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.
Dr. Allison McGeer, an infectious disease specialist at Mount Sinai Hospital in Toronto, says the U.K.’s booster shot plan is ‘spot on’ in laying out who to target this fall. (Evan Mitsui/CBC)
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.
Dr. Caroline Quach-Thanh, pediatric infectious disease specialist and medical microbiologist at Chu Ste. Justine in Montreal, says Canadian officials need to balance the need for booster shots with the need to make sure everyone has access to the regular first and second doses of a COVID vaccine. (CHU Sainte-Justine)
“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?”
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.
