Evidence of meeting #12 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was vaccine.
A recording is available from Parliament.
4:45 p.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
You've anticipated where I was going next, which is on the types of vaccines.
Can you briefly review for us the different types of vaccines and provide your assessment of the current Canadian options for those different types of vaccines?
4:45 p.m.
Adjunct Professor of Medicine, University of British Columbia, As an Individual
Yes. Unfortunately—and this is what I had spoken to previously—we didn't have capacity. I'm glad to hear that we have invested in having our own GMP manufacturing capacity. Hopefully, they'll get the expertise that's needed to make the type of vaccines that we feel would benefit Canadians.
We have the whole type of vaccines. A live attenuated vaccine is best, actually, for children, because it exercises the immune system really well. It's a version of the bug that has been attenuated so it's not as infectious. It sort of handicaps the bug in you and launches an appropriate type of immune response to it. Examples of that are the smallpox vaccine and the measles vaccine. Those are really effective. You don't need to go down this multiple dose issue.
Then you have the whole inactivated vaccines. You basically take the bug, you kill it in some way, and then you add hopefully an adjuvant. To me, the type of adjuvant that you have—I think this is not really recognized as well—is really important for the type of immunity you launch. We've been using alum. It's not really an adjuvant but part of the ingredients for its adjuvant. But anyway, that's going down a long path.
Next are the component vaccines. You take pieces of a bug, add an adjuvant, and use that to stimulate an immune response against these immunogenic types.
The new nucleic acid delivery platforms are ones we'd never really used previously, so there was a learning curve for them. Essentially, these types deliver genetic material. The ones we're using now encode the original spike protein of the Wuhan strain of SARS-CoV-2.
Now, as with any new knowledge, I'm not really sure what the adjuvant for the mRNA is. I know that they say it has its own adjuvant, but it doesn't really trigger the type of immune response you would typically have to a virus or how it's presented to the immune system, because you can't really target it to specialized cells. You're assuming its uptake is around the muscle and is being presented there, so that might contribute to the variable durability of it.
4:45 p.m.
Liberal
The Chair Liberal Sean Casey
Thank you, Dr. Kalyan and Mr. Davies.
Dr. Ellis, go ahead for five minutes, please.
4:50 p.m.
Conservative
4:50 p.m.
Conservative
Laila Goodridge Conservative Fort McMurray—Cold Lake, AB
Thank you, Chair.
Thank you, Dr. Kalyan, and thank you to all the presenters. You guys have raised some very valid and interesting information for us to consider.
Dr. Kalyan, you talked in your opening remarks about how these mandates are impacting public trust. As an MLA and now an MP for rural northern Alberta, I know it's something that I've been hearing quite a bit about. People are really starting to question whether these mandates should be in place, specifically for domestic travel. While many of my colleagues around the table might be able to travel by car to some locations, if someone in my constituency wants to go to Toronto, that's 3,600 kilometres. It's not really all that attainable by car.
Could you possibly expand on the idea of how these public health mandates are now impeding public trust? What kinds of ripple effects does that have?
4:50 p.m.
Adjunct Professor of Medicine, University of British Columbia, As an Individual
I'm an immunologist, so my expertise is not entirely around how one makes decisions around public health. But as a person, I feel that if I don't understand what the mandates are trying to achieve...and it was never really clear to me what the purpose of the mandates was, especially around freedom of movement.
To me, if you're trying to prevent transmission—and obviously the vaccines are not doing that right now—then I think imposing that on people doesn't really make sense. You can see why it would increase resentment and mistrust. Those sorts of heavy-handed measures don't serve any purpose other than to build resentment and anger at a time when we could use more positivity, I think, than negativity.
It's been a hard time for everyone. I think we would want to make life as easy as possible and less filled with resentment at this time, to really all recover together from this pandemic. I really think these mandates at this time should be lifted, especially for travel.
4:50 p.m.
Conservative
Laila Goodridge Conservative Fort McMurray—Cold Lake, AB
Thank you so much.
I'm going to shift gears a bit. Dr. Jacobs, you were talking about how wait-lists have skyrocketed. I'm one of probably thousands of Canadians who had a COVID baby. I had to use quite a bit of diagnostic testing, which is pretty normal for most pregnant women. Just getting the routine ultrasounds was very challenging.
Have you heard of any cases of people forgoing routine or other diagnostics that impacted their health?
4:50 p.m.
President and Diagnostic Radiologist, Ontario Association of Radiologists
Yes, absolutely. The obvious one is breast imaging. Over the course of the pandemic, as I said, we had 300,000 women who decided not to get screened. That will have an impact on future breast cancer mortality.
The other thing we saw was more complex. What we were seeing was people not going to the emergency room, despite having illnesses. Somebody who would normally come to the emergency room with some right lower quadrant pain was holding out, and by the time they got to the emergency room, a week later than they should have, they had a ruptured appendix. It goes on and on and on. We were seeing many more late-stage cancers because people were just letting it grumble at home.
A two-year period is a very long period to sit on any pathology. You have to then take that forward. If we have a nine-month wait-list for MRIs, that's an additional wait for people who have already delayed their treatment and their diagnosis. This will have a knock-on effect, to be certain.
