Cuomo says NY isn’t ready to follow federal advice on going maskless

 Pandemic-weary New Yorkers had their hopes deflated Thursday when Gov. Andrew Cuomo said he wasn’t ready to ease the state’s mask mandate — even though the feds gave the green light for vaccinated Americans to finally show their faces and gather indoors again.

In a late-afternoon statement, Cuomo said he and Health Commissioner Howard Zucker had yet to decide if the Empire State would adopt newly announced guidelines from the federal Centers for Disease Control and Prevention.

“In New York, we have always relied on the facts and the science to guide us throughout the worst of this pandemic and in our successful reopening,” Cuomo said.

“We have received the newly revised guidance from the CDC regarding mask wearing and social distancing for those with vaccinations and are reviewing them in consultation with Dr. Zucker and our partners and health experts in surrounding states.”

The CDC announced Wednesday new guidelines that would allow for vaccinated Americans to forego mask wearing in many instances.

© Michael Nagle/Xinhua via ZUMA Press

Hours earlier, CDC Director Rochelle Walenksy said, “Anyone who is fully vaccinated can participate in indoor and outdoor activities – large or small — without wearing a mask or physically distancing.”

President Biden called the development “a great day for America,” saying, “If you’ve been vaccinated, you don’t have to wear your mask and you can shake hands.”

Updated mask guidance from the CDC.

CDC

“You can even give each other a hug,” he added.

First Lady Jill Biden celebrated by going maskless with actress Jennifer Garner during a visit to a vaccination site in West Virginia.

Gov. Cuomo said he’s reviewing the data with Dr. Howard Zucker.

Lev Radin/Pacific Press/Shutters

“We feel naked,” she said before adding: “I didn’t mean it that way!”

Under state rules that were revised last month, fully vaccinated people can go maskless outdoors, “except in certain crowded settings and venues.”

Masks are still required indoors, regardless of vaccination status.

State Sen. Jim Tedisco (R-Glenville) invoked the state’s scandal over nursing home deaths from COVID-19 in saying that “our best bet as constituents is to always follow the CDC because we’ve seen what the ‘experts’ in New York state have provided.”

“I don’t think anything this governor says about using experts in New York State is true,” Tedisco said.

President Biden had praised the news from the CDC.

Shannon Stapleton/Reuters

“He’s working with people who are basically like working with Moe, Larry and Curly. I’d follow the CDC guidelines anytime before following what the governor says.”

https://nypost.com/2021/05/13/gov-cuomo-says-ny-isnt-ready-to-follow-federal-advice-on-going-maskless/

Irish health system says it’s targeted in ransomware attack

 Ireland’s health service shut down its IT systems on Friday after being targeted in what it called a “significant ransomware attack.”

The Health Service Executive said the move was a precaution, and appointments for coronavirus vaccinations were not affected.

“We’ve taken a precautionary measure to shut down a lot of our major systems to protect them,” chief executive Paul Reid told broadcaster RTE.

“We are at the very early stages of fully understanding the threats, the impact and trying to contain it.”

It was unclear how wide the disruption to the health system was. Dublin’s Rotunda maternity hospital said it was canceling most routine appointments due to the IT issues, calling the situation a “critical emergency.”

Ransomware attacks are typically carried out by criminal hackers who scramble data, paralyzing victims’ networks, and demand a large payment to decrypt it.

Health care systems have been a target before. Two hospitals in France were hit by ransomware attacks in February that crippled their phone systems and forced surgeries to be postponed. In September, an apparently misdirected ransomware attack on a German hospital caused an IT systems failure and led to the indirect death of a woman, while that same month a ransomware attack paralyzed a chain of more than 250 U.S. hospitals and clinics.

In 2017, Britain’s National Health Service was hit in a cyberextortion attack, forcing hospitals to close wards and emergency rooms and turn away patients.

The Irish attack highlights concerns about the vulnerability of critical infrastructure to escalating attacks by hacking groups and criminals, said Steve Forbes, government security expert at Nominet, the U.K.’s web domain registry.

“National healthcare services are already under strain from the pandemic, which will make this ransomware attack even more devastating. That fact will not be lost on the hackers,” Forbes said.

