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Understanding COVID-19 vaccines

     DR NATALIE CASACLANG
 
Dr. Natalie Casaclang after getting vaccinated. Dr. Casaclang is a physician who trained in the Philippines before immigrating to Winnipeg in 2012. She has been a practicing family physician for the past three years and has been working in public health as a Medical Officer of Health for almost a year now.

by Lucille Nolasco

With three approved COVID-19 vaccines in Canada – Pfizer, Moderna and AstraZeneca – and the Johnson & Johnson vaccine’s approval in the horizon, Canadians are hoping to return to some sort of normality in their lives. Now it’s only a matter of when a person actually receives a vaccine. Timelines for when specific age groups will be eligible vary depending on how much vaccine each province or territory receives from the federal government. As of March 29, all Manitobans aged 64 and older, and First Nations people 44 and older are now eligible for the vaccine.

However, as Canada’s National Advisory Committee on Immunization (NACI) is recommending provinces pause the use of the AstraZeneca vaccine on those under the age of 55 because of safety concerns, some people are hesitant to get any vaccine, or they want to get a specific vaccine.

Filipino physician, Dr. Natalie Casaclang of Access NorWest Community Health Centre, sheds some light on the COVID-19 vaccine and other COVID questions.

PE: Have there been many kababayans who have already been vaccinated?

NC: We don’t have specific breakdown of data because as of now, the public health’s collected data is for the whole Manitoba, like what percentage of the population has been vaccinated. There’s no specific data on how many Filipinos or any other ethnic populations have received the vaccine.

PE: Talking to our kababayans, what is the general feeling: are they still hesitant to get vaccinated or they can’t wait to get the vaccine?

NC: Oh yes. In my practice as a family physician, I have many Filipino patients and some of the elderly patients who are now eligible for the vaccine. So what I do is talk to them first, if they are ready or not yet. It’s kind of a split. Some are excited to get vaccinated while others have many questions they want answered first before they book an appointment.

PE: I hear there are people who also seem to be “choosy” when it comes to the kind of vaccine they want.

NC: I do get questions about that. Some people would like the Pfizer vaccine; others would like to wait for the vaccine from J&J because it’s only one dose. What I do recommend is, if you become eligible for any of the vaccines approved and available in Manitoba, you should book an appointment right away because these vaccines, from Pfizer, Moderna and AstraZeneca, are effective against severe illness due to COVID. And if ever you still get infected after getting vaccinated, your symptoms will most probably be just mild, and you won’t need to be hospitalized or intubated. And the risk of dying from COVID will be reduced.

PE: Is the COVID vaccine safe for pregnant women?

NC: We don’t have data about the safety and effectivity of the available vaccines for pregnant or breastfeeding women. The Society of OB-GYN here in Canada strongly recommends the COVID vaccine for pregnant women – because if you’re pregnant and you get infected, there is increased risk of severe symptoms. So we do vaccinate pregnant women, and often there are no complications to the mother or the baby. The only time we don’t give them a vaccine is if it is a live-virus type, like with the measles vaccine, because the virus present in that vaccine might infect them. Now, the three vaccines we have, they are not live-virus vaccines, so there’s no chance of getting infected with COVID through any of these vaccines.

PE: Because of the pandemic and travel restrictions, many visitors to Canada cannot return to their home countries yet, but are also concerned about getting infected while abroad. Can they also be eligible for the vaccine?

NC: Yes, this includes anyone residing in Manitoba, regardless of immigration status: refugee claimants, migrant workers, international students, dependent children of temporary residents, and undocumented residents. These individuals should bring some form of government issued photo ID, such as a passport, in order to get the vaccine.

PE: Why are there different symptoms for different people with COVID?

NC: It depends on how the virus affects the body. We have different risk factors, which make the symptoms severe for some, while almost non-existent for others. Factors like age or if they have other medical conditions like diabetes or heart disease that can worsen the symptoms.

PE: Quite concerning also are people who are asymptomatic who go around oblivious, meeting and talking to people, not knowing they carry the virus and that they can infect others.

NC: Usually when you say “asymptomatic,” they don’t feel or experience any symptoms, but they carry the virus. We have cases of people testing positive through the swab test, but they don’t feel sick or anything. This is often the case with kids, younger children. They don’t have any symptoms, but they are positive for the virus. That is why the advice from public health in Manitoba is to always maintain physical distancing and refrain from gathering because there is a subset of patients who don’t have symptoms but are carriers of the virus and therefore infectious.

PE: Is virus transmission strongest with droplets in the air or touching a surface that’s been touched by an infected person?

NC: Whether it’s droplets from an infected person or by touching an infected surface, often the virus is transmitted if many people are gathered in small, crowded places with poor ventilation. Yes, you are breathing the same air. And droplets from the mouth or nose can travel faster if people are within close proximity to one another.

PE: How about reinfection, is that possible?

NC: What we know right now about COVID reinfection is still developing because this is relatively a new virus, and there’s not a lot of available information about it. What we know is, when you get infected, it’s possible to have short-term protection for up to six months. It’s less likely that you’ll be re-infected within three months after your first infection. But after that, it’s possible that your antibodies will weaken and the possibility of reinfection is there.

Again, I would like to reinforce the message that even if you have already recovered or you have been vaccinated against COVID-19, you are still advised to stay home when you have to, wash your hands often, practice physical distancing and wear your mask because there’s always that possibility of reinfection.

PE: Can you recover from COVID without going to the doctor or to the hospital?

NC: Often, based on statistics, 60 to 70 per cent of people infected have mild symptoms. They are able to isolate at home and then recover. Although I also want to stress that even after recovery, we’re seeing cases where people experience lingering symptoms, like feeling tired, coughing, difficulty breathing, even months after their infection.

I encourage everyone to regularly check their eligibility for the vaccine because it changes often. The web site to visit is Manitoba.ca/vaccine. There is a lot of information there about eligibility criteria. And when you do become eligible, you will also find information there on how to book an appointment at the RBC Convention Supersite.

Access NorWest is also a vaccination site. So if you are a patient there, you will get a call once you are eligible for the AstraZeneca vaccine.

Dr. Natalie Casaclang is a family physician at Access NorWest Community Health Centre, 785 Keewatin St., in Winnipeg. 204-938-5900.

Editor’s note: Dr. Casaclang was interviewed on March 25, 2021, before Manitoba limited the use of the AstraZeneca vaccine to people between the ages of 55 and 64.