People want their vaccines

By Cecilia Nasmith

More than 200 people logged on to the third Ontario Health Team-Northumberland on-line COVID-19 forum to learn more about how vaccinations will roll out locally – which was very encouraging to Northumberland Hills Hospital President and Chief Executive Officer Linda Davis.

This shows how many people are eager to get their vaccinations, she said - and also illustrates the amazing level of compliance local residents have displayed with COVID protocols that has helped case levels stay at a lower level in Northumberland than in many other communities.

Davis - who chairs the OHT-N Collaboration Council – acted as moderator for a panel that included Haliburton Kawartha Pine Ridge District Health Unit Chief Medical Officer of Health Dr. Ian Gemmill, family physician (and NHH Vaccine Steering Committee member) Dr. Emma Smith and Northumberland Family Health Team pharmacist Karen Peters.

Peters led off with a look at how the approved vaccines – Moderna and Pfizer – work. These are non-live vaccines, she stressed, in that they contain no coronavirus. They are what's known as mRNA vaccines that contain the recipe for how to make COVID-19's characteristic spike protein. Once this protein is produced, the body recognizes it as foreign and manufactures an immune response that breaks it down and eliminates it. Having done that, the body knows how to respond immediately in case of actual COVID infection.

Dr. Smith is often asked how a vaccine that was developed so quickly could have been thoroughly tested for safety.

“I truly believe it's safe, as I actually received it today. I was part of the cohort at NHH today to receive the Pfizer vaccine,” she revealed.

The trials for these viruses were about 10 times larger than previous vaccine trials – 43,000 in the Pfizer trials and 30,000 in the Moderna trials - with appropriate Phase I, Phase II and Phase III studies all pharmaceutical products in Canada receive. Greater speed was possible, however, because there was no shortage of participant volunteers or funding – meanwhile the usual bureaucratic delays were greatly streamlined.

“They still pored over every single patient, every single dose in those clinical trials. They just were able to do it in a more time-efficient manner,” the doctor said.

Almost 350,000 Canadians have been vaccinated, she added, so they're learning more all the time. The kind of aches and soreness you typically get are there, she said, and maybe one person in 10 gets as fever. As for allergic reactions, 68-million vaccinations world-wide have turned up very few. A life-threatening reaction occurs about 2.5 times per million COVID doses, compared to one time per 500,000 penicillin doses.

Dr. Smith urges anyone with questions to reputable sources of information, like the website information put out by the province, the health unit, the OHT-N and the Northumberland Family Health Team.

Dr. Gemmill has worked in the vaccine field for more than 25 years, called it “the light at the end of this proverbial tunnel.

“I love vaccines, and the reason is, they make vaccines go away,” he said.

“We need to give as many people as possible the option to get the vaccine.”

Some will have medial reasons why they can't be vaccinated, some will have other reasons, he said. But that 95%-effective rating means almost everyone who takes the virus gets protection. Then, when enough people get that level of protection, even those who could not be vaccinated are protected anyway.

“This will be the largest immunization program in the history of this country. It's a daunting task, but I think it's going to be just fine. Never forget – two months ago, we didn't have any vaccine. Now we have two vaccines and ore on the horizon we can use in the broader community.”

AstraZeneca is a DNA vaccine, as is the Johnson and Johnson one, and they can be stored in more conventional refrigeration – which means they are suitable for taking the vaccine into the community to a greater degree.

Anecdotal evidence suggests long-term-care homes that have been immunized no longer suffer those terrible outbreaks. This may be just the way to get that iron ring around these facilities that Premier Doug Ford wanted.

“It's better for the residents, better for their families, better for the staff and better for public health,” Dr. Gemmill said.

In the HKPR region, all 1,700 long-term-care residents have their first shot and are about to get their second. The latest shipment of vaccines will start vaccinations for the next highest-risk group – the health-care workers at highest risk, the staff and emergency caregivers, as well as residents in congregant settings like retirement homes. The next group at highest risk will be other health-care workers, the Indigenous community in Alderville, adults who receive home-care services, older adults living in the community and other essential workers like emergency responders and people who work in grocery stores.

“We are all on the list. We will all be getting the vaccine over the next weeks, for the older people, and next few months for the younger people,” he predicted – based on the information he has been given that supplies will be ramping up significantly.

The ability to administer all these doses has been honed by 20 years of mass administration of flu vaccine each year. Dr. Smith spoke of administering 400 flue shots a day in her office with about a week's notice.

This is a bigger task, with two doses required, but Dr. Gemmill noted that they are getting wonderful buy-in from community partners like family doctors, pharmacies and municipalities in planning vaccination opportunities and even mass-vaccination clinics (which must be organized in such a way that people can still be appropriately distanced).

The provincial website that will allow people to register for vaccines opens March 15 for those aged 80 and up, April 15 for those 75 and up, May 1 for those 70 and up, June 1 for those 65 and up, July 1 for those 60 and up, and thereafter for the general population.

Priority consideration will be given to other groups as well, like those with chronic medical conditions. For example, Dr. Smith said, that might mean people undergoing chemotherapy or those with conditions like arthritis who take medication that weakens their immune systems. In such a case, she advised, have a conversation with your doctor. For those without a family doctor, visit northumberlandcare.ca where you will find lists of on-call physicians each day (which is how they replaced the walk-in clinic when COVID shut it down), and you can give one of them a call.

As for the dates that these appointments might be made for, Dr. Gemmill said, stay tuned to local news media, social media and reputable websites.

Dr. Smith says she and her colleagues are getting a lot of telephone enquiries from their patients aged 80 and older who don't want to miss the boat.

“We know about you,” she said.

“I have generated a list of 80-plus-year-olds in my practice. And every doctor I have spoken to has done that or can do that with the press of a button.”

Like Dr. Gemmill, she counselled patience.

“If you are over 80 and you live in Northumberland, you have not been forgotten. If you have a family doctor, we know about you.”

Dr. Smith was asked about the vaccine and pregnant women.

“If you or anyone you know is considering pregnancy and you have heard there is a risk of infertility with the vaccines, that is fake news. Fake science,” she declared.

“There is no evidence of that with this vaccine.”

However, she added, there is little in the way of clinical information of the vaccine's effects on a pregnancy as the vaccine trials excluded women who knew they were pregnant. However, a few became pregnant between doses or shortly thereafter. These pregnancies have not come to term, she said, but they do appear normal.

“I have never known a non-live vaccine to cause harm,” she added.

“If you are pregnant, you should have that conversation with your doctor or midwife.”

Dr. Gemmill was asked how important it is to have the same kind of vaccine for your second dose as you had for your first. He expressed his confidence that, by the time a second dose is needed, there will be enough supply of both kinds of vaccine that it won't be an issue.

Dr. Gemmill updated the number of variants of concern in the region to 10, up from nine the day before. Mutation of viruses is inevitable, he said, and eventually the process leads to one that is more effective at reproducing itself. Unfortunately, he said, it is likely that these variants will become dominant – and a virus that is more transmissible will spread faster, will cause more cases and more complications.

You can view the entire hour-long session as of Friday afternoon at www.OHTNorthumberland.ca.

Davis also noted that those who had questions that were not answered because of time restraints can direct them to info@ohtnorthumberland.ca or call 1-800-354-7050 ext. 2335.