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What you need to know about the AstraZeneca vaccine – TheChronicleHerald.ca

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Recent studies have raised concerns about the effectiveness of the AstraZeneca vaccine against variants of the coronavirus that causes COVID-19, as well as possible side-effects such as blood clots.

The questions around this particular vaccine have prompted some Nova Scotians to ask whether they should wait for other vaccines to become available for their demographic.

The Chronicle Herald spoke to immunologist Dr. Gerald Evans of Queen’s University in Kingston, Ont., about these concerns. The following question and answer piece is condensed and edited from that interview:

Q: Some countries in Europe have suspended the use of AstraZeneca because studies have linked it to incidences of blood clots or thrombosis. Should people be worried about that?

A: I’ll start off by quoting William Shakespeare: this is much ado about nothing. It is readily apparent that the rate of thrombosis being seen in people who receive the AstraZeneca vaccine in a number of countries in Europe is in fact lower than the rate of thrombosis that is seen randomly in the general population. In other words, there is no added risk. It’s been picked up (by the media) because there’s been so much discussion about vaccine that people are looking for nuance within the concept of which one might be safer or not. It got traction, I think, because governments were suspending its use or they were saying a certain batch shouldn’t be used but really none of us who study these issues carefully, whether you’re a vaccinologist, whether you’re a hematologist interested in thrombosis, think that there’s anything at all to suggest there’s a causal link between the AstraZeneca vaccine and thrombosis, it’s not there.

Q: What about the effectiveness of AstraZeneca in battling the variants of the coronavirus that causes COVID-19 such as the South African and United Kingdom strains? A recent New England Journal of Medicine paper recently raised questions about its effectiveness against the South African strain (B.1.351).

A: I do know that the study was a rehash of what was talked about in February when this group initially did a press release saying they thought that the AstraZeneca vaccine wasn’t working and the South African government turned around and said it was suspending its use. Now that we have the data to analyze, it’s quite apparent this actually says nothing about efficacy. Because the group that they studied who received the vaccine – and were compared with the group that didn’t get the vaccine – were in fact a very young group of people (median age of 30). To be able to detect there’s a reduction in severe illness like hospitalizations and deaths, you wouldn’t expect to see a difference between a vaccinated and an unvaccinated group, with or without the variant.

What it tells you is that the vaccine may very well have protected some of these younger individuals from getting severely ill and hospitalized so all they ended up with was mild to moderate illness.

All of the vaccines (AstraZeneca, Pfizer, Moderna and Johnson and Johnson) prevent severe outcomes from COVID-19. All of them actually show that they’re really effective at preventing you from dying from COVID-19. This study from South Africa, although it’s done by a very reputable group of investigators there, wasn’t designed to show a reduction in severe illness. If so, they would have enrolled people who were much older.

Q: How much of a factor will these variant strains, which are believed to be more contagious, become as we continue to fight COVID-19?

A: In fact right now in Canada, certainly right here in Ontario, I can tell you over 50 per cent of the isolants that we’re finding are in fact variants, almost all of them by the way the B.117, the variant that arose in the U.K. We have not seen a lot of South African variants in our Ontario data nor across Canada. So, yes, there’s no question, B.117, is pretty well at the stage that it will become the SARS-CoV-2 virus that’s causing all the infections (in Ontario).

If you have low numbers of cases, which is what’s happening in Atlantic Canada, which is what’s happening in my part of Ontario (Kingston), even when the variants arrive, the force of infections is quite low because community prevalence is low. It does bode well that Atlantic Canada may not be as affected by B.117 and the other variants but B.117 will eventually become the dominant strain across the globe, it is just replacing the original SARS-CoV-2.

Q: Getting back to AstraZeneca and the people who are considering putting off their shots and waiting for Pfizer, Moderna or another vaccine what would you say to them?

A: The key message I would give to the public is, there is no difference right now in the efficacy of these vaccines. All of them will protect you from death. The problem you have if you want to delay it is that you run the risk of having no vaccine and if you get COVID-19 and you have certain factors whether you’re older or some other problem medically, then you’re putting yourself at great risk.

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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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