A hodgepodge of things.

Who uses that word anymore? It's a good word though. It's like alphabet soup; a bit of everything all mixed up and a little confusing. That sums things up pretty well. Notice, that we may still be confused about issues related to COVID-19 but there is no question as to where we are. We are heading to a time when COVID will no longer be the first word on our tongues in every single conversation. Man, I am really looking forward to that. I look forward to the main topic of conversation amongst Canadians going back to benign things like the weather. Up first, third doses: Canada's National Advisory Committee on Immunization (NACI) has so far only recommended third doses for people living in long-term care and people who have one of a handful of specific conditions that makes them moderately to severely immunocompromised. Click on this link to review the list of people who are eligible for a third dose: https://wdgpublichealth.ca/your-health/covid-19-information-public/covid-19-vaccine-information/third-dose-eligibility-and-how Why not ramp up third doses for the general public? To put it simply, it's not time yet but that time is coming. Most experts agree that we will need a third dose and subsequent booster doses down the road but at the moment, the signals that would prompt the widespread recommendation for boosters are not there yet. We are are living with the 'Canadian advantage' and that's a really good thing. The powers that be made a couple of risky decisions early on that have really paid off. Last March, NACI recommended lengthening the time between the first and second dose to a maximum of 16 weeks instead of three weeks for Pfizer and four weeks for Moderna. This decision proved to be very beneficial. The longer interval led to a stronger and possibly longer antibody response and increased level of vaccine protection. Researchers, immunologists, infectious disease specialists, public health units and all levels of government are constantly looking for "signals" that would suggest immunity is waning in certain parts of the population. They are watching "daily and obsessively". They are watching for an increase in the number of breakthrough infections and serious illness among fully vaccinated people. They are also monitoring the antibody levels of people enrolled in research trials who have been double vaccinated. Antibody levels in the elderly and in people who are immunocompromised decline more quickly but for healthy individuals, antibody levels appear to be staying high more than six months after the second dose. Another Canadian advantage, and specifically in provinces whose % vaccinated has exceeded 80 %, is that the high rate of vaccination is protecting people with lower antibody levels just by virtue of the fact that the amount of circulating virus is so low. Healthcare workers who received their vaccines more than 10 months ago will likely be next on the list for the third shot followed by the the elderly living independently using the same age-related criteria that was used for the first two vaccines, working from the oldest to the youngest keeping in mind that the vaccination of the under 12 population is just around the corner. Third doses will have to be carefully timed around this age group and their need for vaccines. Second up: Pfizer presented their study results in children under 12 to Health Canada today. We may be only weeks away from the approval of this vaccine in this age group. The spike in cases after the start of school and the possible rapid spread of COVID among school-aged children did not materialize and that is good news. We are still waiting to see if the 'Thanksgiving' effect shows up this week. Third point: Misinformation about vaccines is still out there and many people remain vaccine hesitant. This paragraph is for them. The mRNA in the vaccine does not enter breastmilk. These vaccines do not contain live virus. The mRNA vaccines do not cause transmission of virus or any virus particle to enter breast milk. All known vaccines are safe in breast feeding women, the COVID-19 vaccines are safe as well. There is now a vast amount of research that has proven these vaccines to be safe in pregnancy. The risk of myocarditis after vaccination is highest in men under the age of 39. The risk using Ontario data is 37.4/million doses of vaccine. This condition is more common after the second dose and usually occurs within several days after vaccination. By far the majority of patients who develop this condition respond well to medication and rest, are better within a week and return to normal activities with ease. The risk of myocarditis with COVID infection is 450/million cases but the condition is much more serious when caused by COVID-19. The first vaccine research trials started 20 months ago. One of my vaccine hesitant patients said he believed these vaccines had only undergone three months of research. Not true. Almost 7 billion doses of vaccine have been administered worldwide. 250 million people ( likely a vast under estimate) have been infected with COVID-19 and almost 5 million have died. It's and extremely dangerous virus. Get the vaccine. The vaccines do not cause infertility and biological are not capable of causing infertility. Longterm complications from these vaccines are also highly unlikely and biologically implausible. This point is shocking: up to 35 % of COVID-19 patients develop long-haul symptoms. That's a third of COVID survivors. And their symptoms? Fatigue Shortness of breath or difficulty breathing Cough Joint pain Chest pain Memory, concentration or sleep problems Muscle pain or headache Fast or pounding heartbeat Loss of smell or taste Depression or anxiety Fever Memory loss, brain fog, cognitive decline Worsened symptoms after physical or mental activities So, to be blunt, 'can it' with the concerns over the possible longterm effects of vaccination. It's the longterm effects of COVID that you should really be worried about. Yeah, I am really frustrated with this particular piece of unfounded mis-information. We are doing GREAT Ontario. Widespread vaccinations have made our communities so much safer. We are not there yet. Keep wearing masks. Be careful with indoor gatherings now that we are entering our colder months. If someone in your crowd is not vaccinated, wear a mask and stay six feet apart. Keep the size of your indoor gatherings small, much less than 25 if possible. Protect the frail and elderly whose antibody response to these vaccines is far less robust. Keep them safe and when in doubt, wear a mask. It is also time for flushots. Most pharmacies and many doctors offices now have them. Reducing the risk of the flu will keep our hospitals open and ready to receive patients with other serious illnesses. You can get the flushot and a COVID vaccine on the same day. No need for any delay. That's it for the hodgepodge. Have a good night. Anne-Marie Please share.

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