Know the facts about COVID-19 and the mRNA vaccines

 Many of you have been asking questions about information being shared by some local experts in the field of virology/immunology. Here is a document that will refute some of this mis-information.

Important to read and understand the facts about COVID-19 and the mRNA vaccines. Anne-Marie Please share Our next 'Finding the Balance during COVID-19' webinar is tomorrow night. Our guest is our fearless leader, Dr. Nicola Mercer. We will help clear up the confusion created by mis-information. Lots of good information will be shared about the mental health effects of this pandemic and how we are all struggling more than we imagined we would. Free registration here: https://us02web.zoom.us/webinar/register/WN_3rTA8BKTRqGSU6juk4RQSA For non-Facebook users, you can find this post here: https://braceletofhope.blogspot.com/

Don't stop now!

Great numbers with a caution:

These are great numbers.

The number of new cases in Ontario today is 1057 which is the lowest it has been since March 16th.

The seven day rolling average is 1353. It was 4370 on April 18th.

The R value is down to .8, the number in hospitals down to 934, in ICU 626 and on ventilators 430.....all down.

This is the combined effect of vaccines ( 70 % of Ontarions have had at least their first dose of vaccine - 8.8 million vaccinated) and strict public health measures.

Here is the caution. We cannot loosen public health restrictions yet. The Indian variant is in this province with cases found in both Waterloo and Guelph Wellington. The UK has had a recent resurgence of cases due to this variant which is infecting folks who have had just one dose of vaccine and some who have had both doses. It is a nasty variant.

Dr Theresa Tam has announced that we are coming out of this third wave of COVID-19 and this graph proves it.

https://covid-19canada.com/graphs

Yes, as usual, scroll down to New Cases Analysis by Date in Ontario and click on '7-day rolling average'. That is a remarkable image. Three waves. Look at the decline off the peak of the third wave. We earned that. We suffered for that. It's an achievement. Vaccines are contributing a huge amount to that success. Before we can safely open up, 75 % need to have the the first dose of vaccine and approximately 50% need to have the second. Personally, as these new variants develop and spread, I think we will need to be very careful until more than 80 % of us have had two doses. No country has achieved that yet.

We can.

2.4 million doses of Pfizer will arrive in this country, every week starting this week. We are less certain about the number of Moderna doses Canada will receive but it will be up in the millions and this vaccine, let's get this straight, creates immunity in exactly the way the Pfizer vaccine does. They are both mRNA vaccines. They are equally effective. The risk of rare, serious events is almost zero with both. Other than the basic background ingredients which do not differ very much at all, Moderna is the same as Pfizer. Moderna has been the victim of ridiculous mis-information recently. Can it folks. Anyone who is willfully spreading mis-information is indirectly responsible for deaths from COVID-19.

Yeah, pretty harsh. But if the information you spread leads to vaccine hesitancy, COVID-19 will linger for years and a new wave with new variants will arrive.

The answer: Get a vaccine.

The province will ramp up the administration of second doses very soon. Get one of those too! The more people in this country that receive two doses, the less likely any new variants will be able to grab a foothold.

Two doses. Get both.

As for the AZ vaccine, there is so much confusion. I remain steadfast in my advice. Sit tight. You will be offered a second dose if you received the first dose. Word on the street is you will have the option of getting a second dose of the AZ vaccine or a second dose of a mRNA vaccine ( Moderna or Pfizer).

Ontario is still awaiting guidance from the National Advisory Committee on Immunization about whether it is safe to mix AstraZeneca with a shot of mRNA vaccines from Pfizer or Moderna, but we expect the answer this coming Thursday. I am 99.9 % certain, it will be a go!

The powers that be will find a way to get you that second dose. Have no fear. The road has been bumpy. No one has ever attempted this kind of global vaccine production or this kind of massive vaccine roll out. It simply cannot be done to perfection. But it will be done. All hiccoughs included, this will be done.

Your job is the same. If you have not yet registered for a vaccine, register now. Ages 12 and above can now register. In GWD, register here:

https://register.wdgpublichealth.ca/

We need 5,000 more registrants before we reach our goal of 75% vaccinated with their first dose. Let's get this done.

Anne-Marie

Please share.

