This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
Canadians concerned over waning immunity from COVID-19 vaccines, breakthrough infections and the need for booster shots in the general public could benefit from a dose of some important context, experts say.
Antibodies, your first line of defence against COVID-19 infection, do decline — and may even be doing so as you’re reading this — but that’s not unexpected.
While one aspect of your vaccine-induced immunity to COVID-19 is technically “waning” in the weeks and months after vaccination, that’s not necessarily a bad thing — because it’s not your immune system’s only form of protection against the virus.
“I don’t even like the term,” said University of Toronto immunologist Jennifer Gommerman. “And the reason I don’t like the term is that it implies that the immune response in its entirety is declining.”
It’s “entirely normal” for antibody levels to drop initially after vaccination and your immune response to the virus to become “contracted” over time, she said. But your body is also creating “highly efficient” memory B cells to fight off COVID-19 long term.
B cells work quickly to generate large quantities of antibodies in the weeks after vaccination, but they typically produce more effective antibodies as time goes on, helping sharpen the long-term response to a virus.
So while reports of waning immunity may sound concerning, that initial decrease in antibody levels may also be necessary in the fight against COVID-19, as it helps fine-tune the immune system’s plan of attack.
A new study published in the journal Science found “robust cellular immune memory” from B cells for at least six months after mRNA vaccination against all circulating strains of the virus — even the highly contagious delta variant.
The researchers found those memory cells, unlike the initial wave of antibodies, continue to learn how to fend off the virus months after vaccination and are actually getting better at it over time.
“That doesn’t sound like ‘waning’ to me,” Gommerman said. “There’s a natural contraction, but waning implies that something bad is happening.”
While reports of waning immunity may sound concerning, the initial decrease in antibody levels may also be necessary in the fight against COVID-19, as it helps fine-tune the immune system’s plan of attack against the virus. (John Woods/The Canadian Press)
Breakthrough infections don’t tell the whole story
Reports of waning immunity and breakthrough infections have sporadically emerged across Canada in places like the Northwest Territories and New Brunswick, but lack important context and data on who is seriously affected and why.
The N.W.T. has been in the midst of a COVID-19 outbreak since mid-August that started in the Sahtu region before spreading to Yellowknife and its surrounding communities. It has infected 1,584 residents.
During that time, there have been 54 hospitalizations attributed to the outbreak, about 17 of which were among fully vaccinated people. A government spokesperson declined to comment on how many of the nine deaths in the territory were among those fully vaccinated.
WATCH | Concerns over waning immunity leads to expansion of boosters in N.W.T.:
N.W.T. expands COVID-19 boosters over concerns about waning immunity
5 days ago
Northwest Territories Chief Public Health Officer Dr. Kami Kandola talks about the impact of the fourth wave and why the territory is offering COVID-19 booster shots to residents as young as 50. 2:58
“New Brunswick has not identified confirmed evidence of waning immunity among COVID-19 cases,” a government spokesperson said in a statement.
In terms of national numbers, 94.7 per cent of all COVID-19 cases in Canada since Dec. 14 have been among those not fully vaccinated, as well as 95.8 per cent of hospitalizations and 94.3 per cent of deaths, according to the Public Health Agency of Canada (PHAC).
That means a total of 520 fully vaccinated Canadians have died of COVID-19 in the nearly 10 months since our vaccine rollout started, compared with 8,520 who were not considered fully vaccinated during that same time period.
“If we have 100 per cent or 95 per cent of the population vaccinated, almost all the cases that we see, including severe cases, will be in vaccinated people — just because most everyone’s vaccinated,” said Dr. Lynora Saxinger, an infectious diseases physician and associate professor at the University of Alberta.
“So that very rare outcome becomes the majority of the outcomes, and seeing an increasing number of cases in vaccinated people over time doesn’t actually mean that the vaccine works less well, necessarily.”
A nurse tends to a patient in the intensive care unit at Scarborough Health Network’s Centenary Hospital in Toronto on Apr. 8. A total of 520 fully vaccinated Canadians have died of COVID-19 in the nearly 10 months since our vaccine rollout started, compared with 8,520 who were not considered fully vaccinated. (Evan Mitsui/CBC)
Underlying conditions key to breakthrough infections
PHAC says fully vaccinated Canadians who do get COVID-19 are also 79 per cent less likely to be hospitalized and 64 per cent less likely to die, backing up new Canadian data showing strong vaccine protection from infection, hospitalization and death.
But key information on the age, underlying health conditions or specific vaccine combination administered to those who were hospitalized or died from COVID-19 two weeks after their second shot is not available in Canada due to health privacy laws.
Older, frailer Canadians living with comorbidities in congregate settings, such as long-term care facilities, are at increased risk of breakthrough infections because their antibody levels drop “much faster” than in the general population, said Gommerman.
A recent preprint study from the Toronto-based Lunenfeld-Tanenbaum Research Institute at Sinai Health analyzed 119 Ontario long-term care residents and 78 staff over four months, finding much lower levels of neutralizing antibodies in the elderly patients.
Gommerman also stresses there’s an important difference between infections and disease.
