As health officials warn it could be spring 2022 — after six to eight more months of rolling waves — before COVID is tamed, and only then if 90 per cent of the population is vaccinated, animosity towards the wilfully unvaccinated is growing.
A new poll finds that a majority of Canadians believe that the unvaccinated are selfish, irresponsible and putting others at risk, a view the unvaccinated take strong issue with.
But do strong-arm tactics like vaccine mandates and passports work, or just entrench resistance and feed conspiratorial thinking? Some have argued that dividing people into the “risky” and “safe” underplays that vaccination may not fully stop transmission of the Delta variant.
Vaccines protect against serious disease, Harvard epidemiologist Michael Mina tweeted this week. “Vaccines may slow spread — yes,” he said. “But many policies across (the) US & elsewhere assume vaccines totally prevent spread. This leads to outbreaks among vax’d — which ultimately erodes trust in the whole vaccine effort unless the expectations are set properly.”
A preprint by a Canadian research network estimates that, by late summer, 60 to 80 per cent of the Canadian population will have some immunity to COVID, but that’s still insufficient to stave off a fall resurgence. How severe a rebound depends on the rate of waning immunity, the transmissibility of the hyper-contagious Delta, relaxing of distancing and other public health measures, and how well the vaccines hold up against infection and severe disease, they said. “To prevent large-scale resurgence, booster vaccination and/or re-introduction of public health mitigation may be needed,” the authors wrote.
Liberal Leader Justin Trudeau has vowed to make COVID shots mandatory for boarding planes or trains.
There’s a high level of tension and polarization between the vaccinated, a growing majority, and the unvaccinated, said Jack Jedwab, president of the Association for Canadian Studies. “It’s very difficult to have a conversation, because people have become very entrenched in that position — at this juncture, if they’ve not gotten vaccinated, they’re very entrenched in their position.”
Polling by Leger for the association suggests a majority of the vaccinated don’t think there’s a rights or civil liberties issue. “They’re not giving that argument any credibility whatsoever,” Jedwab said. “In a public health emergency, your purported rights are violating my desire to protect my health, which is superseding what you describe as rights.” The sticking point may be if a mandate threatens a person’s livelihood, and Jedwab expects the discord and tension will only grow as more people get vaccinated and as the unvaccinated feel more “squeezed.”
But it gets messy and murky. While there’s a core contingent of anti-vaccine groups trying to sow disinformation and distrust, “we can’t think of all of these people (the vaccine hesitant or reluctant) as being people who just read something on the Internet and they have decided the virus isn’t real,” said University of Manitoba virologist Jason Kindrachuk. “In a lot of cases there may be a vast, historical context behind all these feelings and reasoning.” Some of the frustration among the pro-vaccine, he said, is the realization that perhaps there was a more appreciable percentage of the reluctant than people realized.
Some concerns may not be totally irrational. Some women have reported unusual menstrual cycles, however studies so far have found no evidence COVID-19 vaccines affect fertility and the ability to have children. A huge new study from Israel appearing in this week’s issue of the New England Journal of Medicine found that while the Pfizer vaccine increases the risk of heart inflammation (about three events per 100,000 people vaccinated) the risk is several-fold higher among people infected with the SARS-Cov-2 virus (11 cases per 100,000). Infection with COVID was also associated with a substantially increased risk of other seriously bad things, like heart attack, blood clots and bleeding inside the skull or brain.
While a preprint paper published this week suggests immunity, including protection against a breakthrough infection with Delta, lasts longer after a natural infection than immunity after two doses of Pfizer, no one is suggesting COVID parties. “What we don’t want people to say is: ‘All right, I should go out and get infected, I should have an infection party,’” Michel Nussenzweig, an immunologist at Rockefeller University told Science magazine. “Because somebody could die.”
“When we look at the risks that come with being infected, all the data say getting vaccinated is your safest way to combatting the virus,” Kindrachuk said. “I think it’s tough to argue right now at all against vaccination.”
Dithering with COVID “would be a fool’s game,” Morris agreed this week. The virus has moved through the global population, it has continued to change with variants of concern and with increased transmission.