Next 'Finding the Balance during COVID-19' webinar is June 1. Free registration here:

https://us02web.zoom.us/.../reg.../WN_3rTA8BKTRqGSU6juk4RQSA

For non-Facebook users, you can find this post here:

https://braceletofhope.blogspot.com/

And if you'd like to help Bracelet of Hope work towards making sure that Lesotho has access to these vaccines, donate here:

https://www.braceletofhope.ca/ways-to-In

What to do if you received the first does of AstraZeneca?

To all the folks who received the first dose of the AstraZeneca vaccine, here is where things stand with all patients in the Guelph-Wellington-Dufferin Public Health Unit: Even though there was an announcement last week that patients could access their second dose of the AstraZeneca as early as this week, we do not have a supply of the AZ vaccine to offer you at this time. Please reconsider reaching out to your primary care provider to find out which vaccine you should get or to find out if you can get the second dose this week. You could overwhelm our administrative staff the day after the long weekend which may make it difficult for patients with urgent medical conditions to get through. Here is what we do know: 1/ 12 weeks has been shown to be the optimal interval between AZ doses. 2/ The first group who received the AZ vaccine at their primary care providers office or a pharmacy, received that dose mid-March which means your second dose is not due until mid-June. There is time and we will use that time to determine what the safest option is for you. 3/ The risk of VITT ( that rare blood clot) after the first dose of AZ is around 1 in 60,000. The risk after the second dose is 1 in 600,000 to 1 in 1 million. This is still a moving target. 4/ The risk of community transmission of COVID is decreasing as every week passes. When you took that first dose of the AZ vaccine, we were climbing the peak of a terrible third wave. Getting vaccinated with the AZ vaccine was completely the right thing to do. Thank you for taking the vaccine. 5/ The results of two mix and match studies are showing very promising results with excellent protection with AZ as the first dose and a mRNA ( Moderna or Pfizer ) as the second dose. Final results are expected in the next two weeks So, sit tight. You will be offered that second dose but in a lot of areas of the province, the second dose of AZ may not yet be available this week and definitely not in GWD. Our offices are now receiving the Moderna vaccine and if the mix and match studies provide proof of efficacy, this vaccine will be available to you in some offices and many pharmacies. As for my patients and for the people who received their first dose of the AZ vaccine at my office, you have a followup appointment already booked at 12 weeks. Keep that appointment. I will make sure you know what your options are before then and provide you with the information you need to make a fully informed choice. I will also tell you what I think you should do based on the evidence. Thanks for hanging in their people. You allowed for 2 million Canadians to be partially protected against COVID-19 and as a result you contributed to the significant decline in COVID 19 cases across the country. T'was a great weekend. We so deserved that. Garden is in, herbs are planted, two friends joined us for drinks on the porch.....felt just a little bit normal. Amen to that.

Anne-Marie This is a very important post. I'd like to reassure as many people who received the AZ vaccine as possible so please share.

For non-Facebook users, you can find this post here:

https://braceletofhope.blogspot.com/

And if you'd like to help Bracelet of Hope work towards making sure that Lesotho has access to these vaccines, donate here:

https://www.braceletofhope.ca/ways-to-In

MODERNA

 

Well, would you look at that.

The first vial of the Moderna vaccine arrived in my office today. Major photo op before I safely tucked it away. Liquid gold. It was the highlight of an incredibly busy week.

I cannot stress enough how important and scientifically incredible these vaccines are. The technology behind these vaccines has allowed for the production of a very robust and durable immune response even after the first does. So powerful that they work against variants. The World Health Organization announced today that the current COVID vaccines appear to be protective against all of the variants of concern circulating globally.

That is great news.

Our immune response to these vaccines is so significant that the COVID virus is not able to get a foot hold in a person who has been exposed. They are pushing us over the peak of the third wave.

In Ontario, the seven day rolling average has declined to 2182. . Yes, the number of new daily cases is up today but the 7 day rolling average takes into consideration the ups and downs of the daily case counts.

Even more importantly, hospitalizations are down to 1320 , ICU admissions are down to 721 and the number of people with COVID-19 infection on a ventilator is down to 493. Four weeks ago, it was projected that with no new restrictions, the number of people in hospital in Ontario would exceed 1500 which would have overwhelmed our health care system. Our present lockdown slid into a period of unprecedented mass vaccinations which allowed us to avoid that catastrophe. We need the number of people in hospital with COVID -19 to be under 500 before restrictions can be loosened significantly. Our present trajectory will see us there by mid-June.