“We expect people to get infected — even healthy people to get infected — as antibody levels decline, because the only thing that can protect you against a breakthrough infection are antibodies,” she said.
“But we have to think about who we’re looking at, and what underlying comorbidities might be there in people who experienced breakthrough disease.”
Other immunocompromised groups, such as transplant patients, have shown declining protection from COVID-19 vaccines, as evidenced in the New England Journal of Medicine from researchers at the University Health Network (UHN) in Toronto.
WATCH | NACI recommends COVID-19 booster shots for long-term care residents:
NACI recommends COVID-19 booster shots for seniors in long-term care
24 days ago
Amid a global debate over COVID-19 vaccine boosters, the National Advisory Committee on Immunization is recommending third doses for Canada’s most vulnerable, especially seniors in long-term care homes. 1:58
“If you are a healthy person and you’ve been fully vaccinated, you don’t need to worry about getting severe COVID-19,” Gommerman said.
“If you are worried about getting infected with SARS-CoV-2, you should worry because you have people around you who are not vaccinated or who are under-immune.”
Boosters for general population ‘premature’ in Canada
New data from researchers at the Institute for Clinical Evaluative Sciences (ICES) in Toronto, which has not yet been peer-reviewed, found fully vaccinated people over 16 in Ontario were highly protected against both infection and severe COVID-19 after eight months.
ICES’s vaccine estimates, which have not yet been published, show that protection against symptomatic infection does drop — from 94 per cent to 81 per cent — but protection against severe outcomes remained high, at more than 90 per cent.
“The main takeaway is that we don’t need to do boosters at this time for the general population. We can hold off and wait and see — and when we start seeing the waning, then that’s when we should use the boosters,” said Dr. Jeff Kwong, an epidemiologist and senior scientist at ICES.
“It would be premature to do it at this time and not in our best interest, because we’re allowing other variants to emerge potentially if we let the pandemic spread uncontrolled in other parts of the world [where] they’re not vaccinated.”
WATCH | PHAC reviewing data supporting COVID booster shots in Canada:
Public Health officials say they are reviewing the data supporting COVID booster shots
8 days ago
Chief Public Health Officer Dr. Theresa Tam says Canada’s Public Health Agency is reviewing the data supporting third doses of a COVID vaccine and will issue recommendations soon. 1:23
Saxinger said the vast majority of Canadians who get severely ill or hospitalized after full vaccination are the very elderly, the immunocompromised, transplant patients and people with certain types of cancers.
“That group of people, of course, they should get a third dose,” she said. “But even with a third dose, they still are going to remain vulnerable as long as we have circulating virus in the community.”
MONTREAL – Laurent Courtois knows his team is struggling.
With CF Montreal on a slide and their Major League Soccer season hanging in the balance, the head coach needs his players to keep their heads high.
“Keep the course,” Courtois said. “Keep the course no matter what happens because we know what we are capable of doing.
“Most of us are extremely convinced we can still make the playoffs. We have suffered a lot lately, but let’s not drag our feet — let’s move forward boldly. In the end, there’s nothing to lose, so give it your all.”
Montreal (6-12-9) is winless in its last four MLS games heading into Saturday’s match against Charlotte FC (10-9-8) at Saputo Stadium.
Courtois’s men slipped to 13th in the Eastern Conference after back-to-back emphatic defeats before the international break. Montreal lost 5-0 at home to the New England Revolution on Aug. 24 before falling 4-1 on the road to FC Cincinnati on Aug. 31.
The team now sits five points behind the playoff line with seven games remaining in the regular season.
Asked what Montreal needs to do to turn things around, midfielder Bryce Duke put it bluntly.
“Win,” he said. “That’s as simple as the answer can get, just win games.
“Stick to the game plan, don’t give up easy goals. Don’t shut off. Obviously, a team is going to score on us, but we just can’t let that situation be ‘Okay, they scored on us, game’s over.’”
Caden Clark, acquired on Aug. 8 from Minnesota United FC, has only experienced defeat since moving to Montreal.
The 21-year-old midfielder said he doesn’t see a team that’s playing poorly but echoed that Montreal has lacked resolve.
“At least in the home game (against New England), we played good soccer,” he said. “We kept the ball, had possession, and tried to create chances through that.
“It’s just a lack of mental focus at certain times that gets us in trouble. That game shouldn’t have been 5-0.”
Montreal has the worst goal differential (minus-23) and has conceded the most goals (58) in the East after the lopsided losses.
Charlotte, meanwhile, has allowed only 29 goals, which ranks second-best in the conference.
Courtois identified Charlotte’s patience, compete level and experience as reasons for its defensive success.
But the visiting side is also looking for a better result on Saturday with two losses and three draws in its last five games. Head coach Dean Smith said Charlotte won’t take Montreal lightly despite what its record might suggest.
“They’ve conceded a lot of goals, so I’m expecting them to look to tighten up,” he told reporters in Charlotte. “But if you don’t respect them, that’ll be at your peril, because they’re a good footballing team. They play in tight situations and a lot of one-touch football. They’re looking to entice you into playing behind you, so we have to be at our best.”
