a small portion of the money owed to buyers of its investment products, weeks after people protested against missed payments at its Shenzhen headquarters, pictured here on Sept. 30, 2021.
Gilles Sabrie | Bloomberg | Getty Images

After lurching from deadline to deadline, China Evergrande Group is again on the brink of default, with its pessimistic comments condemning its stock to a record low just as direct state involvement raises hope of a managed debt restructuring.

Having made three 11th-hour coupon payments in the past two months, Evergrande again faces the end of a 30-day grace period on Monday, with dues totaling $82.5 million.

But a statement on Friday saying creditors had demanded $260 million and that it could not guarantee funds for coupon repayment prompted authorities to summon its chairman — and wiped a fifth off its stock’s value on Monday.

Evergrande, once China’s top-selling developer, is grappling with over $300 billion in liabilities, meaning a disorderly collapse could ripple through the property sector and beyond.

Its Friday statement was followed by one from authorities in its home province of Guangdong, saying they would send a team at Evergrande’s request to oversee risk management, strengthen internal control and maintain operations — the state’s first public move to intervene directly to manage any fallout.

The central bank, banking and insurance regulator and securities regulator also released statements, saying risk to the property sector could be contained.

Analysts said authorities’ concerted effort signaled Evergrande has likely already entered a managed debt-asset restructuring process.

Morgan Stanley said such a process would involve coordination between authorities to maintain operations of property projects, and negotiation with onshore creditors to ensure financing for project completion.

Regulators would also likely facilitate debt restructuring discussion with offshore creditors after operations stabilize, the U.S. investment bank said in a report.

After the flurry of statements, Evergrande’s stock nose-dived 20% on Monday to close at an all-time low of HK$1.82.

Its November 2022 bond — one of two bonds that could go into default upon Monday non-payment — was trading at the distressed price of 18.560 U.S. cents on the dollar, compared with 20.083 cents at Friday’s close.

Liquidity squeeze

Evergrande has been struggling to raise capital through asset disposal, and the government has asked Chairman Hui Ka Yan to use his wealth to repay company debt. 

The firm is just one of a number of developers starved of liquidity due to regulatory curbs on borrowing, prompting offshore debt defaults, credit-rating downgrades and sell-offs in developers’ shares and bonds.

To stem turmoil, regulators since October have urged banks to relax lending for developers’ normal financing needs and allowed more real estate firms to sell domestic bonds.

To free up funds, Premier Li Keqiang on Friday said China will cut the bank reserve requirement ratio “in a timely way.”

Still, the government may have to significantly step up policy-easing measures in the spring to prevent a sharp downturn in the property sector as repayment pressure intensifies, Japanese investment bank Nomura said in a report on Sunday.

Quarterly dollar bond repayments will almost double to $19.8 billion in the first quarter and $18.5 billion in the second.

Yet easing measures such as the ability to sell domestic bonds are unlikely to help Evergrande refinance as there would be no demand for its notes, CGS-CIMB Securities said on Monday.

Evergrande’s inability to sell projects — with almost zero November sales — also makes short-term debt payments “highly unlikely,” the brokerage said.

Contagion

On Monday, smaller developer Sunshine 100 China Holdings Ltd said it had defaulted on a $170 million dollar bond due Dec. 5 “owing to liquidity issues arising from the adverse impact of a number of factors including the macroeconomic environment and the real estate industry.”

The delinquency will trigger cross-default provisions under certain other debt instruments, it said.

Last week, Kaisa Group Holdings Ltd — China’s largest offshore debtor among developers after Evergrande — said bondholders had rejected an offer to exchange its 6.5% offshore bonds due Dec. 7 , leaving it at risk of default.

The developer has begun talks with some of the bondholders to extend the deadline for the $400 million debt repayment, sources have told Reuters.

Smaller rival China Aoyuan Property Group Ltd last week also said creditors have demanded repayment of $651.2 million due to a slew of credit-rating downgrades, and that it may be unable to pay due to a lack of liquidity.

Aoyuan Chairman Guo Zi Wen on Friday told executives at an internal meeting to have a “wartime mindset” to ensure operation and project delivery and to fund repayment, a person with direct knowledge of the matter told Reuters.

Such tasks will be priorities for the developer, which will leave bond repayment negotiation to professional institutions in Hong Kong, said the person, declining to be identified as the matter is private.

Aoyuan did not respond to a request for comment.

The developer’s share price fell nearly 8% on Monday. Kaisa lost 3.8% whereas Sunshine 100 plunged 14%.

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China Evergrande Debt Restructuring Looms – Bloomberg Markets and Finance

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