At the same time, a study published this week by the U.S. Centers for Disease Control found that the effectiveness of mRNA vaccines (Pfizer and Moderna) in preventing infections in frontline workers decreased from 91 per cent to 66 per cent after Delta became the dominant strain. The trend should be interpreted with caution, the CDC said — protection might also be declining “as time since vaccination increases.” And the vaccines remain very effective against bad outcomes, like hospitalization and death.
But reports of dwindling immunity and breakthrough cases are now driving debate over the need for boosters. In Israel, of 680 people hospitalized with COVID on Thursday, 331 were fully vaccinated. As Reuters reports, most severe breakthrough cases involve people over 60 who also have heart disease, lung problems or other underlying health issues. And despite alarming posts on social media about breakthrough cases in highly vaccinated populations, some context is missing: As an increasing percentage of the population is vaccinated, it follows that the proportion of vaccinated among the infected will also increase, because the shots don’t promise 100 per cent protection. Still, though severe cases are rare, Mina believes breakthrough infections aren’t as rare as they are being made out to be. “The continued message that breakthroughs are rare ultimately shoots us in the foot. They aren’t rare & public is seeing this,” he tweeted.
It’s important to monitor for waning immunity, Kindrachuk said. “We don’t have that one specific marker that says, ‘OK, you have X amount of this antibody so that gives you Y amount of years or months of protection.’”
And while the vaccinated can still spread the virus, they appear to be less infectious and clear COVID faster than the unvaxxed. Their infections also tend to be milder. “The only people that are really at risk are the unvaccinated,” said Eric Arts, a professor of microbiology and immunology at Western University.
“And, in certain provinces, we’re taking very serious steps to protect the unvaccinated by preventing their exposure to the virus and the vaccinated population,” he said. “It’s sad that we have to go to the extent to do that, to protect the unvaccinated. But that is what is necessary in this situation, until we get them vaccinated.” B.C., like Quebec before it, saw a jump in vaccination bookings after announcing its passport program.
Severe cases of COVID-19 were very rare among Canadian children during the first waves of the pandemic, according to a new study by researchers who warn the findings should not be taken as a reason not to vaccinate youth.
The study was published Monday by the Canadian Medical Association Journal and looked at 264 reported cases of children hospitalized in Canada between March 25 and Dec. 31, 2020, before the more infectious Delta variant emerged.
Of those cases, 43 per cent had been hospitalized for another reason, such as a fracture, and it was only after they were admitted that the positive test came to light.
Nearly 34,000 Canadians of all ages were hospitalized during the same time frame.
“If you look at the numbers in total, that’s only 150 children hospitalized with COVID during the first two waves here in Canada,” said study co-lead author Dr. Fatima Kakkar of Montreal’s Ste-Justine Hospital.
“These are very small numbers, when you compare with what has happened in adults.”
The study was conducted before the emergence of the more infectious Delta variant, which now accounts for most COVID-19 infections in Canada.
The research also took place before COVID-19 vaccines were authorized for youth aged 12 and older. Of the cases studied, 77 involved kids aged 13 to 17. Pfizer has said it intends to seek authorization soon for a vaccine intended for kids aged five to 11.
Researchers originally believed that children may be at higher risk for severe disease, since this is typically seen with respiratory infection in the pediatric population.
Among the 150 children admitted directly because of the coronavirus, the most common symptoms were fever (70 per cent) and cough (34 per cent).
4:53 COVID-19: the upward trend in cases among children
COVID-19: the upward trend in cases among children
Half had a severe form of the disease, with 21 per cent admitted to intensive care and 13 per cent needing respiratory or cardiac support.
Researchers add that more than three per cent of Canadian children — a high among all age groups in the country — have recently been shown to carry antibodies to COVID-19, indicating that they have been exposed to the virus.
But the relatively small number of pediatric admissions shows that children had less severe infections than adults, even though they were potentially infected more often, Kakkar said.
Overall, 39 per cent of children and youth hospitalized for COVID-19 had at least one co-morbidity and those with severe disease were more likely to have an underlying health condition including obesity, neurological or respiratory issues.
“We often talk about children who have comorbidities and who are sicker, (…) but 60 per cent had no comorbidity,” she said.
“They were healthy children who were hospitalized for the disease. On the other hand, when we look at the severity, the most severe cases were in children who had comorbidities, such as obesity, major neurodevelopmental disorders.”