Courtois’s message to his team? Play freely, stay focused and enjoy being on the pitch.
“We owe ourselves something different,” he said. “There are moments where we did good things but didn’t reward ourselves because we let stuff slip away due to a lack of concentration.
“Enjoy the games, bring out the best version of yourself. We know the elements that will put us in a good spot and the ones we want to avoid against this really solid team defensively. Be disciplined, have fun and give your heart.”
HONOURING NACHO
Former Montreal star Nacho Piatti will be inducted into the club’s Wall of Fame on Saturday. He is the sixth player to receive the honour, joining Patrice Bernier, Mauro Biello, Greg Sutton, Nevio Pizzolitto and Gabriel Gervais — the current team president.
Piatti produced 66 goals and 35 assists in 135 MLS regular-season games over six seasons in Montreal (2014 to 2019). The Argentine winger won the team’s outstanding player award four times in a row and was named an MLS All-Star in 2016, 2017 and 2018.
ON THE SHELF AGAIN
Montreal will likely have to play without winger Lassi Lappalainen, who practised alone during training this week. The 26-year-old from Finland has played sporadically this year, often off the bench, due to ongoing injuries, including a groin issue.
He produced three shots in the second half against New England but only played 31 minutes versus Cincinnati.
“It’s complicated. We know his qualities, but we also know he’s struggling to find a rhythm,” Courtois said. “It’s a shame for him.”
This report by The Canadian Press was first published Sept. 13, 2024.
As authorities keep searching for a highway shooter in Kentucky, a Friday night tradition of football, pep bands and cheering fans has been sidelined for some towns.
Games were canceled at a handful of high schools near where the assailant opened fire on Interstate 75 in southeastern Kentucky. Twelve vehicles were hit and five people wounded in the attack last Saturday near London, a city of about 8,000 people roughly 75 miles (120 kilometers) south of Lexington.
Security was being bolstered at high school football games that played on Friday evening.
Authorities continue to search a rugged, wooded area where Joseph Couch, the suspected gunman, is presumed to be hiding. The area has cliff beds, sinkholes, caves and dense brush.
Police have urged area residents to be vigilant and look out for their neighbors as searchers try to track down the suspect. Schools have been at the forefront of those safety measures.
Schools remained closed in several area districts, as students shifted to virtual learning. The disruption has paused a range of fall sports, including soccer, volleyball and cross country as well as football.
Among the schools calling off football games were North Laurel, South Laurel and Corbin high schools. The shooting occurred in Laurel County, and Corbin is 14 miles (22.5 kilometers) south of London.
Fans faced an uncharacteristically quiet Friday evening in towns that rally around their football teams.
“Friday night games are huge to our community,” said Tackett Wilson, athletic director at Corbin High School. “It’s a huge part of our community and our school.”
Practices were disrupted as schools took extra precautions while the search for Couch continues.
“Anytime you have a disruption during your season, it’s an issue,” Wilson said by phone Friday. “But you have to error on the side of caution. It’s student safety.”
Corbin officials will try to schedule a makeup football game later in the season, he said.
Amid the disruptions, fans are rooting for the law enforcement officers involved in the search.
“Right now, we are focused on backing our front-line officers and first responders so they can do their job in catching this guy and we can return to a safe and positive environment for our students,” North Laurel athletic director Ethan Eversole said.
He praised the safety plan devised by school district administrators. But students have had a big part of their lives put on hold as athletic activities have been idled.
“Our teams have not been able to practice all week,” Eversole said in an emailed statement.
Kentucky State Police brought in reinforcements to aid with the search, and authorities have bolstered efforts to keep area residents safe as the search continues.
“We will not pull resources away from the search for those other activities,” Gov. Andy Beshear said Thursday. “We just want to make sure that people are ready to try to get back to their day-to-day lives, that there’s that extra (law enforcement) presence where people can feel just a little bit better.”
The day after the shooting, law enforcement officers searched an area near where Couch’s vehicle was found, with a view of I-75. There, they found an Army-style duffel bag, ammunition and spent shell casings, authorities said in an arrest warrant affidavit.
A short distance away, they found a Colt AR-15 rifle with a sight mounted to the weapon and several additional magazines. The duffel bag had “Couch” hand-written in black marker. Couch fired 20 to 30 rounds in the attack, investigators said.
JASPER, Ohio – The municipality of Jasper in Alberta’s Rocky Mountains is taking the next step this weekend as it recovers from a July wildfire that destroyed a third of its buildings.
Jasper Mayor Richard Ireland says the state of emergency will formally end on Sunday.
Ireland says the move means Jasper is transitioning from a short-term recovery perspective to a long-term view.
He also says removing the state of emergency order will help the tourist town’s much needed visitor economy return.
The wildfire destroyed more than 350 of the town’s buildings, including 800 housing units.
The town estimates 2,000 of its 5,000 residents lost their homes.
Although still burning, the wildfire that hit the community was listed as under control a week ago.
This report by The Canadian Press was first published Sept. 13, 2024
