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PEI health minister at a microphone

May 27, 2021 - Dr. Archer's Update on COVID-19 response from the DOM and Medicine Program

Headlinesanimated smiling red lobster in a circle

A ray of hope

I add the following update for my own pleasure! The pandemic is not over but we are nearing the beginning of the end (at least in the “1st world”). Here is one cheery story for those of us who have east coast roots (click here). P.E.I. targets June 27 for opening to Atlantic Canadian travelers. Before you read Dr Morrison’s plan may I suggest you ask Siri to play Bud the Spud!

Female PEI health minister at a microphone

I fully expect that many more such reopening stories will follow as vaccination rates rise.

1) KFL&A update: 3rd wave resolving with 29 active cases locally (4 in hospital) and >59% of eligible residents vaccinated (see update from KFL& A Public Health)

2) Wave 3 continues to subside as Ontario infection rates fall with 1,135 new cases (a 26% decline in case rate), a 19% decline in hospitalizations and a 3.6% positive test rate (click here(click here)

3) Canada’s COVID-19 epidemic shows a continued resolution of wave 3 but Manitoba is in crisis: New and active cases (down -30% and -27%, respectively) and hospitalizations falling (-14%) (click here) (click here): Manitoba has transported >28 patients to Ontario (click here)

4) World vaccine roll-out tops 1.78 billion people (click here)! but it’s mainly rich countries benefiting

5) The global pandemic continues to escalate: ~168.5 million cases of COVID-19 (up 3.5 million from last week) and 3,501,358 deaths to date and new case rates on the rise, particularly in India and South America (click here): 

6) Reopening the USA-Canada Border?

7) FAQs-answers to common questions about the COVID-19 vaccines: New FAQ1 - 4

8) Continued Stability in COVID-19 in Ontario’s Long Term Care facilities (LTC)…6 deaths in the past week-evidence vaccines working: click here

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1) KFL&A update: 3rd wave resolving with 29 active cases locally (4 in hospital) and >59% of eligible residents vaccinated (see update from KFL& A Public Health)

The flow of patients from Toronto has stopped. We have only 4 patients with COVID-19 at KHSC and they are all from KFL&A. We do have 25 patients recovering from COVID-19 (green bar, see below); most from the greater Toronto area. Two COVID-19 patients are on Medicine’s COVID-19 ward, Connell 3. The Medicine service remains very busy with >167 patients at KHSC and a ward of patients at Hotel Dieu hospital. KUDOS to the medicine attendings and trainees who have taken on Johnson 3 at HDH with grace and professionalism!

various types of colourful graphs showing bed capacity at KHSC

KHSC has adequate bed capacity for care of local patients

The total number of cases of COVID-19 in KFL&A since the pandemic began is 1528, not counting the resolved prison outbreak or people from other regions (see below). This is up 21 cases in the past week. There are now 26 active cases in KFL&A, down from 63 cases last week (see below). There are only 95 active cases in our entire SE Ontario region. To date we have cared for >133 patients from the GTA with COVID-19 at KHSC. 

table of numbers graphs and maps outlining current KFL&A covid data

A snapshot of KFL&A on May 27th 2021

59% of people in KFL&A over age 16 years of age have received at least 1 dose of a vaccine (see update from KFL& A Public Health) and table below. We are still seeing active community spread. Most cases in KFL&A are due to variant strains of the SARS-CoV-2 virus.

2) Wave 3 continues to subside as Ontario infection rates fall with 1,135 new cases (a 26% decline in case rate), a 19% decline in hospitalizations and a 3.6% positive test rate (click here(click here): 

salmon coloured bar graph with 4 text boxes below and arrows pointing down

Weekly rolling average of new cases show wave 3 is subsiding in Ontario 

New and active cases are down 26% and 24%, respectively. The 19% decline in hospitalization is welcome relief and bodes well for reopening in the first week of June. Moreover, the positive test rate has fallen from 10% 2 weeks ago to 3.6% today; which will allow us to control the community spread more effectively.