In the U.S., the nation’s largest fuel pipeline was hit with a ransomware attack a week ago. The disruption of the Colonial Pipeline caused long lines at gas stations due to distribution problems and panic-buying, draining supplies at thousands of gas stations. It restarted operations on Wednesday.

Forbes said the attacks on the pipeline and the Irish health care system both show “criminal groups are choosing targets that will have the greatest impact on governments and the public, regardless of the collateral damage, in order to apply the most leverage.”

https://apnews.com/article/europe-coronavirus-pandemic-technology-health-f9478d95ff0f085fa382819e981f4b56

Parents Rush to Get Covid-19 Vaccines for Their Children

 Parents across the U.S. are rushing to get their adolescent children vaccinated against Covid-19 after regulators authorized the use of the Pfizer Inc. and BioNTech SE vaccine for children ages 12 to 15.

The Centers for Disease Control and Prevention recommended Wednesday the use of the vaccine in the younger age group. More than a dozen states -- including California, Washington, Maine, Illinois, Massachusetts, Arkansas and Florida -- followed the CDC's recommendation and made the 12 to 15 age group eligible, many scheduling vaccination appointments starting Thursday.

Public-health experts say vaccinating children is crucial to protecting them from infection and achieving communitywide immunity. Some parents and school officials want children to be vaccinations ahead of summer camps and the start of the next school year. And many teens are eager to resume social activities with friends.

Jen Ferris, who works in communications for a nonprofit in Chapel Hill, N.C., has been texting with other moms for weeks in anticipation of the Food and Drug Administration's authorization of the Pfizer-BioNTech shot for adolescents.

"When the news came through, my mom network just lit up -- my phone wouldn't stop buzzing," she said. "All the messages were, 'FDA-Approved, ' then a bunch of heart emojis."

She scheduled her 13-year-old son for a vaccine appointment at his pediatrician's office for Thursday and then sent the doctor's number to a half-dozen friends so they could make appointments for their children.

Elliott Ferris, who likes videogames and fishing, shouted, "That's so dope!" upon hearing the news, his mother said.

"I've had such a long year-and-a-half without friends," Elliott said. "We're just so bored and a little bit lonely."

The FDA's authorization of a Covid-19 vaccine for adolescents is expected to provide an immediate boost in demand for vaccinations. There are 16.7 million children between the ages of 12 and 15, according to U.S. Census Bureau data analyzed by the Annie E. Casey Foundation. With 45.1% of adults fully vaccinated, demand for Covid-19 immunizations seems to have plateaued, creating excess supply of doses in some states.

"It's harder to reach people now," said Ashish Jha, dean of Brown University's School of Public Health. "You can't set up a mass vaccination site and give shots to 5,000 people in a single day anymore."

Dr. Jha said he expects about a third of eligible children ages 12 to 15 to be vaccinated in the coming weeks. He said the pace of shots will probably slow over the summer, as parents wait to see whether or not summer camps and schools will require vaccinations for attendance. If so, and if the virus continues to circulate among unvaccinated teenagers, those could be powerful motivators for parents to sign up their children, he said.

States appear to be taking different approaches to vaccinating adolescents. In California, hospitals are joining with county health departments and community clinics to hold mass-vaccine events focused on children but are also offering shots to caretakers who bring children in.

"There's no one way that's the best way" to vaccinate, said Dr. Nicholas Holmes, chief operating officer of Rady Children's Hospital-San Diego. "Leveraging pediatricians allows parents to ask questions and have their fears allayed, and that personal relationship is sometimes instrumental."

In North Carolina, state officials have signed up 400 pediatricians to do outreach to parents and administer vaccines to children at their offices. Hospitals will break up Pfizer's 1,200-dose packets of vaccines into smaller batches to distribute at pediatric practices, said Mandy Cohen, the state's health secretary.

In addition, dozens of public school districts in the state have expressed interest in holding on-site vaccination events for students or joining with local agencies to transport students to vaccination sites.

"It'll be almost like a field trip," said Dr. Cohen. "We want to make this process convenient and easy, so parents can just sign a permission slip and a consent form, and they don't have to take off work to get their children vaccinated."

