Health
Will Canada have COVID booster shots this year? Probably, but not for everyone, experts say – CBC.ca


Janet Lang had two doses of coronavirus vaccine, but she still double-masks every time she leaves her house.
That’s because Lang, 73, takes oral chemotherapy to control a rare blood cancer. Although the drugs have helped to keep the cancer at bay, they also suppress her immune system, leaving her with the constant worry that although she’s fully immunized, it’s not enough to protect her against COVID-19.
“I’m feeling quite fragile,” Lang told CBC News in an interview near her home in Waterloo, Ont.
A booster shot, she said, would help ease her fears, especially when it comes to the delta variant, she said.
“I’d like to see it put on the agenda [in Canada],” Lang said.
Booster shots will be one of the next big decisions for Canadian officials, with the rise of the more transmissible delta variant, a lack of clarity over when boosters might be needed, and calls from the World Health Organization to get the planet vaccinated before rich countries worry about third doses.
In general, booster shots are used to increase the body’s antibody response to a virus after the immune system has been “primed” by the initial vaccination (for example, tetanus shots). Additional vaccine doses can also help the body fight off different variants of a virus (like the yearly flu shot).
Vaccine manufacturers, including Pfizer and Moderna, are working on developing and testing the safety and efficacy of booster shots against Sars-CoV-2 — the virus that causes COVID-19 — and potential new variants.
At this point, Canadian experts say, the existing COVID-19 vaccine schedule is offering excellent protection, including against the delta variant. But it’s not yet known, they say, how long that protection lasts in various populations — and therefore when or whether a booster shot will be needed.
Still, Lang may get her wish in the coming months if Canada follows the lead of the U.K.’s Joint Committee on Vaccination and Immunisation (JCVI), which is already issuing guidance on potentially starting a booster shot campaign in about two months.
“The JCVI’s interim advice is that, should a booster programme be required, a third COVID-19 vaccine dose should be offered to the most vulnerable first, starting from September 2021 to maximise individual protection and safeguard the NHS [National Health Service] ahead of winter,” said Prof. Wei Shen Lim, COVID-19 chair for JCVI, in a news release.
The British committee recommends that those who are immunosuppressed, living in long-term care or retirement homes, people aged 70 years and older, and front-line health workers should be the first to get a third dose of COVID vaccine, or booster shot.
The U.K.’s targeted approach to booster shots is “spot on,” said Dr. Allison McGeer, an infectious disease specialist at Mount Sinai Hospital in Toronto.
“People who live in long-term care facilities, people who are immunocompromised, do generate lower antibody levels and they decline faster over time,” McGeer said.
“There are likely to be some of those people who will not be well-protected come October or November and who might be better protected if they get an extra dose of vaccine.”
WATCH | COVID-19 vaccine booster being considered for the most vulnerable
As more Canadians get vaccinated against COVID-19, now the discussion is turning toward a possible third dose. A booster shot, not necessarily for everyone, could potentially help control the spread of variants of concern, including delta. 2:01
Dr. André Veillette, an immunologist at the Montreal Clinical Research Institute and member of Canada’s COVID-19 vaccine task force, said that although vaccines are doing an excellent job at controlling COVID-19 in Canada right now, he thinks it would be wise to offer booster shots to vulnerable populations in the fall.
“[In] light of the fact that we’re probably going to get in Canada more and more of this delta variant, I think it’s reasonable to start thinking that we’re going to need also a booster or a third dose,” Veillette said.
Both McGeer and Veillette agree that booster shots should go to people in long-term care, those who are elderly and people with suppressed immune systems first.
WHO chief slams booster shots
But some experts, including the World Health Organization, say that policymakers need to look at the broader picture when they’re considering whether to offer booster shots — including the fact that many people in the world have not yet been able to get even their first dose of a COVID vaccine.
“Some countries with high vaccination coverage are now planning to roll out booster shots in the coming months,” said Dr. Tedros Adhanom Ghebreyesus, WHO’s director general, in a news briefing on Wednesday.
“Vaccine nationalism, where a handful of nations have taken the lion’s share, is morally indefensible and an ineffective public health strategy against a respiratory virus that is mutating quickly and becoming increasingly effective at moving from human-to-human,” he said.
Some Canadian physicians, including Dr. Caroline Quach-Thanh, pediatric infectious disease specialist and medical microbiologist at Chu Ste. Justine in Montreal, share that concern — and argue that one of the best ways to protect vulnerable people against COVID-19 is to vaccinate as many people as possible to build herd immunity.