3) Canada’s COVID-19 epidemic shows a continued resolution of wave 3 but Manitoba is in crisis: New and active cases (down -30% and -27%, respectively) and hospitalizations falling (-14%) (click here) (click here): Manitoba has transported >28 patients to Ontario (click here)

map of Canada with surrounding bodies of watertable showing Canadian outbreak at a glance

With many provinces having enacted stay home orders and with rising vaccine rates in Canada (see orange bar graph upper left-below) we are seeing new and active case rates falling rapidly and hospitalizations declining as well (-14%) (above). To date we have had 1,369,677 cases of COVID-19 since the pandemic began. The case mortality rate is 1.47% with 25,390 deaths (see below). 

The current hospitalization numbers are also declining (with 2780 people in hospital today-down from >4100 two weeks ago). One ongoing challenge is that ICUs which are emptying of COVID-19 patients are now full of the 99% of people with other medical and surgical problems, exacerbated by the delays in delivery of care during the past year. We have done ~35 million COVID-19 tests with a cumulative positive test rate of ~3.9%. 

graphs and number graphics

Manitoba remains Canada’s hotspot. This relates to a combination of the provincial government’s late adherence to strict public health lockdowns and inadequate numbers of hospital beds and physicians. The province has transferred >28 patients to Ontario to deal with this crisis. 

blue bar graph

Manitoba’s 3rd wave

The Manitoba crisis is similar in root causes and impact to the situation on Toronto this month (click here).

ambulance, paramedics outside hospital doors

Canada is no longer a vaccine laggard: 22.1 million doses have been administered, up from 19.7 million vaccines last Thursday. 53.6% of the population have received at least 1 dose) (click here): To date, 25.7 million doses of COVID-19 vaccines have been delivered and 86.4% of delivered doses have been administered. 234,234 people per day are being vaccinated. 1,786,201 Canadians are fully vaccinated (click here)-see below.

text on the left and a map of canada on the right with all provinces listed along with the number of vaccines administered

Canada has become a success story in vaccine roll-out after a slow start

4) World vaccine roll-out tops 1.78 billion people (click here)! but it’s mainly rich countries benefiting

Vaccines are they key to ending COVID-19 and the graph below shows some vaccine champs (China in the lead). 

colourful horizontal bar graphs ranking countries with most vaccine doses administeredcolourful horizontal graph showing covid vaccine given per 100 people by country

Total vaccines administered (left); Vaccines administered per 100 people (right)

Unfortunately, the good news about progress in vaccine administration largely applies to a few countries, right above (Israel, USA, UK and Canada). However, if we show not the total number of vaccines given but the number given per 100,000 residents, it becomes clear that India (and most of the world, especially Africa) has had little vaccination. In fact the graph below shows that economically poorer continents (left) and countries (right) have seen little vaccine. This is not only inhumane and unjust; it also allows the creation of new viral mutant which are more likely to keep the pandemic going. We need an effective global vaccine program and Canada should soon start shipping vaccine abroad.

2 colourful thick wave graphs

Africa and South America are largely unvaccinated (left); as are people in low income countries (right)

There is real world evidence that the vaccines work. Look at the fall in confirmed COVID-19 deaths in the vaccinated countries (Germany, France, Canada, USA, UK) vs the high ongoing death rates in Brazil and India (which have low vaccine rates).

colourful line graphs

Vaccinated countries have had marked reduction in death rates; not so in unvaccinated India and Brazil 

Vaccines are safe: If you get vaccinated in Canada you have less than a 6/100,000 risk of a serious allergic reaction and very few people have died from a COVID-19 vaccine in Canada (largely several people with VITT). In return for getting vaccinated you get >90% protection from a serious COVID-19 infection and almost complete protection from a COVID-19 death. 