Here’s the ticket. Restrictions and vaccinations were necessary to slow the transmission of the virus and get us to this point. Combined, they dropped the Reproductive value to below one (0.86 today). But once 75 % of the population is vaccinated, the vaccines alone will keep the R value down. They will reduce community transmission to low levels. They will become the main barrier to the reproduction of COVID-19 allowing us to move out of our present public health restrictions. Not right away, but slowly over the course of the summer.

What we have done has worked. But all of that could be wiped out with one long weekend. Just over 50 % of us have received one dose of vaccine. The vaccine barrier is not strong enough to stop transmission without continued public health restrictions. That one beer in your neighbours back yard, that gathering around the bonfire at your cottage, that get together of family and friends around your BBQ, just isn’t worth it. Let’s celebrate on Canada Day or the August long weekend, labour day or oh, wait; thanksgiving. Many small sparks of transmission from thousands of ‘ innocent’ gatherings this weekend will cause an alarming uptick in hospitalizations which will required a prolonged lockdown.

Please don’t wipe out four long weekends for the sake of this one. It’s just not worth it.

Get vaccinated. Stay home.

We are almost there.

Anne-Marie

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For non-Facebook users, you can find this post here:

https://braceletofhope.blogspot.com/

And if you'd like to help Bracelet of Hope work towards making sure that Lesotho has access to these vaccines, donate here:

https://www.braceletofhope.ca/ways-to-In

PLUMMET

 So....here we are.

A space of relative stability mixed with a lot of hope. Our numbers in Ontario were under 2500 again today with a 7 day rolling average that continues to decline. Fifty-six percent of the population of Ontario have received their first dose, that's a 4 % increase in 3 days. Our rate of vaccination has increased dramatically and will continue to do so with the supply of Pfizer and Moderna vaccines ramping up. The R value was .89 on May 13th. It is .86 today. Very nice. The lower we go below one, the less community transmission of COVID-19. The number of patients hospitalized, in ICU and on ventilators continues to decline. We are preserving the capacity of our healthcare system. I harp on this graph but it gives me hope. https://covid-19canada.com/graphs Scroll down to the Ontario graph titled 'New Cases Analysis by Date Clickable & Scrollable Graph As of 5/16/2021, 12:52 PM (PST) New Cases: 2,199 New cases and the 7 day rolling average both declining. Here is what I have learned about the Pfizer vaccine. The antibody response to this vaccine is 3 and 1/2 times larger in older people when a second dose is delayed to 12 weeks after the first. Source: https://www.cbc.ca/news/health/covid-19-pfizer-second-dose-delay-more-antibodies-study-1.6026765 That's good news. Canada made the right decision in our era of vaccine scarcity, to delay the second shot. I'd like to put this to rest at this point. People who expected to get their second dose sometime in July are now being called in 4 weeks earlier for their second dose. That is why the date of the second vaccine was often not given after the first dose. There was an expectation that we would be able to shorten the interval between vaccines once our supply of vaccines ramped up. Here is what I have learned about the AstraZeneca vaccine: A very, very small group of people have an immune system that responds to this vaccine by producing antibodies that go after their own platelets. Platelets are tiny blood cells that help your body form clots to stop bleeding. They stick together in clumps at the site of an injury or damage and form a plug or clot that stops the bleeding and begins the process of healing damaged tissue. If your own antibodies attack these platelets, the whole clotting process gets messed up causing either clotting or bleeding where we would not normally see it. In the case of the AstraZeneca vaccine, the clots that are formed in this cascade of events are called VITT ( vaccine-induced thrombotic thrombocytopenia ). The rate of these clots after the first dose is about 1 in 60,0000 to 1 in 100,000. Rare. But enough for the powers that be to press pause and only because at this point, we have other vaccine options. If AZ was the only vaccine we had, this rare risk would be an acceptable risk in light of a virus that is now extremely dangerous and deadly with variants of concern tripling the rate of serious illness, hospitalization and death. Please stay safe until 75% of us are vaccinated. But the thing is, people who get this rare clot after the first dose, do not get the second dose of the AstraZeneca vaccine. In a study of millions of people in the UK, the risk of getting this clot after the second dose appears to be 1 in a million. The unfortunate folks with that quirk in their immune systems that led to VITT after exposure to the vaccine are no longer in this group of people who get the second vaccine. Take home message: Your risk of getting VITT after the second dose is very, very rare. Turning to Mix and Match studies, also out of the UK, there is good evidence that having an AZ vaccine first and a Pfizer vaccine second is safe and effective.....BUT, this study is small, only 800 or so participants. When you are looking for rare events like a 1 in 60,000 clot, you need to follow more study participants than that. That 800 may be a group that is not a risk and was not destined for VITT after exposure to the vaccine. To search for very, very rare events, you require millions of study participants. So, in the coming weeks, the smart people - scientists, medical experts and epidemiologists will determine whether or not the 2 million Canadians who had a first dose of the AZ vaccine and are waiting to find out what their second dose will be? It looks like either option, a second dose of AZ or a second dose of Pfizer will be safe and effective. I trust these folks. Let's wait and see. Extending the dose between these vaccines improves the immunity we develop. We have time. In the meantime, one dose of any of these vaccine protects us significantly. That one dose combined with our public health restrictions ( which will be reset and loosened in June as a result of rapid mass vaccinations, have not doubt) will keep us safe. Watch these posts over the next to weeks as we hit 60 % first dose vaccination rates. I will use the word, 'PLUMMET' many times over and with great glee. Proof: U.S. CDC says nearly 45% of adults in the USA are fully vaccinated, 58% have had 1 dose. COVID-19 deaths in the United States have tumbled to an average of around 600 per day, the lowest level in 10 months, with the number of lives lost dropping to single digits in well over half the states and hitting zero on some days. Restrictions have loosened in many states. In some states, restrictions no longer exist. I don't think that's a good idea until we have reached herd immunity. The variants may have a hay day if more than 40 % of the population are still at risk for COVID-19.....sitting ducks. Hang on tight and don't change a thing for the next three weeks people. Again, we have got this. Grateful that we live in a country, one of only a handful that is now in this privileged position, to have these vaccines and these intact health care systems. I will remind you of that when I come asking for help to get the folks in Lesotho vaccinated too. Anne-Marie Please share For non-Facebook users, you can find this post here: https://braceletofhope.blogspot.com/ And if you'd like to help Bracelet of Hope work towards making sure that Lesotho has access to these vaccines, donate here: https://www.braceletofhope.ca/ways-to-In