Deaths of children infected with COVID-19 were also very rare, confirming the findings of other studies.
But even with the encouraging conclusions, parents should not take from it a false sense of security and not vaccinate their child, Kakkar said, given children in good health also ended up in hospital.
“We do not know, among these children who are in good health, which will be the sickest, and we know that when we have a severe disease, we have consequences,” Kakkar said.
“A child intubated in intensive care needs months of rehabilitation, and unfortunately we cannot predict which child will fall into this category.’
An unvaccinated child will also be more likely to continue the spread of the virus within their own family and friends.
She also noted the Delta variant is much more transmissible and currently wreaking havoc among unvaccinated adults.
“I do not want to discourage parents at all from having their child vaccinated,” she said.
“We really have to look at the total well-being of the child: what will allow them to have a normal life, to do activities, to play sports, to see friends? It’s vaccination.”
Still, Kakkar said the benefits of attending school and seeing friends are essential to development.
“There is a lot of anxiety among parents about the risk of COVID in children,” Kakkar said.
“It is important to reassure parents, it is not the same disease as in adults, (so) I hope that will allow the children to live a little more normal life.”
Public Health Sudbury and Districts staff are determined to get more shots in arms and have planned a series of COVID-19 vaccination opportunities in the region this week.
Eligible individuals looking to get their first or second dose can book an appointment or visit a walk-in, mobile, or pop-up vaccination clinic.
Vaccination is available every Tuesday at the Carmichael Arena in Greater Sudbury, and every Wednesday at the Espanola Mall.
Vaccination is also available by appointment every Wednesday at the health unit’s Chapleau office and every Thursday by appointment at its Sudbury East office in St. Charles.
This week’s vaccination clinic schedule is:
Tuesday, Sept. 28
Mobile clinic at TownePlace Suites located at 1710 Kingsway.
Appointment and walk-in clinics at Carmichael Arena. and at Manitoulin Secondary School located at 107 Bay St. in M’Chigeeng.
Wednesday, Sept. 29
Mobile clinic at Food Basics located at 1800 Lasalle Blvd.
Pop-up clinics at the New Sudbury Centre (centre court) located at 1349 Lasalle Blvd. and at the Salvation Army (Community and Family Services) located at 634 Notre-Dame Ave.
Appointment and walk-in clinic at the Espanola Mall (storefront inside the mall) located at 800 Centre St.
Appointment-only clinic at Public Health’s Chapleau office.
Thursday, Sept. 30
Appointment-only clinic at Public Health’s Sudbury East office.
Friday, Oct. 1
Mobile clinics at the Garson Community Centre/Arena located at 100 Church St. and at the Skead Community Centre located at 3971 Skead Road in Skead from 2 to 6 p.m.
Pop-up clinic at Valley East Public Library located at 4100 Elmview Dr. in Hanmer.
Saturday, Oct. 2
Appointment and walk-in clinic at Carmichael Arena.
Sunday, Oct. 3
Pop-up clinic at the New Sudbury Centre (centre court) located at 1349 Lasalle Blvd.
Everyone born in 2009 or earlier is eligible to receive their first dose of an mRNA vaccine.
Those aged 18 and older can get either the Pfizer or Moderna vaccines (these two mRNA vaccine can be safely interchanged).
Those aged 12 to 17 are only eligible to receive the Pfizer vaccine in Canada.
Anyone who received their first dose of the Pfizer vaccine more than 21 days ago or the Moderna vaccine more than 28 days ago is eligible to receive their second dose.
Those looking to receive their second dose can attend a walk-in, pop-up or mobile vaccination clinic or book their second dose online at www.covid-19.ontario.ca/book-vaccine or call 705-674-2299 from 8 a.m. to 8 p.m.
Public Health reminds people it is possible there won’t be enough doses to offer vaccine to everyone who attends a walk-in, pop-up, or mobile clinic.
More vaccination opportunities may be added throughout the week.
For regular updates, follow Public Health on social media @PublicHealthSD or visit their website at www.phsd.ca/COVID-19/vaccine-clinics.
Visit www.covid-19.ontario.ca/vaccine-locations for a list of pharmacies in Ontario offering COVID-19 vaccination and for booking information or contact your primary care provider.