5) The global pandemic continues to escalate: ~168.5 million cases (up 3.5 million from last week) and 3,501,358 deaths to date and new case rates on the rise, particularly in India and South America (click here) (click here): 

satellite image of earth taken from spaceworld map with shades of red to show most daily cases per country

India and South America have high rates of COVID-19, indicated by dark red) (and low rates of vaccination)

large number graphic with 3 numbers in red white and green

COVID-29 May 20th, 2021: a global snapshot 

Helping India The Department of Medicine has collaborated with the Red Cross through a fundraising page to help support the Red Cross’ efforts on the ground in India. To date we have raised $7650. This funding will provide COVID-19 education, hygiene items and handwashing stations as well as supporting the health care system and quarantine centres. You are most welcome to join this effort and will receive a personal tax receipt from the Red Cross Canada.

text of India fundraiser showing Red Cross worker handing care pkg to young boy on bicycle

6) Reopening the USA-Canada Border? The pandemic is improving in the USA largely due to an effective vaccine program. America now has a 2.4% positive test rate, the lowest rate since the pandemic began (click here; see below). The American turnaround should offer hope to Canadians-this should be us in 2-3 months and hopefully will mean border opening is imminent!

cars, piling and border officers with lit up sign saying US border closed

The issue of when to open the US-Canadian border has been politicized (Conservatives want it open sooner-Liberals want it open later). Mr. Trudeau’s government announced another month-long extension of border restrictions, until June 21 (click here). Only 23 per cent of respondents in a recent Angus Reid poll said they would like the border to be reopened already. I may start a poll to guess the opening date-my bet? June 22nd!

7) FAQs-answers to common questions about the COVID-19 vaccines: New FAQ 1 - 4.

grey human figure holding hands to head with orange question marks swirling

New FAQ 1: Is a single shot of the mRNA COVID-19 vaccine protective  For those who are anxiously awaiting shot 2: be reassured that there is excellent protection from shot 1. The slide below shows the effectiveness of 1 shot vs 2 shots of each of the mRNA vaccines in health care workers. So, while you wait for shot 2 you are highly protected (slide courtesy of Dr. Gerald Evans). (2 shots are still recommended).

light and dark green bar graph

FAQ 2: If your first vaccine was AstraZeneca what to do for the second shot? A reminder VITT is rare with shot 1 (click here) and even rare with shot 2 (1/million) (click here)

If you had AstraZeneca as your first vaccine you are likely frustrated/confused/annoyed about the lack of information re: shot #2 (click here). The cause of the uncertainty is not vaccine supply (we have lots of AstraZeneca vaccine available). The cause of the uncertainty re your second shot is the very confusing data on the incidence of a rare clotting/bleeding complication called VITT which is associated with the AstraZeneca vaccine. VITT has occurred in 28 Canadians (click here) and likely occurs in 1/100,000 people that receive this vaccine. Unfortunately, reported rates of VITT vary widely by country from 1/25,000 to 1/200,000, which has been a challenge to understand and has made health policy to say the least confusing (click here). 

Personally, I am convince the vaccine is safe and our monitoring systems (with 15 million vaccines given thus far) shows that adverse reactions are not higher with AstraZeneca than other vaccines (they actually are lower-click here and see below). 

light and dark purple bar graphs

In the UK where lots of AstraZeneca has been used it is clear risks of VITT are low and are even lower for the second shot (click here)! More than 22 million first doses of the AstraZeneca vaccine have been administered with only 209 cases of VITT reported (~1/100,000 people).To date, vaccine with 4 a cases of rare clotting were reported following the second shot (1 in a million people).

In the past week (May 21st) many provinces (including Ontario and BC) authorized second dose administration of AstraZeneca. In BC for example, Dr. Henry indicated “British Columbians who opted for the AstraZeneca plc COVID-19 vaccine for their first dose will be able to get their second doses from the same manufacturer” (click here). I fully support this policy…this vaccine is very effective and has changed Britain from a COVID-19 plagued country to a reopening society!