MORE ON THE ASTRAZENECA VACCINE:

Further explanation for the pause.

First off, for those of you who received the first dose of the AstraZeneca vaccine, recommendations were, and still are, that we get the first vaccine that is offered to us. As a result of getting the vaccine you reduced your risk of getting COVID 19 by 70 % and almost wiped out your risk of becoming seriously ill. You contributed enormously to slowing the spread of COVID-19.

It's easy to forget where we were at that time.

Click on this familiar graph:

https://covid-19canada.com/graphs

Follow the blue line for Ontario. There were 6098 new cases of COVID-19 in the province on April 3rd. We were locked down that same day. It was projected that without strict new measures, cases would soar to 10,000/day with a catastrophic effect on our health care system and a devastating increase in deaths due to COVID-19.

We needed to get vaccinated and we needed to do it fast!! I started giving the AstraZeneca vaccine in my office at the end of March. Also, at that time, there was word that there may be an increased risk of a rare blood clot, now called VITT. Initially, the signal for this clot was not greater than that seen in a population that had not been vaccinated but as more and more people received the AZ vaccine in the UK, that signal became larger and researchers agreed that the clots were likely being caused by the vaccine. The incidence of this rare clot was initially thought to be 1 in a million. Once it was identified as a risk of the AZ vaccine, we started to look for it.

We started to connect these rare clots that occurred in the month after vaccination to the vaccine. The clots were reported to the public health authorities who are responsible for collecting this data. In short order, the incidence of this clot was found to be between 1 in 100,000 to 1 in 250,000. Extremely rare. This information came out of the UK just as we started to ramp up the use of the AZ vaccine on our offices and pharmacies and just when we needed the vaccine the most.

As the vaccine was rolled out in Canada, public health experts, physicians and scientists were on high alert, watching for these clots and dutifully reporting them. The more you look, the more you will find. As of this week, 12 VITT clots have been reported in Ontario. That's an incidence of 1 in 60,000.

We paused the vaccine. That's how an excellent public health system works. If the motivation of health and government officials was to keep the vaccine going for the sake of saving face or using up the vaccine that we have or other nefarious political reasons, the AstraZeneca vaccine roll out would have continued and you would never have known.

That is not how we work in this country.

Some of you feel betrayed. I get that. But there was no betrayal. There is a solid, tried and true scientific process being followed by solid, trustworthy experts who are responding appropriately as new data evolves

I like this quote in which Dr. Jessica Hopkins of Public Health Ontario comments on the one in 60,000 risk based on new Ontario data.

