Chief Chris Moonias looked into a web camera as he prepared to get a COVID-19 vaccine just after precious doses arrived in his northern Ontario community.
“I’m coming to you live from Neskantaga First Nation community centre where our vaccines will be administered,” a jovial Moonias, wearing a blue disposable mask, said during a Facebook live video at the start of February.
Moonias was first to get the vaccine in the fly-in Oji-Cree First Nation on the shores of Attawapiskat Lake north of Thunder Bay.
The vaccine had arrived by plane earlier in the day after weeks of planning, and the chief’s video was part of a campaign to get community members on board.
Moonias said in an interview that he had done his own research, had spoken with medical professionals and wasn’t concerned about getting the shot.
About 88 per cent of eligible on-reserve members have since received a first dose of the Moderna vaccine. Second doses are to arrive Monday.
However, earlier this week, the reserve declared a state of emergency due to a COVID-19 outbreak, with some cases linked to the Thunder Bay District Jail.
Moonias said four off-reserve members in Thunder Bay, all under the age of 40 — including his nephew — have died. And he’s worried about the 200 other members who live off the reserve — almost the same number as those on the reserve — and when they’ll get inoculated.
“I even thought about flying my people up … to get the vaccine,” said Moonias, who added it’s unlikely to be an option because of cost.
Canada is in the midst of the largest vaccine rollout in its history. The second wave of the COVID-19 pandemic has hit Indigenous populations much harder and Ottawa says they are a priority for vaccinations.
The actual distribution remains complex and varied across the country.
Neskantaga is one of 31 fly-in First Nations included in Operation Remote Immunity, part of the first phase of Ontario’s vaccination rollout. The operation was developed with Nishnawbe Aski Nation and Ornge, the province’s air ambulance service. The goal is to provide mass vaccinations by April 30 and it is having early successes.
There are challenges getting the vaccine to remote First Nations and questions about distribution for urban Indigenous populations.
The Assembly of First Nations says most Indigenous communities haven’t received sufficient supply to extend doses to their off-reserve members. The National Association of Friendship Centres says there is no national vaccination plan for urban Indigenous people.
There’s also concern there is no national plan to tackle decades of mistrust created by systemic racism and experimentation on Indigenous people.
There are many examples throughout Canadian history of scientists sponsored by the federal government or the government itself doing medical experiments on Indigenous people, including children, who were the subject of a tuberculosis vaccine trial in Saskatchewan that began in the 1930s.
Ontario New Democrat Sol Mamakwa, who represents the electoral district of Kiiwetinoong, said some constituents tell him they are scared to take the vaccine. They don’t trust it.
He has been travelling to communities to help promote it and received his first dose alongside members of Muskrat Dam Lake First Nation.
Community engagement has been key in vaccine uptake, Mamakwa said. Promotion begins weeks before vaccine teams arrive and includes radio campaigns, social media posts and live online question-and-answer sessions.
It’s about giving people information, he said.
“One of the only ways out of this pandemic is the vaccine,” said Wade Durham, Ornge’s chief operating officer, who added it’s key to have Indigenous people involved in vaccine planning.
Each First Nation in Operation Remote Immunity has a community member responsible for answering questions and setting up a vaccination site. Immunization teams are required to take cultural training and, when possible, include Indigenous medical professionals and language speakers.
Indigenous Services Canada said it is aware that a history of colonization and systemic racism has caused mistrust, so campaigns are being developed specifically for First Nations, Inuit and Metis communities.
Michelle Driedger, a Metis professor of community health sciences at the University of Manitoba, said experience has shown that stakes are high when it comes to Indigenous communities.
During the H1N1 pandemic in 2009, the Public Health Agency of Canada prioritized vaccines by geography. A main lesson learned was to increase Indigenous representation at decision-making tables, she said.
At the time, Indigenous people were over-represented in hospitalizations and intensive care stays, as well as in deaths. Those living in remote and isolated communities experienced worse outcomes.
Driedger said the vaccine response is better now, but there is “rational skepticism.” There needs to be a transparent vaccination plan for Indigenous communities — no matter where they are, she said.
The Matawa First Nations tribal council said its four communities reachable by road are not getting the same vaccine access as its five fly-in ones, and more needs to be done.
Provincial officials have said that remote First Nations received priority for the vaccine rollout because of less access to on-site health care and increased health risks. Chief Rick Allen from Constance Lake First Nation has said the vaccine needs to go where the outbreaks are.
Back in Neskantaga, Moonias said he’ll do anything he can to protect anyone he can.
He continues to give updates about his vaccination. In another Facebook video posted soon after he received his shot, the chief gave a thumbs-up and said he had no pain or discomfort.
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.
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.
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.