FAQ 3: Are mix and match vaccine strategies safe and effective? Another possibility for those who had AstraZeneca for their first dose is to take Pfizer or Moderna vaccines for dose 2. This strategy does appear safe and we are awaiting proof it is effective. There is a small clinical trial of 663 people underway in Spain assessing this mixed and match vaccine strategy and results look encouraging (it is tolerated and safe-click here); but it’s still too early to know if it as effective as the two dose of the same vaccine regimen. The data to date shows that a Pfizer booster in people that got an AstraZeneca first shot increased protective antibody levels. The study investigators state: “After this second dose, participants began to produce much higher levels of antibodies than they did before, and these antibodies were able to recognize and inactivate SARS-CoV-2 in laboratory tests. Control participants who did not receive a booster vaccination experienced no change in antibody levels.

One cautionary note of a mix and match approach is that a UK study called Com-COV, which analyzed combinations of the same two vaccines, found that people in the mix-and-match groups experienced higher rates of common vaccine-related side effects, such as fever, than did people who received two doses of the same vaccine (click here) (34% vs only 10% if the two doses of vaccine were the same brand).

screen shot of many vaccine bottles in a pile

FAQ 4: What we know about vaccine induced thrombosis and thrombocytopenia (VITT) (click here) (click here)-any why the Astra Zeneca vaccine is still a safe and effective Many provinces including Ontario have put a hold on using the AstraZenca vaccine because of a rare complication called VITT (click here), which involves unusual clots in veins in the brain and elsewhere. In my opinion this decision is unjustified. However, I acknowledge this is a challenging public health policy. We do not yet know whether the province will approve the use of a 2nd dose of AstraZeneca in those who already received a first dose. I present a summary of the data below to help inform you. 

research paper titletitle on editorial paper
  1. The risk of VITT in Canada as of May 8, 2021 is estimated to be approximately 1 per 55,000 doses (click here).
  2. There is tremendous and unexplained variation in the incidence of VITT between countries, ranging from 1 case per 26,500(Norway) to 1 case per 127,300
  3. No major safety warnings, other than rare anaphylaxis, were reported in the A-Z clinical trials with tens of thousands of adults.
  4. Cerebral venous thrombosis occurs (as seen in VITT) spontaneously in people who are not vaccinated! The incidence of cerebral thrombosis of the venous sinuses in the head is 0.22-1.57/100,000 unvaccinated people which is similar to the incidence of VITT post vaccine (1 case per 100,000 exposures). This raises question about the extentto which the AstraZeneca vaccine actually increases the incidence of cerebral venous sinus thrombosis above that seen normally in the general population
  5. The European Medicines Agency has identified 169 possible cases of cerebral venous sinus thrombosis and 53 possible cases of splanchnic vein thrombosis among 34 million recipients of the AstraZeneca vaccine
  6. Adverse reactions to the AstraZeneca vaccine (as tracked by Canada) are lower than with the other COVID-19 vaccines
  7. Immune thrombocytopenia and bleeding (without thrombosis-clots) have also been reported with Moderna and Pfizer vaccines. The European Medicines Agency has reported 35 possible cases of VITT among 54 million recipients of the Pfizer–BioNTech mRNA vaccine,and 5 possible cases of cerebral venous sinus thrombosis among 4 million recipients of the Moderna mRNA vaccine.
text from Dr. Stephen Archer

FAQ 5: Is VITT less common with the second dose of AstraZeneca vaccine? (short answer yes-1/million cases). Yes it is! In the UK where lots of AstraZeneca has been used it is clear risks of VITT are low and are even lower for the second shot (click here)! More than 22 million first doses of the AstraZeneca vaccine have been administered with only 209 cases of VITT reported (~1/100,000 people).To date, about 4.4 million people in the U.K. have received a second dose of the vaccine with 4 a cases of rare clotting were reported following the second shot (1 in a million people).