“If you give those [third] doses here, it means that you’re not giving them elsewhere, you know, worldwide. And at this point in time, what is absolutely needed is for the entire planet to be vaccinated, because if we want to stop the emergence of all those variants of concern that we’re seeing like day in, day out, we absolutely need to have everyone vaccinated,” Quach-Thanh said.
Both Veillette and McGeer, however, said that by the fall, everyone who wants to be vaccinated in Canada will likely have received their doses, and there should be plenty of supply to allow for boosters, especially if it’s limited solely to those who are elderly and those who are immunocompromised.
NACI watching to see if boosters needed
Canada’s National Advisory Committee on Immunization (NACI) is watching the scientific data develop as they consider whether booster shots will be needed — or when, said Anna Maddison, spokesperson for the Public Health Agency of Canada, in a statement emailed to CBC News.
“Based on previous evidence, booster vaccines may be required when immunity decreases below levels of protection and if there is an increase in breakthrough disease,” Maddison said.
“Booster vaccines may also be required if the evolution of the virus, due to variants of concern, is no longer efficiently recognized by the natural immune system or the vaccine.”
Even if all the data on boosters isn’t in yet, Canada should be ready to use them as a proactive measure, Veillette said.
“I think the science may not be there [yet] to prove that elders need a third dose, but at the same time, do we need to go through what we went through before? Meaning, you know, outbreaks in elders’ homes and then people getting very sick, people dying?”
Health
Quebec COVID-19 hospitalizations rising as new variants gaining ground


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MONTREAL — Quebec is seeing an increase in COVID-19 cases and hospitalizations driven by new Omicron subvariants that account for about 75 per cent of infections, the province’s public health director said Wednesday.
Dr. Luc Boileau said the subvariants, such as BA2.12.1, BA.5 and BA.4, appear to be more transmissible than previous strains but not necessarily more severe. The rise in cases was “expected,” though it came earlier than authorities had thought, he said, adding that the number of new infections should continue to rise in the coming days or weeks before declining.
Boileau said the province doesn’t plan on reimposing any broad-level public health restrictions, but he recommended that people who are over 65 or medically vulnerable take precautions such as wearing a mask. He was firm in his advice against a new provincewide masking order, insisting that such a measure was not “realistic” or necessary at this point.
“We’re not at all on a path to reimpose population-level measures such as mask-wearing, or other measures that needed to be taken in the last two years,” he said.
“We’re not there, and we’re not heading in that direction with the current variants.”
He said people who are over the age of 60, who are immunocompromised or who have chronic illnesses should seek a second booster shot if they haven’t had one or if their last shot was more than three months ago. As well, he said those who want to wear masks should be “encouraged” to do so, especially in crowded places.
His update came as COVID-19 hospitalizations rose by 34 in the previous 24 hours, after a 113-patient rise the day before. There were 1,260 people in hospital with COVID-19 in Quebec, including 35 in intensive care. Health officials also reported four more deaths associated with the novel coronavirus.
Dr. Don Vinh of the McGill University Health Centre says Quebec is facing a “perfect storm” of factors that include the emergence of new variants, waning immunity from vaccination or previous infection, and the removal of public health restrictions.
The new Omicron subvariants BA.4 and BA.5, he said in an interview Tuesday, appear to be gaining ground and finding vulnerable people to infect, especially since the mutations seem to be better able to evade immunity compared with previous strains.
“You put the two together, the new variants and waning immunity from either infection, immunization or a hybrid, and what happens is you have a renewed pool of susceptible people with an emerging variant,” he said.
The rise in hospitalizations, he added, comes at a time when the health system is least prepared to handle it.
Hospital workers at “all levels” are overwhelmed, he said, from paramedics and ambulance drivers to ER staff and the community and home care workers who need to be present to care for frail people leaving hospital.
COVID-19 is also putting increased pressure on the system by forcing sick health-care workers to stay home at a time when they’re most needed, he said. “This a catastrophic, systemic failure being unmasked and perhaps even exacerbated by unmitigated community transmission.”
On Wednesday, Boileau said he was concerned with the impact the increase in cases will have on the system, adding that authorities were working with hospitals to readjust services when necessary. He said, however, that he didn’t expect the new rise in cases to get “very, very high” and that the numbers should begin to decline in the next few weeks.
This report by The Canadian Press was first published June 29, 2022.
Morgan Lowrie, The Canadian Press
Health
Canada extends COVID-19 border measures until Sept. 30, including ArriveCan app


