COVID-19 Pandemic: Get vaccinated!
Dr. Rey D. Pagtakhan
“Vaccination is still the best way to reduce the risk of infection, hospitalization and death from COVID-19,” reiterated world pandemic expert, Dr. Anthony Fauci, recently. “Get fully vaccinated” is the main takeaway message.
My immediate family in Winnipeg is fully vaccinated, except for our grandchildren under 12. We joyfully gathered at home on October 11 for our annual Family Thanksgiving tradition. Still, we missed one family in Ottawa; although both parents are fully vaccinated, their only son is still non-eligible and we felt, for an abundance of caution, travel for the family celebration was best postponed.
Efficacy and safety of COVID-19 vaccines is crystal clear
Frankly, our family did not think we could do it this year when we missed last year’s get-together. In fact, we did not anticipate that COVID-19 vaccines would become available for mass emergency use in December 2020 to urgently slow the spread of COVID-19. Last month on September 16, Health Canada gave full approval to both the Pfizer and the Moderna COVID-19 vaccines (henceforth to be known as “Comirnaty” and “SpikeVax,” respectively) for anyone aged 12 and older – a testament to their efficacy and safety after billion of doses have been administered worldwide. Thanks, indeed, to the preceding years of persistent scientific research, many serious illnesses, hospitalizations, admissions to intensive care units and deaths due to COVID-19 have since been prevented. And even when breakthrough infections with the more recent deadly delta variants occurred, the illness had not been as severe and the mortality was much less among the fully vaccinated. Evidently, the safety and effectiveness of the vaccines are crystal clear.
Current track record of vaccination in Canada
As of October 13, only about a third (35.42 per cent) of the world’s population has been fully vaccinated, with 47.69 per cent having received the first dose. It is only close to a fifth of the population in the Philippines for both the first and the full dose (22.69 per cent and 21.1 per cent, respectively). For the U.S., the respective figures are much better at 64.64 per cent and 55.81 per cent. Fortunately for Canada, the corresponding vaccination rates are even higher: 76.83 per cent and 71.99 per cent of the total population, or 87.82 per cent and 82.29 per cent of those eligible 12 years of age and over. This makes Canada’s standing at 19th place among the nations of the world. But the vaccine coverage for both Alberta and Saskatchewan – the two provinces that had experienced a resurgence in crisis proportions – are below the national average.
Availability of vaccine supplies helps explain the differences in rate of immunization, a challenge the World Health Organization is continually issuing to the world’s wealthy countries. Another factor is the difference in the political climate in North America. There is greater polarization and divide in the U.S. than in Canada.
The good and the sad news
As with any medical story, waves of good and sad news have accompanied the ongoing pandemic, seen starkly in the U.S. and, to a much lesser extent, in Canada.
1. Vast majority of Canadians vaccinated: Canadians overall can be grateful for the availability of COVID-19 vaccines for everyone eligible and for the fact that the vast majority have chosen to be vaccinated. This translates to lesser morbidity and mortality among the citizenry and to easing the burden to the health care system and national economy.
This also translates to the fact that about 12 per cent of eligible Canadians have yet to receive one dose of a COVID-19 vaccine, and 18 per cent have yet to receive their second.
2. Young Winnipeg adults leading the way: Just over 88 per cent of Winnipeggers between the ages of 20 to 29 are nearing 90 per cent to being fully vaccinated with 95 per cent having had at least one dose. In contrast, the Southern Health region of my home province lags behind with less than two thirds (63 per cent) of eligible residents fully jabbed.
3. Enhanced effectiveness with delayed interval between first and second dose validated: CBC News (Adam Miller · October 09, 2021) and Canadian Press recently reported on research data soon to be reported in medical journals from both the British Columbia Centre for Disease Control (BCCDC) and the Quebec National Institute of Public Health (INSPQ). The data shows that the earlier strategic decision “to delay (by as long as four months) and mix second doses of COVID-19 vaccines (for the purpose of vaccinating more Canadians sooner at the time when the vaccine supply was limited) led to strong protection from infection, hospitalization and death – even against the highly contagious delta variant.”
These observations have implications as countries presently review their policies on international travel and make them conform to new scientific data that have emerged from “the analysis of close to 250,000 people in B.C.” and “1.3 million people in Quebec.” Note further that the earlier policy decision generated public debate as we also commented at the time.