In Chapel Hill, Pascale Georges, one of Ms. Ferris's friends from the neighborhood, is eager to have her 11-year-old son, Harrison, vaccinated as soon as he turns 12 next week. Ms. Georges wants her son to be protected from infection and to visit his grandfather in Haiti.

Most of all, she wants Harrison to go back to school. For much of the past year, she has awakened at 4 a.m. to write home-schooling lesson plans for him and get a head start on her day's work as a project manager at a digital-branding agency.

"I need life to be somewhat normal for us in the fall or the summer," Ms. Georges said.

Mindy Wagner, who works at the same company as Ms. Georges, spent most of a whole day this week checking the websites of area clinics and pharmacies looking for an opening for her 12-year-old son, Wyatt, to be vaccinated. Late Wednesday night, she found a Facebook post from the University of North Carolina advertising a vaccination clinic open to children and immediately made him an appointment for Tuesday.

"While [Covid-19] might not affect Wyatt that badly, we do have friends who are immunocompromised, and there are plenty of people who can't get the vaccine," Ms. Wagner said.

Daniel Benjamin, an epidemiologist and professor of pediatrics at Duke University, has two sons, ages 14 and 15, who participated in the Pfizer trials, one receiving the vaccine, the other a placebo.

Dr. Benjamin predicts, based on polling data and conversations with other parents, that about 30% of parents in the 12-to-15 age group will be early adopters, 30% won't want their children to be vaccinated, and a third group will wait and need convincing.

He plans to try to convince other parents of the benefits and safety of the vaccines on the baseball diamond, where he serves as coach of his sons' youth teams.

"I've had these types of conversations already with a lot of baseball coaches, and I'm getting ready to have it with a bunch of baseball parents," Dr. Benjamin said.

https://www.marketscreener.com/quote/stock/PFIZER-INC-23365019/news/Parents-Rush-to-Get-Covid-19-Vaccines-for-Their-Children-33258240/

Post-COVID Era Will Chart Course for Future of American Healthcare

 This spring marks the end of a full year most of us would like to forget. We appear to be finally on the downslope of the COVID-19 curve, but we shouldn’t fool ourselves about its lasting effects on our healthcare system. From the pandemic, to the ensuing system-wide fiscal crisis, to landmark legislation, the past year marked the beginning of a transformation in American healthcare. Now is our opportunity to make sure that America’s healthcare system is viable for years and decades to come. 

The COVID-19 pandemic will continue to define how our healthcare system operates for the foreseeable future. Patient volumes plummeted last spring, wiping out 1.4 million healthcare jobs in April alone. We saw some recovery in volumes by October, but many areas of medicine, including emergency medicine, remain at reimbursable volume levels that are 25 percent below pre-pandemic levels. Policymakers wisely avoided inflicting additional financial pain upon healthcare providers at the end of 2020 by passing a fair and equitable fix to surprise medical billing and also halting steep Medicare reimbursement rate cuts that have likely allowed many clinicians to keep their doors open in 2021.

TeamHealth and other provider groups fought aggressively against a catastrophic policy “solution” to surprise medical bills that would have decimated providers for the benefit of insurers. We won an important victory by instead passing into law an arbitration system that will prevent insurers from unilaterally setting payment rates. Crucially, insurers weren’t given absolute leverage over reimbursement rates that would result in a rapid decline in physician pay, but challenging long-term trends remain. An increasing percentage of patients without insurance and little ability to pay, aggressive insurer tactics to deny legitimate claims, and the continued shift of healthcare costs from insurers to patients through higher deductibles and copayments all result in downward rate pressure. The surprise billing fix buys time for clinicians, but it will not eliminate the erosion of reimbursement rates.

The Biden administration and Department of Health and Human Services Secretary Xavier Becerra will preside over the rulemaking process implementing surprise medical billing legislation, which takes effect in 2022. Rulemaking might seem like an afterthought given the lengthy public debate over surprise medical bills, but the details are critically important. If the considerations built into the independent dispute resolution process are too heavily weighted toward insurers, providers will face additional financial pressure as they attempt to recover from the prolonged loss in reimbursable patient volumes that accompanied the COVID-19 pandemic. After losing out in the legislative process, large health insurers will undoubtedly try to exert influence in rulemaking and shape arbitration in their favor.