“That’s a significant safety signal that we don’t want to ignore. Given that we are seeing the overall case numbers of COVID going down and an increase in the safety signal, at a population level, it makes sense to pause AstraZeneca because the risk of severe outcomes with VITT shouldn’t be underestimated.”

For those of you who have recently received the AZ shot, your risk of VITT is still very small. These clots occur between 4 and 28 days of vaccination, the majority within 20 days.

Symptoms to watch for: swelling in pain in one lower leg, shortness of breath and chest pain, severe abdominal pain, severe headache, blurred vision, confusion, difficulty speaking. Present to ER immediately if these symptoms occur. VITT is treatable if a patient presents early.

My heart breaks for the fact that we are all living through this very difficult time. This is the worst health crises the world has experienced in over 100 years and we are all caught up in it.

The pause in the use of the AZ vaccine is proof that Ontario's vaccine safety surveillance system is working and the experts that hold our lives in their hands are following the data and making wise decisions.

This is a process that can be trusted.

Hold tight for more news on what your second dose will be. It is coming. The mRNA vaccines ( Pfizer and Moderna) have been given to hundreds of millions of people in the world with no evidence of VITT or any other life-threatening condition. Register for a vaccine if you have not already registered. These vaccines are pulling us out of this pandemic!!! They will allow us to live without restrictions and get back to our jobs, school, our families, travel and play!

Anne-Marie

Please share.

For non-Facebook users, you can find this post here:

https://braceletofhope.blogspot.com/

And if you'd like to help Bracelet of Hope work towards making sure that Lesotho has access to these vaccines, donate here:

https://www.braceletofhope.ca/ways-to-In

SCIENCE IS NOT THE TRUTH

Love this quote: Science is not the truth. Science is finding the truth. When science changes it's opinion, it did not lie to you, it learned more. (From Sandy, one of the members of this Facebook family)

Ontario has announced that the AstraZeneca vaccine will no longer be used for first doses. New information from statistics derived in Canada show that the risk of VITT ( Vaccine Induced Thrombotic Thrombocytopenia- those rare but serious blood clots associated with the viral vector vaccines ) appears to be higher than originally determined in the EU and Great Britain. One in 60,000 instead of 1 in 100,000 to 1 in 250,000.

There are enough doses of Pfizer and Moderna to make up for the removal of this vaccine. It makes sense. Why would the experts continue to promote the AZ vaccine with this new information? "Science is not the truth. Science is finding the truth. When science changes it's position, it did not lie to you, it learned more".

We are also in a much better position this week than we were three weeks ago. It is still urgent to vaccinate everyone but cases are declining and we are no longer in a state of vaccine scarcity. We are now in a state of vaccine abundance....so offer the safest available.

If you received the first dose of the AZ vaccine, you absolutely did the correct thing. You saved lives at a time when transmission was out of control and you may have saved your own life.

It is anticipated that NACI will make recommendations within the week concerning the use of a mRNA vaccine ( Moderna or Pfizer) as a second dose for those that have received a first dose of the AstraZeneca vaccine. I will know more by week's end, including whether or not those that want a second dose of the AstraZeneca vaccine will be able to receive it.

A study of a "mismatched" vaccine regimen is underway in the U.K. Researchers at Oxford University launched a study in early February to explore the possible benefits of alternating different COVID-19 vaccines. The study (known as the COVID-19 Heterologous Prime Boost study, or "Com-COV"- cause we love long titles in medicine and science) is collecting data to determine whether receiving two different types of vaccine generates an immune response at least equal to the response that follows receiving the same product twice.

Early results....administering two doses of different products like the AstraZeneca vaccine first and the Pfizer of Moderna vaccine second seems to allow for a greater boost in a person's immune response than using the same vaccine for both doses. Translated, you develop a greater immunity to COVID-19 with two different vaccines. Go figure. That is science learning more and you and I receiving the benefits of that knowledge.

Just three new cases in guelph today......this it what happens when you approach a 50 % vaccination rate.

Much to hope for and we are being so well cared for.

Anne-Marie

Please share.

For non-Facebook users, you can find this post here:

https://braceletofhope.blogspot.com/

And if you'd like to help Bracelet of Hope work towards making sure that Lesotho has access to these vaccines, donate here:

https://www.braceletofhope.ca/ways-to-In