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Want a COVID-19 booster? Experts say most Canadians should wait for updated shots | RCI

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Vulnerable groups could benefit from more frequent boosting than broader public

It’s been close to a year since Edwina Thomas last had a COVID-19 vaccine, and in a couple of weeks, she’ll be back to her job as a school librarian right while infection rates are rising again.

The 59-year-old Dartmouth, N.S., resident wants another booster shot — but said she was told she’s not eligible for another round yet, and doesn’t know when updated vaccines will arrive.

Now she feels stuck in limbo.

I don’t want to get sick, I don’t want to pass it on to older family members that are immune-compromised, I don’t want the children at school to be sick, I don’t want it to be my fault, she told CBC News.

I think it’s just going to go through us like a tidal wave.

While the size of Canada’s apparent fall COVID wave (new window) won’t be clear for some time, there are early signals that cases are spiking — as drug makers such as Pfizer and Moderna are still waiting for Health Canada (new window) and other regulatory bodies to greenlight their updated shots. Those boosters, once approved, will likely start rolling out by early October, officials say.

In the meantime, how are Canadians supposed to navigate the weeks ahead?

Wait for updated COVID-19 booster this fall, experts suggest

Despite an expected fall wave of COVID-19, health experts recommend most people wait for the next, updated vaccine — still a few weeks away — to get a booster for the most protection.

Dr. Theresa Tam, Canada’s chief public health officer, told CBC News most people should simply wait for the latest shots to become available.

The reason, several experts explained, is two-fold: First, the new boosters will be better tailored to the currently-circulating Omicron subvariants, which should help ward off infections over the fall and winter months.

Second, even without that extra dose, experts say the majority of the population (new window) has already developed longer-lasting protection against serious illness after multiple rounds of vaccination, infection, or both.

For anyone at a higher risk of severe disease, however, Tam said an earlier dose of the currently available vaccines may be beneficial if it’s been more than six months since someone’s last vaccination or infection.

We do recommend people go and talk to their health provider about their own particular risk situation, she said.

What we know about fall COVID-19 boosters

  • Officials expect vaccine roll-outs to begin by October.
  • Drugmakers updating vaccines to better match current strains.
  • Most Canadians can consider getting another shot six months or so after their last vaccination or infection.
  • Anyone at a higher risk of serious illness, including older adults, pregnant individuals, people who are immunocompromised, or people with other health conditions, should talk to their health provider if they want another dose sooner.
  • It’s considered safe to get both your COVID booster and a flu shot at the same appointment.
  • Health Canada is also reviewing updated booster shots for children six months and up.

No one-size-fits-all approach

At this point in Canada’s vaccine rollout, there’s a lot more nuance and less of a one-size-fits-all approach.

Figuring out when people are supposed to get vaccines … it’s getting more complicated, said Dr. Allison McGeer, an infectious diseases specialist at Sinai Health System in Toronto.

The days when Canadians of all ages lined up outside pop-up clinics to get a first or second dose — all to gain protection against a new virus their bodies had never encountered before —  are long gone.

Since then, uptake for boosters has dwindled, while people are regularly being exposed to this virus at various times. Antibody-based protection after an exposure does fade as the months pass, meaning people may benefit from a booster at different points.

There’s different sets of circumstances that make it difficult to just give a blanket recommendation across the country, Tam noted.

McGeer said most people can safely wait six months or so between a previous vaccination or infection before getting another dose, which means the booster timing for each person can vary.

It’s also worth holding out for the latest formulations, since matching the vaccine as much as possible maximizes the immune response against the virus’ ever-evolving spike proteins, said Matthew Miller, an immunologist at McMaster University in Hamilton.

But there’s another part of the fall push: Practicality. Vaccine rollouts, several experts stressed, are pricey and time-consuming, while uptake is often low. Only around four in 10 Canadians got flu shots during the last three seasons (new window), for instance. Officials are now trying to streamline that process by offering both the influenza vaccine and COVID booster shots.

And the goal is to try as hard as we can to be prepared for both of those vaccines rolling out at around the same time, Tam said.

Miller agreed most Canadians can consider a two-for-one approach: Getting a COVID booster and flu shot this fall during the same appointment.

There’s no inherent risk in doing that, and it increases convenience, he said. For vaccines, like the flu shot that we have to update regularly, one of the biggest barriers to uptake of the vaccine is just the convenience factor.

Hospitals still ‘stretched to the limit’

Medical experts are hopeful that vaccination coverage in the months ahead will help combat what could be another busy respiratory virus season.

Our hospital capacity is so stretched to the limit that we need to do everything we can to reduce community rates of vaccine-preventable diseases like COVID, and influenza, and increasingly RSV, in order to ensure that things like routine surgeries and procedures and ER availability is there for all of the other things that people are dealing with, Miller said.

Kids may also have access to updated vaccines in the months ahead, officials say. In an email to CBC News, federal spokesperson Mark Johnson noted some children are at increased risk of severe disease due to COVID-19 or developing post-COVID-19 condition, and vaccination is particularly important for these children.

Health Canada, he added, is actively reviewing submissions for updated vaccines for children six months of age and up.

Some people may benefit from more frequent shots

But what’s most critical, several experts agreed, is for vulnerable populations to get the latest shots, perhaps even more frequently than the broader public.

People who are immunocompromised or pregnant, individuals with other pre-existing health conditions, and older adults all remain at a higher risk of serious illness from a COVID infection.

McGeer said for high-risk seniors such as long-term care residents, getting a booster in both the fall and spring will likely make sense. (Tam said Canada is planning ahead for the possibility of a broader spring vaccination campaign as well, if needed.)

A new analysis from a Yale University research team, published on Monday in the Journal of the National Cancer Institute (new window), also suggests more regular shots should be considered for some cancer patients.

The majority of people undergoing cancer treatment could benefit from boosters every six months, the researchers found, with one key exception. Patients whose therapies directly impact their immune response likely need more frequent vaccinations to achieve the same level of protection, said Jeffrey Townsend, a professor of biostatistics at the Yale School of Public Health.

It’s becoming quite clear that for different individuals, there are different levels of risk, and that for different individuals, we need a flexible system that enables them to get boosters as they want, he said.

Lauren Pelley (new window) · CBC News

 

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Scientists show how sperm and egg come together like a key in a lock

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How a sperm and egg fuse together has long been a mystery.

New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.

“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.

The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.

Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.

It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.

Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.

Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.

The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.

The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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Older patients, non-English speakers more likely to be harmed in hospital: report

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Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.

The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.

The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.

The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.

“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.

When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.

“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.

“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.

The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.

Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.

The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.

“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.

They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.

“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”

This report by The Canadian Press was first published Oct. 17, 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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Alberta to launch new primary care agency by next month in health overhaul

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CALGARY – Alberta’s health minister says a new agency responsible for primary health care should be up and running by next month.

Adriana LaGrange says Primary Care Alberta will work to improve Albertans’ access to primary care providers like family doctors or nurse practitioners, create new models of primary care and increase access to after-hours care through virtual means.

Her announcement comes as the provincial government continues to divide Alberta Health Services into four new agencies.

LaGrange says Alberta Health Services hasn’t been able to focus on primary health care, and has been missing system oversight.

The Alberta government’s dismantling of the health agency is expected to include two more organizations responsible for hospital care and continuing care.

Another new agency, Recovery Alberta, recently took over the mental health and addictions portfolio of Alberta Health Services.

This report by The Canadian Press was first published Oct. 15, 2024.

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