FAQ 6: I’m pregnant, should I get the vaccine? Vaccination is recommended for all women who are pregnant or breast feeding at any time in pregnancy unless there is some specific reason not to be vaccinated. The reason for this advice is that the mRNA vaccines for COVID-19 appear to be safe in pregnant women (click here) whereas COVID-19 has higher morbidity (is more severe) when contracted during pregnancy.

female healthcare worker giving vaccine to pregnant womantext from Dr. Stephen Archer

FAQ 7: New FAQ: Does one dose of vaccine provide protection from COVID-19? Short answer: yes (within 2 weeks). Pfizer vaccine confers 80% immunity within 2 weeks of first shot (click hereA real world study by the U.S. Centers for Disease Control and Prevention (CDC) evaluated the vaccines’ ability to protect against infection, including infections that did not cause symptoms. The study looked at the effectiveness of the mRNA vaccines among 3,950 participants in six states over a 13-week period. About 74 % of people had at least one shot, and tests were conducted weekly to catch any infections without symptoms. BothCOVID-19 vaccines developed by Pfizer-BioNTech and Moderna reduced risk of infection by 80% two weeks or more after the first shot. Immunity rises to >90% 2 weeks after the booster shot. This is reassuring, since Canada has spread out the interval from 1 month to 4 months, due to limited vaccine supply, as we try to get more people their 1st shot.

FAQ 8: If I have a solid organ transplant or I am a cancer patient should I have my secondvaccine dose at the original interval? 

The short answer is yes (although it is not based on clinical trial data). Emerging “real world” data (aka experience) suggests that transplant recipients and active cancer chemotherapy patients (with specific treatment and timing considerations) are now eligible to have their 2nd dose of COVID-19 vaccine at the original interval (<30 days from dose 1); rather than the revised 16-week interval. KHSC is currently in the process of operationalizing this new recommendation (which was issued at noon today).

FAQ 9: Which vaccine will/should I get? The short answer is that all vaccines effectively prevent COVID-19 death and severe adverse outcomes-so take the one that you are offered. They are all safe. That said, the vaccine someone receives will depend on your age, where you live and where you are vaccinated. The AstraZeneca-Oxford vaccine, which has an overall effectiveness of 62%-vs >90% for Moderna and Pfizer, will be administered mostly through pharmacies and primary care clinics, as will the Johnson & Johnson vaccine (I suspect). This is the case because they both can be stored safely in a regular freezer (click here). The AstraZeneca vaccine is recommended for people between 18-64 years of age. The mRNA viruses (Pfizer/Moderna) are recommended for people over age 64 years. The advantages of getting a vaccine earlier (even if it’s a little less effective) outweigh waiting longer for a more effective vaccine. This is especially true since all vaccines seem to prevent death and severe COVID-19 complications. Emerging data show that the Astra-Zeneca vaccine is safe and effective in people over age 70 years (based on real-world data emerging from its use in the UK) (click here). In the recent US study it was over 90% effective in preventing severe COVID-19 and prevented death with 100% effectiveness!

FAQ 10: (updated May 20th, 2021): Which COVID-19 Vaccines have been approved by Health Canada? Currently Canada has 4 approved vaccines: Pfizer, Moderna, and Astra-Zeneca and J&J (click here). Pfizer and Moderna are mRNA-based vaccines while AstraZeneca and J&J vaccines use a non-infectious adenoviral vector. All vaccines target the viral spike protein and none containing the SARS-COV-2 virus. The J&J vaccine is a single shot vaccine (all others require two shots). The bottom line: All approved vaccines are protective against severe adverse outcomes and I would still advise you to take the first vaccine you are offered!

info memo re authorized vaccines

FAQ 11: updated May 20th 2021: Does the vaccine work against new variants (mutations) in the SARS-CoV2 virus? Short answer is YES. The vaccines work albeit not quite as well for the variants. In the 144,000 participants in all randomized clinical trials of vaccines to date, those receiving any active vaccine had only 3 cases of severe COVID-19 (vs 37 in the control group). There were no deaths in people who were vaccinated with any of the vaccines versus 5 deaths in the control group. Even though absolute protection is slightly less for UK and South African variants the vaccines (including the AstraZeneca vaccine and J&J) prevent serious adverse outcomes (like hospitalization and death). Recent data shows levels of neutralizing antibodies are lower against mutant strains than the original SARS-CoV-2 virus BUT (and this is important) the levels of antibody produced appear to be sufficient to prevent (or at least markedly attenuate the severity) of COVID-19 (click here ) Thus, despite variant viruses the vaccines are lifesavers!