Visit www.phsd.ca/COVID-19 or call Sudbury’s health unit at 705-522-9200 for more information.
The Local Journalism Initiative is made possible through funding from the federal government.
Ontario health units are developing plans for the vaccination of children aged five to 11 once COVID-19 shots are approved for them.
Toronto Public Health said Monday that it had formed a planning group that includes health partners, school boards, community representatives and the province, while top doctors for Peel Region, Middlesex-London, Hamilton and Ottawa also said they were making arrangements.
Toronto Mayor John Tory said plans are being made now so that young children can be vaccinated as soon as possible after Health Canada authorizes a COVID-19 shot for them.
“This will help keep our kids safe and provide greater protection in our schools and communities across the city,” he said in a statement, noting Toronto was home to approximately 200,000 children in the five-to-11 group.
Peel Region’s top doctor said his public health unit is “ready to deploy a vaccine strategy” for that cohort, pending approval from Health Canada and guidance from the province, and would keep residents informed on a timeline.
The top doctor for the Middlesex-London said his health unit was working with pediatric care providers to ensure clinics were “appropriately designed to support young children and young families.”
“We are working with families and children to make sure that we’ve thought of all of the potential aspects of this,” Dr. Chris Mackie said in a statement. “We very much hope and expect to hit the ground running as soon as that announcement is made.”
Ottawa Public Health said it is working with stakeholders on different scenarios for vaccinating the city’s 77,000 kids in that age group.
Those scenarios, which will depend on timing of vaccine approval, include looking at increasing staffing and clinic locations as well as outreach to children and their families.
Hamilton’s medical officer of health said her health unit was hoping to announce a plan for vaccinating young children as soon as possible.
“We recognize the anticipation and interest community members are feeling as they wait for a potential announcement regarding COVID-19 vaccine approval for this age group, and the peace of mind and strong protection being fully vaccinated would mean to these young people and their loved ones,” Dr. Elizabeth Richardson said in a statement.
Children born after 2009 are currently not eligible to receive any of the COVID-19 vaccines approved for use in Canada. Pfizer has said it intends to seek authorization soon for a vaccine intended for kids aged five to 11.
In Toronto, the city’s top doctor said Monday that public health is aiming to be ready for a November start to their immunizations.
Dr. Eileen de Villa noted that COVID-19 infection rates have been increasing among children aged four to 11 in the last three weeks. Last week, that cohort had the highest rate of infection in the city for the first time since the start of the pandemic, she said, at 64 cases per 100,000 population.
That trend isn’t surprising given that children born after 2009 can’t be vaccinated against COVID-19, de Villa said. But she urged families to get vaccinated to protect those who can’t get the shots.
“It is absolutely key for parents to get vaccinated to help ensure the safer reopening of school and the ability to provide ongoing in-person learning,” she said.
She also flagged that “work that has yet to be done” in vaccinating people between the ages of 30 to 49, many of whom may be parents. She said 25 per cent of that age group in the city is not fully vaccinated.
Ontario health units are responsible for administering COVID-19 shots with guidance from the provincial government.
Provincial data as of Monday showed 80 per cent of youth aged 12 to 17 had at least one COVID-19 vaccine dose and 70 per cent were fully vaccinated.
Vaccination clinics have been run at or near Ontario schools in the weeks since students have returned to classes in an effort to boost vaccination for eligible students, staff and families.
School staff in Ontario must be vaccinated against COVID-19 or be regularly tested for the virus.
No such rule is in place for students, but de Villa wrote to the city’s board of health this month, asking that it request the province to require COVID-19 vaccination for eligible students. The board voted in favour of her recommendation Monday.
In her Sept. 13 letter to the board of health, de Villa referenced the nine other diseases covered under the Immunization of School Pupils Act, which students enrolled in school must be vaccinated against.
COVID-19 is currently not one of those designated diseases, and de Villa wrote that the safety and effectiveness of approved vaccines has been proven in children 12 and older.
“Given the current epidemiology of COVID-19 and the need to support the safe reopening of schools, it recommended that the province require COVID-19 vaccination for students who are eligible based on their age/year of birth,” she wrote.
The province’s top public health doctor has said the province is looking into adding COVID-19 vaccinations to the list of those required for students by law, which allows for some exemptions.
– With files from Noushin Ziafati.
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