Similarly, the Medicare Physician Fee Schedule rule still represents a material risk to physicians. The final resolution to amend the rule for 2021 didn’t eliminate the six to eight percent cuts, but only granted providers temporary relief. Many specialties – including those that comprise the country’s healthcare safety net – will see combined rate cuts of over eight percent in 2022 and 2024. This is an existential threat that the Biden administration and Congress must address.

Aggressive behavior from major insurers further complicates the healthcare landscape in 2021 and beyond. In addition to reduced patient volumes, COVID-19 created downward rate pressure by tilting the payer mix away from private insurance and toward Medicare and Medicaid. Despite posting record profits during the height of the pandemic, large insurers continue to demand arbitrary, unsustainable reimbursement rate cuts that do not reflect market rates, terminating network agreements with those who do not comply.

In the midst of all of these challenges to their livelihoods, our hospital-based clinicians and other healthcare providers have been on the front lines providing heroic service and life-giving care in extremely challenging conditions - unwavering in their dedication throughout the pandemic.

The year of COVID-19 left a lasting mark on society at large, but the immediate future will chart the course of American healthcare. The brief reprieve from the Medicare rate cut and the promise of a fair and equitable surprise billing fix will help sustain the system as we continue to fight COVID-19. Now is the time to embrace long-term solutions that will put healthcare on stable footing before the calendar turns to 2022. 

Leif Murphy is the President and CEO of TeamHealth and has more than 20 years of experience in healthcare operations, business development and finance.

https://www.realclearhealth.com/articles/2021/05/13/the_post-covid_era_will_chart_the_course_for_the_future_of_american_healthcare_111204.html

Biden's COVID-19 vaccine patent waiver would benefit China

 The record-breaking development of COVID-19 vaccines is a marvel of modern medicine, American ingenuity, and free enterprise. The vaccines saved thousands of lives, prevented countless sicknesses, and have already come close to ending the pandemic in America.

Since we will surely face another pandemic someday, we should be doing everything in our power to preserve and enhance the innovative environment that facilitated such amazing breakthroughs. Instead, the Biden administration is doing the opposite — it is supporting a waiver proposed at the World Trade Organization that would strip developers of COVID-19 vaccines and therapeutics of their intellectual property rights and force them to teach their foreign competitors how to make these groundbreaking products.

The waiver will create obvious disincentives to the fast development of successful future vaccines. Developers will be more reluctant to make fast, huge investments in novel research if they believe, or even suspect, that the U.S. government will place onerous demands on them after they produce reasonably priced vaccines.

Consider the implications with respect to just one nation: China. Ruled by the Communist Party, China is a brutal authoritarian state that seeks to gain international power at the expense of the free world in general and the United States in particular. Unable to compete with American innovation, Beijing conducts a massive program to pilfer American innovation, technology, and trade secrets shamelessly through cybercrime, industrial espionage, infiltration of U.S. higher education institutions, and forced technology transfers from U.S. firms operating in China.

As detailed in the regime’s Made in China 2025 plan, Beijing aims to displace America as the world leader in biotechnology, a goal it pursues by stealing and copying others’ innovations. In fact, last July, the Department of Justice indicted two Chinese nationals for stealing trade secrets and hacking into the computers of, among other victims, U.S. firms working to develop COVID-19 vaccines. But with the Biden waiver, China won’t even have to bother stealing this proprietary information anymore. Instead, President Joe Biden will force the American developers to hand it over.

It’s hard to imagine a more self-defeating or unjust policy. What does the public have to gain from penalizing American vaccine developers, disincentivizing future vaccines and treatments, and empowering our chief geostrategic rival, which birthed the pandemic in the first place and tried to cover it up?

The proprietary information at issue here is sensitive and promising. The mRNA technology used in the Pfizer and Moderna vaccines represents unique technology developed through billions of dollars of investments from the companies themselves as well as U.S. taxpayers. The technology may have wide-ranging applications aside from its use as a COVID-19 vaccine. What possible benefit is there in allowing Beijing to leapfrog the entire research and development phase that we underwent at a huge expense?

