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What Canada’s new COVID vaccines say about the future of the virus and our fight against it


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What Canada’s new COVID vaccines say about the future of the virus and our fight against it

Three quarters of a million doses of a new, updated vaccine are slated to land in Canada on Friday as officials seek to inject new life into the COVID-19 vaccination campaign ahead of what the country’s health minister says could be a “challenging” fall.

Not quite two years after the first COVID vaccines arrived on Canadian soil, this next phase of the campaign is being ushered in by a generation of doses designed to catch up to a rapidly shifting virus.

But with polarization over shots and pandemic fatigue being felt across the country, getting the message out about the importance of vaccination has become a more complex challenge, health officials acknowledge.

“I understand that people can feel overwhelmed. There’s a lot of information and, you know, the messaging has changed a bit from the beginning of the pandemic,” Dr. Supriya Sharma, Health Canada’s chief medical adviser, told media Thursday.

“At the beginning, it was, ‘Run, don’t walk and get your first vaccine; get the first vaccine that’s available to you,’ and it was really straightforward in terms of that initial messaging. … But it does get more complicated, because we are in a different situation.”

Canada has become the latest in a handful of wealthy countries to authorize the new offering from Moderna. The new shot is essentially two vaccines in one — a cocktail that combines the original formula with one designed specifically to target the original Omicron variant that upended pandemic responses worldwide last December.

The new shots reflect a virus that has mutated from its original version into something more spreadable and more able to escape the protection offered by the first vaccines.

That initial crop of vaccines continues to offer a defence against serious illness — unvaccinated people are still much more likely to die of COVID than their vaccinated counterparts — but the protection against infection has been chipped away by the new variants, and also wanes over time.

“From a public health perspective, we understand the virus continues to evolve, and we need to continue to evolve with it in terms of our vaccine programs and the vaccines themselves,” said Dr. Howard Njoo, Canada’s deputy chief public health officer.

The new shots dangle the full promise of the mRNA technology that has been used to create them. The technology, pioneered by Moderna and Pfizer-BioNTech, allows for formulas to be updated more quickly than traditionally possible. It offers the potential of further potential updates as needed.

“That’s similar to the construct we’ve used for many years for influenza vaccine, where the basic vaccine is the same, and it’s a matter of adjusting from season to season in terms of the strains that we put into the vaccine,” Njoo said.

“So I’m not saying we’re there yet, and it’s not a perfect sort of analogy to influenza, but that’s where the thinking is starting to go.”

The race to keep up with the evolving virus is on display even in the different strategies that are emerging on the global stage.

While the United Kingdom recently authorized the same booster as Canada, the American Food and Drug Administration took a slightly different route. In the spring, it asked vaccine-makers to go back to the drawing board and start work on a booster that was tailored not to original Omicron, but to the newer subvariants known as BA. 4 and 5. Those are the subvariants that caused cases around the world to spike and by July were being blamed for new summer waves in Ontario and Quebec. The U.S. regulator authorized that newly tailored shot just this week.

Canadian officials say they’ve asked Moderna and Pfizer to submit the paperwork to start the authorization process for that vaccine here as well, but that hasn’t happened yet.

Chief Public Health Officer Theresa Tam says the Canadian government remains confident in its choice of booster, pointing to early data that suggests the BA. 1 booster Canada is set to receive is also reasonably protective against BA. 4 and 5.

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In some ways, the debate seems to boil down a vaccine that has the potential to be more effective versus one that may be more widely available sooner.

“There’s that saying, ‘perfection is the enemy of good,’” Dr. Zain Chagla, an infectious diseases physician with McMaster University, told the Star last week.

He said the BA. 1 shot may be less likely to face supply and distribution bottlenecks this fall.

In an email to the Star before the newly announced authorization, a Moderna spokesperson said the BA. 1 version Canada has ordered was its “lead candidate” for fall, and that volunteers in the BA.4/5 trial had only been given doses in early August.

Health officials, meanwhile, have done away with the idea of being “fully vaccinated,” or that vaccination meant two shots and done.

Instead, they stress it’s important to stay up to date with COVID vaccination. It’s too soon to know what the future will hold or if, like the flu shot, we’ll end up seeing a retooled COVID vaccine released regularly.

As Health Minister Jean-Yves Duclos put it, “We know that the immunity we gain from a vaccine or infection declines over time, just like a phone battery. So we need to take action to charge our batteries.”

Yet despite the lines that once snarled around the block of people seeking their first dose of vaccine, uptake has dropped off with each successive dose. According to Health Canada, more than 80 per cent of the population got their first two shots, but only half got a third and just 12 per cent have received a fourth.

Now, the messaging is complicated by the fact that many people in Canada have had an initial round of vaccination, but at different times and involving different vaccines. To that end, the official advice from the advisory body has been simplified, Tam said.

“If you haven’t had a dose in six months, you should get another one,” she said.

When it comes to choice, Duclos stresses that supply on the new bivalents won’t an issue, though some jurisdictions, such as Ontario, say that the first doses will go to those at high risk.

The National Advisory Committee on Immunization further says that a regular mRNA vaccine is a better booster than nothing.

But what’s clear is that the urgency remains. Despite the general feeling that has settled in some circles, that the pandemic is on its way out the door, Duclos points out that deaths this summer have been four times higher than last.

Fall is likely to be “difficult,” as flu season roars back and people move indoors, at a time when restrictions and such measures as mandatory masking have largely been rolled back.

Tam said that modelling shows that waiting too long for a booster can dim its effects.

Getting ahead of the fall resurgence, she said, is “very important.”

Alex Boyd is a Calgary-based reporter for the Star. Follow her on Twitter: @alex_n_boyd

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