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OTTAWA — The federal government will extend current COVID-19 public health measures for travellers entering Canada, including the use of the ArriveCan app, until at least Sept. 30.
In a release Wednesday, the Public Health Agency of Canada also said it will continue the pause of mandatory random testing for fully vaccinated travellers at all airports until mid-July.
It first announced the pause on June 11 and said in the release that it’s allowing airports to focus on streamlining their operations.
The public health agency said it’s moving forward with plans to relocate COVID-19 testing for air travellers outside of airports to select test provider stores, pharmacies or by virtual appointment.
Mandatory random testing is to continue at land border points of entry with no changes.
The release added that travellers who are not fully vaccinated and don’t have a valid exemption must continue to test on Day 1 and Day 8 of their 14-day quarantine.
“As we move into the next phase of our COVID-19 response, it is important to remember that the pandemic is not over. We must continue to do all that we can to keep ourselves and others safe from the virus,” said Health Minister Jean-Yves Duclos in a statement.
He also urged people to remain up to date with the recommended vaccinations to ensure they are adequately protected against infection, transmission and severe complications.
“As we have said all along, Canada’s border measures will remain flexible and adaptable, guided by science and prudence.”
All travellers will have to continue to use the ArriveCan app or website to provide their travel information within 72 hours before their arrival in Canada or before boarding a cruise ship destined for the country. The government said 95 per cent of land and air travellers are using the app and it’s taking steps to enhance compliance.
The government also said moving testing outside of airports will allow Canada to adjust to increased traveller volumes while still being able to monitor and quickly respond to new variants of concern or changes to the epidemiological situation.
It said border testing has been essential in helping Canada slow the spread of the virus, as data from the tests are used to understand the current level and trends of importation of COVID-19 into the country.
The testing program also allows for detection and identification of new COVID-19 variants of concern, it said.
Tourism groups and border-community mayors and MPs have called on the government to ease restrictions and scrap the ArriveCan app, saying the measures are limiting cross-border travel.
Transport Minister Randy Boissonnault said the government is deeply invested in growing Canada’s visitor economy.
“From our reputation as a safe travel destination to our world-class attractions and wide-open spaces, Canada has it all and we are ready to welcome back domestic and international tourists, while prioritizing their safety and well-being.”
This report by The Canadian Press was first published June 29, 2022.
The Canadian Press
Health
Western researchers use MRI to learn cause of long-COVID symptoms – BlackburnNews.com


Western researchers use MRI to learn cause of long-COVID symptoms
File photo of woman coughing. Photo courtesy of © Can Stock Photo / HighwayStarz
June 29, 2022 7:30am
A study led by researchers at Western University has revealed the cause of long-COVID symptoms.
New data published by Western professor Grace Parraga and the LIVECOVIDFREE study, based out of five centres in Ontario, is the largest MRI study of patients with long-COVID. The term long-COVID refers to symptoms of brain fog, breathlessness, fatigue and feeling limited while doing everyday things, often lasting weeks and months post-infection.
This is the first study to show a potential cause of long-COVID, which has helped physicians in the study target treatment for the patients.
“I think it is always a conundrum when someone has symptoms, but you can’t identify the problem,” said Parraga, a Tier 1 Canada Research Chair in Lung Imaging to Transform Outcomes at the Schulich School of Medicine and Dentistry. “If you can’t identify the problem, you can’t identify solutions.”
By using MRI imaging with inhaled xenon gas, researchers have identified that the symptoms are caused by microscopic abnormalities that affect how oxygen is exchanged from the lungs to the red blood cells.
Researchers used the technology to watch the function of the 300-500 million tiny alveolar sacs, which are about 1/5 of a millimetre in diameter and responsible for bringing oxygen to the blood.
“What we saw on the MRI was that the transition of the oxygen into the red blood cells was depressed in these symptomatic patients who had had COVID-19, compared to healthy volunteers,” Parraga said.
Further CT scans pointed to ‘abnormal trimming’ of the vascular tree, which indicated an impact on the tiny blood vessels that deliver red blood cells to the alveoli to be oxygenated.
Parraga said the study showed no difference in severity between patients who were hospitalized with COVID-19 and those who recovered without hospitalization. She said this is an important finding as the latest wave of COVID-19 has affected many people who did not receive hospital-based care.
To conduct the study, researchers recruited patients suspected to be suffering from long-COVID from London Health Sciences Centre’s Urgent COVID-19 Care Clinic and St. Joseph’s Health Care London’s Post-Acute COVID-19 Program. Some participants experienced persistent shortness of breath more than six weeks post-infection, while others were still symptomatic after 35 weeks.
One of the participants is Alex Kopacz, a London-native and Canadian Olympic bobsleigh gold-medalist, who called his experience with COVID-19 “harrowing” and believed the virus would not affect him long-term as he is a young athlete.
“I was on oxygen for almost two months after COVID, and it took me almost three months to get to a place where I could go for a walk without gasping for air,” Kopacz said. “The take home message for me is that we have to remember that this virus can have very serious long-term consequences, which are not trivial.”
Researchers are now conducting a one-year follow-up to better understand these results.
The study was done in collaboration with researchers outside of London at Lakehead University, McMaster University, Toronto Metropolitan University and Sick Kids Hospital in Toronto.
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