It’s hard to say whether Biden’s decision stems from pressure from the Democrats’ socialist wing or an affinity for meaningless virtue-signaling. But it’s clear this action will do nothing to help spread vaccinations to countries in need. Even Dr. Anthony Fauci, the president’s chief medical adviser, warns that gambits such as the Biden waiver could backfire, and he points to other ways to increase international vaccine distribution. One possibility would be for the U.S. government to fund a large-scale effort to acquire vaccine doses and distribute them internationally as a form of foreign aid. Although expensive, this course of action has the fairly significant benefit of not selling out our most innovative, lifesaving developers to Communist China.

Moreover, it will take manufacturers many months, possibly years, to build the facilities to produce vaccines even with the intellectual property that Biden is forcing innovators to give away. So it won’t address the short-term problem of vaccine availability now, and it will discourage innovation in the future.

Instead of sabotaging our most effective medical firms, we should incentivize more American innovation and encourage developers to invest even more in developing the next miracle cure. But if we expect these companies to take the enormous risk of spending billions on these efforts, they need to know the U.S. government will not legalize the theft of their final products. The time to bolster American technology is now because our scientists and our patients, not the Chinese Communist Party, are the rightful future of modern medicine.

Devin Nunes represents California's 22nd Congressional District in the U.S. House of Representatives.

https://www.washingtonexaminer.com/opinion/op-eds/bidens-covid-19-vaccine-patent-waiver-would-benefit-china

What happens when people get two different COVID-19 vaccines?

 As some experts continue to warn of very rare side effects associated with the AstraZeneca vaccine, Canadian health officials are now reviewing the research on mixing various COVID-19 shots.

A study of a "mismatched" vaccine regimen is underway in the U.K. — but some scientists say there's reason to believe that administering two doses of different products could boost a person's immune response beyond what can be achieved by giving the same shot twice.

The National Advisory Committee on Immunization (NACI) caused some confusion earlier this month when it said the viral vector shot from AstraZeneca is not the "preferred" product given its associated risk of vaccine-induced immune thrombotic thrombocytopenia (VITT) — a condition that causes blood clots. That warning came out after hundreds of thousands of Canadians had received the AstraZeneca vaccine already.

According to the Ontario Science Table, estimates of the frequency of VITT in individuals who have received the AstraZeneca vaccine now range from 1 case in 26,000 to 1 case in 127,000 doses administered.

The risk of developing this side effect, combined with an uncertain delivery schedule for future supply, has prompted some provinces to consider pausing AstraZeneca vaccinations altogether.

Dr. Brent Roussin, Manitoba's chief provincial public health officer, said Sunday a temporary suspension "has been discussed at many levels, and certainly discussed at our provincial program right now."

Christine Elliott, Ontario's health minister, said Monday that recipients of the AstraZeneca vaccine may receive a different shot for their second dose.

While the AstraZeneca product has been deemed safe and effective repeatedly by Health Canada regulators, some people who already have received that vaccine are now looking at their options.

What does the research say about mixing vaccines?

Researchers at Oxford University in the U.K. launched a study in early February to explore the possible benefits of alternating different COVID-19 vaccines. According to the lead scientists, the study is "looking for clues as to how to increase the breadth of protection against new virus strains."

The study — otherwise known as the COVID-19 Heterologous Prime Boost study, or "Com-COV" — 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. (A "heterologous" vaccination regimen is one that uses more than one product.)

Some early results may be available soon; the study team told CBC News it's "anticipating sharing data in the next week or so."

All of the shots currently in use in Canada and the U.K. follow the same two-dose schedule, with a "prime" dose followed by a second "boost" dose some weeks later. (The one-dose Johnson & Johnson shot has been approved for use in Canada but it has not yet been administered.)

The Oxford researchers are evaluating the effects of vaccine combinations — comparing the results of a first dose of the AstraZeneca vaccine followed by either the Pfizer vaccine or a second AstraZeneca dose, or a first dose of the Pfizer vaccine followed by either the AstraZeneca or a second dose of the Pfizer.

A second study, called Com-COV 2, includes the products from Moderna and Novavax as booster vaccines.