FAQ 12: I’m on a blood thinner, can I be vaccinated for COVID-19? Short answer YES. Here is a more detailed answer from a Canadian agency with expertise on the use of blood thinners, Thrombosis Canada

memo from Thrombosis Canada for those receiving vaccines

FAQ 13: I have a history of allergic reactions, can I be vaccinated for COVID-19? Short answer YES. Out of ~1.8 million vaccinations there have only been 21 reported episodes of anaphylaxis (the most serious type of allergic reaction). Most (70%) of these events occurred within 15 minutes of the vaccine (which is why you will be monitored for this period of time post vaccine). There were also 83 cases of non-anaphylaxis allergic reaction after Pfizer-BioNTech COVID-19 vaccination with symptom onset within a 0–1-day risk window. Most (87%) of these allergic reactions were classified as nonserious. Thus, the risk of severe allergic reactions to the Pfizer vaccine are low and manageable. Allergy testing is NOT necessary prior to COVID-19 vaccination even in people with history of allergies. It is important note that none of the people who developed anaphylaxis after vaccination died and most did not have a prior history of anaphylaxis (see table below). The incidence of anaphylaxis is lower still with the Moderna vaccine. The Canadian Society of Allergy and Clinical Immunology has recently updated and reinforced this advice (see Tweet below):

tweet from Dr. Stephen Archer

The adverse effects of the COVID-19 vaccines in clinical trials are similar in vaccinated people vs people who got a placebo-saline injection except for: local pain at the vaccine site and increased muscle ache and headache, all of which were more common with the vaccine but were short-term (see below). This is a very good safety profile relative to other vaccines.

table listing side effects of Pfizer vaccine vs placebo

The CDC does advise against the use of the two mRNA vaccines for a very select group of people with the following allergy histories (click here):

  • Severe allergic reaction (e.g., anaphylaxis) after a previous dose of an mRNA COVID-19 vaccine or any of its components
  • Immediate allergic reaction of any severity to a previous dose of an mRNA COVID-19 vaccine or any of its components (including polyethylene glycol [PEG])*
  • Immediate allergic reaction of any severity to polysorbate (due to potential cross-reactive hypersensitivity with the vaccine ingredient PEG)*

FAQ 14: I’m immunosuppressed, should I get vaccinated? This question has a less clear answer. First, be reassured is no virus (dead or alive) in the Pfizer or Moderna vaccines so it is not possible for a person to get infected from the vaccine. However immunosuppressed people were not included in the initial clinical trials. That said, they probably are safe to be vaccinated but this is more a matter of expert opinion. In Canada the National Advisory Committee on Immunization (NACI) currently advises that the COVID-19 vaccine should not be offered to populations excluded from clinical trials “until further evidence is available.” However, they also say “an immunosuppressed person or those with an autoimmune disorder can still be vaccinated if a risk assessment deems that the benefits of vaccine outweigh the potential risks for the individual.” (click here).

The British Society for Immunology recently issued a statement indicating that vaccination is safe in immunosuppressed people (click here), albeit the resulting immune response may be weaker. They remind us that because there is no virus in the vaccine there is absolutely no risk of acquiring COVID-19 from the vaccine. Dr. Mike Beyak (gastroenterology) nicely summarized evidence from a registry of ~4500 patients who were immunosuppressed for their inflammatory bowel diseases (Crohn’s disease and ulcerative colitis). There was no increased risk of contracting COVID-19 in these 4500 patients. Apart for patients on prednisone, there was also no increased complications from COVID-19 when it occurred. Interestingly, some biologic therapies (antibody treatments for IBD) actually appear to reduce adverse outcomes in IBD patients who contracted COVID-19. This is not surprising since the truly bad outcomes in COVID-19 seem to occur in people who mount a hyper-aggressive immune response. Overall these data are good news for our many patients with rheumatoid arthritis, asthma and IBD who are on immunosuppressive therapies. However, since these people were not included in the vaccine clinical trials, it is advised they consult the physicians/clinic that is managing their care to inform their vaccine decision.