Dr. Danuta Skowronski, the BCCDC research scientist who spearheaded the move to lengthen the two-dose interval, said, “Protection was even stronger when the interval between the first and the second doses was more than six weeks apart.” Dr. Gaston De Serres, an epidemiologist at the INSPQ, said, “The takeaway is whatever vaccine people had, if they got two doses, they should consider that they are very well protected against severe COVID-19.”
4. Travel to the U.S. reopens next month: Travel to the U.S. will reopen early next month to fully vaccinated Canadians. Since last August, Canada has allowed fully vaccinated Americans to enter. Whether U.S. border officials will recognize a mix of vaccines doses is yet to be clarified. Reopening the Canada-United States land border that had been closed to non-essential travel since March 2020 has a significant impact to economic activity, particularly to close border communities. Optimism must be guarded, however, since the pandemic, although at a reduced intensity overall, is still ongoing.
5. Legal challenge of vaccine mandate for health-care workers launched: Quebec has mandated that all health and social services workers – from nurses and technicians to administration and cleaning staff – who are not fully vaccinated by November 15th will be suspended without pay. This would certainly cause serious disruptions to health care services. I trust both sides would come to a meaningful resolution of the issue and recognize the paramountcy of public health and the health of those served. Any outcome to the legal dispute could have unforeseen implications elsewhere in the country.
6. Vaccination key to avoiding another wave: CTVNews (Rachel Aiello, October 8) recently reported on the national projection released by Chief Public Health Officer Dr. Theresa Tam that “in Saskatchewan, Alberta, and the Northwest Territories, COVID-19 infections are continuing to put ‘significant strain on the health system,’ with similar challenges in smaller health regions with low vaccine uptake as well.” The modelling data reveal “new cases were 10 times higher and 36 times more likely to end up in hospital” among the unvaccinated compared to those vaccinated. The report quoted Dr. Tam: “It is important to stress that even as the fourth wave recedes, COVID-19 is unlikely to disappear entirely, and there could continue to be bumps along the way,” while calling attention to the current vaccination rates data.
7. Full approval for Pfizer and Moderna vaccines: Dr. Chris Beyrer, a professor of Epidemiology and Medicine at Johns Hopkins University, wrote in his Vaccine Blog: “Full authorization is a sea change” for mandating the use of the vaccines in the military, business, and academic institutions, with “exemptions for medical conditions and religious objection granted only on a case-by-case basis and with a formal process for review.” Canada can draw precedence. It has also contributed to increasing vaccine uptake.
8. Pfizer seeks authorization of COVID-19 vaccine for children ages 5 to 11: A week before press time. Pfizer-BioNTech sought emergency use authorization from for their COVID-19 vaccine for children ages 5 to 11. They had shown in a strong immune response in a clinical trial that included 2,268 participants ages 5 to 11, using two doses of 10-micrograms (one-third of the dose regimen for older children and adults) administered 21 days apart. When finally approved in Canada, some three million more children would become eligible to get immunized against COVID-19. I trust Canada would have a well-laid out plan by then – perhaps as early as before the end of this calendar year.
9. Children and COVID-19 risks: The Canadian Paediatric Society recently released its year-long study of all pediatric cases of COVID-19 in hospitals and ICUs. The have validated earlier observations that “children and youth fared better than adults and were at less risk of severe disease or death.” At the same time, it emphasized that children with COVID-19, “with and without underlying conditions can be hospitalized or admitted to ICUs.” The impact of the more contagious delta variant is still under surveillance. With Pfizer seeking regulatory approval in the U.S., few can begin preparing and encouraging families to get their children vaccinated when the vaccine is also approved for use in Canada.
We clearly need further uptake of vaccine and at a faster rate to get ahead of the delta and other variants. Both coverage and pace matter. Indeed, the best and pivotal approach to controlling the pandemic, including protecting Canadian children for whom no vaccine is yet approved, is via full vaccination of the older children and adults in the community.
Dr. Rey D. Pagtakhan, P.C., O.M., LL.D., Sc.D., M.D. M.Sc. is a retired lung specialist, professor of child health, author of articles and chapters in medical journals and textbooks, and a former health critic, Parliamentary Secretary to the Prime Minister, and cabinet minister, including Secretary of State for Science, Research and Development. He graduated from the University of the Philippines, did postgraduate training and studies at the Children’s Hospitals of Washington University in St. Louis and the University of Manitoba in Winnipeg, and spent a sabbatical year as Visiting Professor at the University of Arizona Medical Center. In June 2003, he spoke on “The Global Threat of Infectious Diseases” at the G-8 Science Ministers/Advisors Carnegie Group Meeting in Berlin.