Jonathan Van-Tam is the deputy chief medical officer for England and one of the senior officials responsible for this study. He said this research will "give us greater insight into how we can use vaccines to stay on top of this nasty disease."

"It is possible that by combining vaccines, the immune response could be enhanced, giving even higher antibody levels that last longer," he said in a statement. "Unless this is evaluated in a clinical trial, we just won't know."

Dr. Helen Fletcher is a professor of immunology at the London School of Hygiene and Tropical Medicine in the U.K. She said a "mismatched" vaccine program would deliver some practical benefits — vaccine delivery logistics would be greatly simplified — but there could be another good reason to pursue a mixed-dose regimen.

The prospect of a 'stronger immune response'

"I'm excited about the study because I think it's likely that the immune response will be even better if you mix and match vaccines," Fletcher said in an interview with CBC News.

"Mixing vaccines could give you a stronger immune response, or it could give a broader type of immune response — generating a wider range of antibodies, or T cells as well as antibodies. It's also possible that a mix and match regimen could strengthen our immune response against virus variants because of this stronger or broader immunity."

Vaccines teach the immune system — which includes both antibodies and T-cells — to recognize part of a virus. A T cell is a type of white blood cell that responds to viral infections and boosts the immune function of other cells.

A single dose of either the AstraZeneca or Pfizer shots has been found to generate a significant antibody response to the novel coronavirus. But a recent study by the U.K. Coronavirus Immunology Consortium and the University of Birmingham found that the AstraZeneca vaccine may actually induce a stronger cellular immune response than the Pfizer shot.

So a combination of the two shots "could lead to a higher quantity of antibody, but it can also broaden the immune response," Fletcher said.

Is there any history of mixing different vaccines like this?

Yes. Fletcher said people have been combining vaccine types for several decades in an effort to boost immune responses to malaria, tuberculosis, HIV and cancers.

A mixed vaccine regimen was approved for Ebola last year.

"When we give immunizations to infants, we use several different types of vaccine over a period of months and years with no safety concerns," Fletcher said.

Are there any risks associated with a mismatched regimen?

Fletcher said there have been no reports of any side effects beyond the ones already reported when the vaccines are administered individually.

"The Com-COV study will, of course, be looking very closely at safety and it's great that this is being carefully monitored as part of a clinical trial, but I would not anticipate any safety problem with mixing vaccines," she said.

Different vaccines administered as part of a two-dose regime do not directly interact with each other, as the vaccine particles are swiftly cleared by the immune system within days of immunization, Fletcher said.

"There's no remaining vaccine mRNA or vaccine viral vector around when you give a second dose," she said.

Jorg Fritz, a microbiology and immunology professor at McGill University, said he doesn't see why there would be any additional danger involved in receiving two different vaccines.

Fritz said he also thinks it would be better to mix two vaccines that use different technologies than to wait too long to give the second shot.

"I think it's more important to get a booster vaccination to have a more robust and more durable immune response against the viral proteins than using the same technology," Fritz told the Canadian Press.

What have Canadian officials said about this?

Dr. Theresa Tam, Canada's chief public health officer, said last week the current guidance is for AstraZeneca recipients to get a second dose of the same product, but NACI is now reviewing the Oxford research on mixing AstraZeneca with an mRNA shot.

"There will be further advice forthcoming on that second dose based on the evolving science. We should watch this space," Tam said.

"All of the vaccines being used in Canada are targeting the virus' spike protein, so I think the science will look not just at whether the mixed schedule is safe, but whether that's actually an even better approach than using exactly the same vaccine for the two doses. Those questions remain to be answered."

Would we have enough mRNA doses for a mix-and-match program?

Probably. According to Health Canada, at least 1,540,000 AstraZeneca doses have been administered in Canada as of May 1. Thousands of Canadians have been vaccinated since then.

With delivery of millions more mRNA shots expected over the coming months — Pfizer alone will deliver 2 million shots each week in May before ramping up to 2.4 million a week next month — there should be enough shots on hand to vaccinate AstraZeneca recipients with a second dose of a second product.

But provinces may have to hold back some Pfizer supply to make this work.