FAQ 15: How long can I wait after my first dose to get a second vaccine dose? It appears a second dose at day 42 is as effective in producing a neutralizing antibody response as when the dose is given at day 21 (the normal interval from dose 1). This more lenient 42-day interval is necessitated by our vaccine shortage and has been approved by Health Canada. 

syringe with needle drawing vaccine from bottle

FAQ 16: Can I contract a COVID-19 infection from the vaccines? This answer is simple-NO! None of the approved vaccines in Canada contain the virus itself. They do not contain live virus; they do not contain dead virus. Canada’s approved vaccines (from Pfizer and Moderna) contain only the messenger RNA (genetic code) to allow you cells to make the viral spike protein which then triggers your immune cells to build anti-spike antibodies which protect you. The Astra Zeneca vaccine is much the same but delivers the SARS-CoV-2 spike protein gene via a chimpanzee adenovirus-vector. The J&J vaccine also uses an adenoviral vector but again, there is no SARS-CoV-2 virus (not dead; not alive) in this vaccine (click here). So, while you might get a sore arm or a fever from vaccination this is just your immune system responding as it should; there is no chance of getting COVID-19. Obviously one could contract COVID-19 around the time of vaccination the normal way, before the vaccination’s protection develops (i.e. in the first 2 weeks after vaccination). 

FAQ 17: Are vaccines safe? Yes, serious adverse effects of vaccines are rare (occurring in only 977 of 17.7 million Canadians vaccinated). Most people get (at worst) sore arm at the injection site, fatigue, or fever, all signs the immune system is being activated. Based on the clinical trials and experience in millions of people who have been vaccinated world-wide we can be reassured of vaccine safety and efficacy. All the side effects (called adverse events and abbreviated AEFI) are tracked and reported by the government of Canada (see below). (click here) (last updated May 14th). Note there are only ~6 serious adverse responses for every 100,000 vaccines administered in Canada.

table of 6 text boxes with number graphics

FAQ 18: Is it safe to increase the time span between dose 1 and 2 of the COVID-19 vaccine? Most vaccines are given with an initial dose and a booster dose 3 months later. The reason the COVID-19 vaccine regimen initially specified a shorter interval was simply the rapid pace of the clinical trials which compressed the vaccination interval. Regulators approved the vaccine based on the information that came from these trials. With time it is now clear that spacing out the interval up to 4 months is safe and effective. This longer interval between vaccines allows more people to get the first dose asap and as the data have shown, the first dose yields substantial immunity within 1-2 weeks. That said, once vaccines become more available it would be prudent to return to the initial interval between vaccine doses. My second dose of Pfizer vaccine will occur 4 months after the first dose I received.

8) Continued Stability in COVID-19 in Ontario’s Long Term Care facilities (LTC)…3 deaths in the past week-evidence vaccines working: click here

three senior citizens all wearing masks sitting at a table

Most COVID-19 deaths occur in people who are not only old but who are also frail and live in nursing homes and LTC facilities. While LTC residents account for only 5.3% of all cases in Ontario, they account for 51.8% of all 8029 deaths in Ontario. As of today, the 3,773 deaths in nursing homes account for ~46% of all deaths. There were 6 new deaths in LTCs due to COVID-19 in the past week. There are 61 active COVID-19 cases in LTC residents and 119 active cases in LTC staff, the lowest numbers in months. These numbers remain low and stable, which is testimony to the effectiveness of mass vaccination in a high risk population! For example 2 months ago we were seeing death rates of >100/week; now it is 0-6/week.

Stay Well! …. Get Vaccinated!!!

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