4:50 p.m.
Conservative
Laila Goodridge Conservative Fort McMurray—Cold Lake, AB
For me, there was a six- to eight-week delay to get the dating ultrasound that needed to be done before 12 weeks. By the time I found out I was pregnant, I was seven weeks along, so it was virtually impossible to get the dating ultrasound. That's just one small example. It really required some creative thinking to get that diagnostic testing. It's so critically important.
Do you have any messages for people who are delaying getting a mammogram? It's so critically important. You have the floor. I'd really like it if you could say something to women to get breast cancer screening.
4:55 p.m.
President and Diagnostic Radiologist, Ontario Association of Radiologists
Without a diagnosis, there can be no treatment. Without treatment, you can't have your health.
You shouldn't delay. It's very safe to go to the hospitals now, whether it be for breast screening or anything. We're at the nadir of the omicron wave. Don't delay your care any longer. Come in. You're quite safe.
4:55 p.m.
Liberal
The Chair Liberal Sean Casey
Thank you.
Thank you, Mrs. Goodridge.
Mr. van Koeverden, you have five minutes.
4:55 p.m.
Liberal
Adam van Koeverden Liberal Milton, ON
Thank you, Mr. Chair.
I'll just start by reading a quote from the Canadian Society for Immunology:
The Canadian Society for Immunology supports unbiased, well-informed and non-politicized scientific debate as vaccine rollouts occur with unprecedented speed; however, we strongly condemn concerted disinformation campaigns that misuse selected scientific data to advance political or economic ideologies. These activities not only undermine the scientific process but also actively impair public health efforts and prolong the pandemic at great cost to us all.... Based on the overwhelming evidence for vaccine safety and efficacy, we urge all Canadians to get fully vaccinated as soon as possible.
Dr. Kalyan, do you disagree with that statement?
4:55 p.m.
Adjunct Professor of Medicine, University of British Columbia, As an Individual
I certainly don't disagree with the feedback for having good, rigorous scientific discussion. I think that has been lacking.
4:55 p.m.
Liberal
Adam van Koeverden Liberal Milton, ON
My question was pretty simple. Do you agree that Canadians should get fully vaccinated as soon as possible?
4:55 p.m.
Adjunct Professor of Medicine, University of British Columbia, As an Individual
I believe it's the individual's decision. I believe in education and understanding of the different types of vaccines and their efficacy and safety. They should make that decision for themselves, along with their doctors.
4:55 p.m.
Liberal
Adam van Koeverden Liberal Milton, ON
Thanks, Dr. Kalyan.
Not to put you on the spot or anything, but if you'll indulge me, can I ask you if you've received a vaccine?
4:55 p.m.
Adjunct Professor of Medicine, University of British Columbia, As an Individual
I prefer not to respond to that question.
4:55 p.m.
Liberal
Adam van Koeverden Liberal Milton, ON
Okay. Thank you very much.
Yesterday, 35 Canadians died from COVID-19 and about 4,000 are in hospital today. That's the same as the average between December 10 and March 10.
My question is for Dr. Warshawsky. The typical duration of acute COVID-19 illness is two to six weeks. However, some patients have described debilitating symptoms persisting or occurring for weeks or months after acute illness. These longer-term symptoms are often referred to as “long COVID”, and we know that this condition can affect both adults and kids. Affected individuals are commonly referred to as “COVID-19 long haulers”.
I have a couple of questions. Do you believe that the COVID-19 vaccines available to Canadians can help mitigate long COVID? Do you think they have a good impact on preventing long COVID symptoms in Canadians?
With the information with respect to the number of Canadians who have died from COVID-19 and how many are hospitalized, do you believe this pandemic is currently in an endemic phase?
4:55 p.m.
Medical Advisor, National Advisory Committee on Immunization
Thank you very much for the question.
The National Advisory Committee looks at the effectiveness of vaccines. As we know, if you don't get infected with COVID-19 because of vaccination, then you are not at risk for post-COVID syndrome or long COVID.
By being vaccinated, you are preventing getting infected, to the extent that vaccines are able to do that. We do know that three doses of vaccines do offer reasonable protection against infection. It does decrease over time, but definitely when you get your third dose, you're better protected than when you have your second dose. It's around 60% protection initially after vaccination with that third dose. The extent to which the third dose will protect you from infection, it will also protect you from post-COVID syndromes.
There are also some studies that are looking at the fact that even if you do become infected when you're vaccinated, in general you're less likely to get post-COVID syndrome compared to an unvaccinated person.
4:55 p.m.
Liberal
Adam van Koeverden Liberal Milton, ON
Thank you, Dr. Warshawsky.
I have a question for anybody who would like to take it.
If Canada had the same death rate from COVID-19 as peer countries like the United States and the U.K., instead of a devastating 27,000 Canadians who have died from COVID-19, we'd be looking at closer to 90,000, and potentially even more like 100,000 Canadians, who would have passed away in the last two years from COVID-19.
How do we account for this difference? Obviously there are multiple factors.
The question is open to the floor. What have we learned?
5 p.m.
President and Diagnostic Radiologist, Ontario Association of Radiologists
I can take that, if you want.