Canada has ordered 48 million Pfizer doses — 5.5 million were delivered in the January-through-March period, 24.2 million will arrive in the second quarter of this year and 18.3 million more are to follow between July and September.

That's enough shots to vaccinate 24 million people with two doses. If some of that product is earmarked for people who already have doses of AstraZeneca, that leaves less product for first doses.

Moderna is also expected to deliver 12.3 million doses of its mRNA product in the April-through-June period, with millions more doses expected in the third quarter of this year.

Maj. Gen. Dany Fortin, the military commander leading vaccine logistics at the Public Health Agency of Canada, said last Thursday that officials are "only starting to do deliberate planning on second doses."

"What I would tell you is provinces and territories have a good handle on what they need. They keep tabs on who is getting which vaccine," he said. "Everybody is working on a very deliberate plan making sure people get the right vaccine when they're supposed to receive it."

Will Canada shorten the time between shots?

Possibly. NACI said in early March that, given the limited vaccine supply, provinces and territories may want to wait up to 16 weeks between first and second doses to give more people at least some level of protection.

The provinces have since followed this guidance, with a few exceptions. For example, many long-term care home residents have been fully vaccinated on the timeline recommended by the vaccine makers. Pfizer calls for a second dose 21 days after the first, while Moderna stipulates the second shot should come 28 days later.

Ontario announced Monday that it would begin offering second doses to some high-risk groups this week.

"As more vaccines come in, that interval can be shorter," Tam said.

https://www.cbc.ca/news/politics/vaccines-mix-and-match-1.6020986

Canada could be mixing and matching COVID vaccines by summer: Health chief

 Canada’s top doctor believes Canada could be mixing different kinds of COVID-19 vaccines in the next few months, as several provinces have already halted administering first doses of the AstraZeneca vaccine over concerns surrounding rare blood clotting.

In an interview during CTV News Channel’s “Get the Facts on the Vax” special on Wednesday, Canada’s chief public health officer Dr. Theresa Tam was asked whether Canadians who already received a dose of AstraZeneca would be given a second dose of another brand this summer.”

“That's a possibility,” she said. “It will be really helpful, because then it makes subsequent doses easier to administer and predict, given the supply.”

Tam’s comments come as preliminary results from the United Kingdom-based study showed that receiving one dose of Pfizer's COVID-19 vaccine and one dose of AstraZeneca's vaccine is safe, but could result in more frequent mild side-effects.

The early results, published in a research letter in the journal The Lancet on Wednesday, looked at 800 individuals who were given Pfizer and AstraZeneca vaccines and found that there were more frequent minor side-effects – including fever and fatigue – compared to those who received two doses of the same vaccine.

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The research did not measure how effective mixing doses is in fighting COVID-19, however.

“Early indications are looking favourable towards use of an mRNA vaccine if you had a first AstraZeneca vaccine,” Tam said. “We'll be providing advice, hopefully hearing from the National Advisory Committee on Immunization shortly.”

This week, several provinces, including Ontario, Alberta, Manitoba, Saskatchewan and Nova Scotia, halted or restricted inoculation with the AstraZeneca vaccine due to a lack of supply and out of an abundance of caution concerning rare cases of blood clotting known as vaccine-induced immune thrombotic thrombocytopenia (VITT).

VITT is estimated to occur in one in every 100,000 to one in every 250,000 people vaccinated with the AstraZeneca vaccine.

Despite the concerns, Tam said the AstraZeneca vaccine is safe and anyone who took it already did the right thing.

“If you’re looking at those effects, overall vaccines are safe and effective and Health Canada has essentially authorized their use, but with millions of vaccines going into arms across the world, you're beginning to see some rare effects,” she said.

Dr. Marla Shapiro, CTV News' health and medical expert, said she wasn’t surprised to hear Tam suggest that Canada could soon be mixing vaccine brands.

“I think that there's a possibility that it will happen, and I think we're expecting to see that the data is going to look good, but given the communication and how lightly we're treading in that, we don't want to take a road without having the science to tell us about the efficacy,” she said.

“It's just speculation at this point.”

https://www.ctvnews.ca/health/coronavirus/canada-could-be-mixing-and-matching-covid-19-vaccines-by-the-summer-tam-1.5425807