In April 2021, The New York Times reported that 8 per cent of Americans missed their second dose appointment, according to the Centre for Disease Control. The report outlines several reasons behind the no-shows, including a fear of possible side effects, overconfidence in the first shot, and a lack of supply for certain brands of the vaccine.

After a slow start, Canada has officially surpassed the United States in vaccination rates for residents who are fully vaccinated. However, despite the promising increase, Dr. Rob Kozak, clinical microbiologist and scientist at Sunnybrook says we must remain diligent.

“The worst thing that could happen would be for Canadians to refuse or delay getting vaccinated. This will lead to it taking longer to get population level immunity,” he says.

Dr. Kozak offers insight on common concerns surrounding second doses, and why getting fully vaccinated is the best way to protect yourself and the people you love.

Improvement of overall efficacy

“There are so many reasons to get both doses,” Dr. Kozak says. “The second dose of the vaccine is important for building immune memory, and robust antibody and T-cell response against the variants.”

Having both doses of the vaccine also increases overall efficacy, meaning your chance of having an infection is reduced, Dr. Kozak adds.

Furthermore, he says, if you do get infected with the virus, you are more likely to have a milder case, and less likely to spread it to those close to you when you are fully vaccinated.

Increased protection against variants

“There is data coming out that is showing that one dose provides much more limited protection against variants,” Dr. Kozak says.

As the contagious Delta variant continues to increase in prevalence across Canada, you can put yourself at risk by not getting the second dose.

“Plus, we will likely see more variants emerging in the future, and so far all our data is showing that 2 doses is more protective against variants than a single dose,” he says.

Necessary to achieve herd immunity

Herd immunity occurs when enough people have a protective immune response against the virus that will prevent them from getting very sick and reduces the chance of the virus spreading to others. In order to achieve herd immunity, Dr. Kozak says viruses needs a susceptible host to replicate and spread to others.

However, he notes that we cannot solely rely on others around us to be have their shots. In order to protect those who are more vulnerable to infections, we must also ensure we are doing our part.

“It is important to remember that the vaccine will not work perfectly in everyone. For example people who are immunocompromised may not be as well protected if they are vaccinated, and they are relying on all of us to get our shots to help keep them protected,” he says.

By continuing to increase the vaccination rate, we can all contribute to a healthier future. Of this, Dr. Kozak remains optimistic.

“This pandemic has been hard on everyone, but now we can see an end in sight.”

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The post Don’t skip out on your second dose of the COVID-19 vaccine appeared first on Your Health Matters.

The couple, 87 and 91, received their first dose of the COVID-19 vaccine on March 8, 2021, and decided to mark the day as their anniversary.

Mervin and Myrna on their wedding day, nearly 68 years ago.

It was nearly a year to the day since the pandemic was declared.

“On March 11, 2020 we were enjoying our time in sunny Florida when we heard the news of the pandemic and that Canada might be locked down,” Mervin recalled. “We packed our things and booked plane tickets immediately and came straight home.”

Ever since, Mervin and Myrna have been hunkered down in their Toronto condo.

It’s been a long 12 months, of course. Family dropped off groceries and supplies. And the pair used the hallways of their building as their exercise track.

“Myrna lit candles every night for dinnertime to help break up the monotony,” Mervin says.

“It was just a little something I could do to add some excitement,” Myrna added.

Myrna says getting the notification that they were able to book vaccine appointments was the “best day of the year.”

“It was so amazing,” she says. “We are so happy to have science on our side.”

Myrna and Mervin don’t yet have plans for their actual wedding anniversary in May, as they will wait to hear what the public health advice on gatherings is at that time.

“Our celebration might be a toast of champagne on Zoom, and that’s OK,” Myrna says.

Facetime and Zoom have been a wonderful way to stay connected with their three children, eight grandchildren and five great-grandchildren throughout this past year, she says.

“And the telephone,” adds Mervin. “We are so lucky to have so many ways to stay connected.

“We have just a short while longer to keep up with all the public health rules; don’t give up now. Hang in there and we will get through this.”

And Mervin’s advice for couples who are feeling cooped up as stay-at-home orders continue:

“Let things fall where they may. Don’t be demanding on each other. Myrna and I have never been demanding on each other, and it works.”

The post Couple celebrates 68th wedding anniversary by getting COVID-19 vaccines at Sunnybrook appeared first on Your Health Matters.

Flu season is already here. Have you gotten your flu shot yet?

As a physician working in internal medicine and infectious diseases at Sunnybrook, I’m often asked about the flu and the flu shot. Here are answers to some of the most commonly asked questions I hear:

1. What’s the difference between a cold and the flu? What are the symptoms of flu?

A simple cold and the flu are actually quite different. A person with a cold may have a cough, sneezing, runny nose, and feel unwell. A person with the flu may have those symptoms and can be sicker with symptoms such as high fever and full body muscle aches. Most people can generally still function when they have a cold. Flu symptoms can cause a person to feel unable to even get out of bed.

Flu causes over 3000 deaths every year in Canada and is the tenth-leading cause of death overall. The very young and old are at highest risk of complications, but bad outcomes in otherwise healthy people can happen too.

2. Can I get the flu from the flu shot? I got sick after my shot last year.

No, you can’t, because the flu shot contains dead virus. If you did get sick after getting the flu shot, there are a number of possible explanations:

1. Maybe you had rhinovirus (common cold) and this was not flu;
2. You were in contact with the flu before vaccination (it takes 2 weeks to develop full immunity); or
3. Because the flu shot doesn’t provide 100 per cent immunity, you can still get the flu if you get the flu shot. But the shot doesn’t give you the flu.

3. Can I prevent the flu with holistic remedies (chicken soup, vitamins, infusers) instead of getting the flu shot? 

No. Hot liquids can soothe a sore throat and provide much needed fluids. But there is no evidence that chicken soup has any specific qualities that help prevent the flu. Your best protection against the flu is getting the flu shot, as there is lots of scientific evidence for this.

4. I heard there are a few different flu vaccines available this year. What are the differences? 

There are trivalent and quadrivalent vaccines available. The trivalent vaccine contains three strains of flu virus and higher levels of an antigen, which helps the body produce a stronger immune response. This vaccine is recommended for people over age 65.

The quadrivalent vaccine contains the same as the trivalent, plus an additional strain (four strains total), but with a lower dose of antigen. This vaccine is given to people over 6 months old to 64 years.

5. I heard there’s weird stuff like formaldehyde and thimerosal/ethylmercury in the flu shot. Are those things safe to put in my body?

Formaldehyde occurs naturally in your body, and is a product of healthy digestive function. While it can be toxic and potentially lethal in high doses, it’s present in such small amounts in a flu vaccination that it is harmless.

Thimerosal acts as a preservative, keeping the flu vaccine free from contamination by bacteria and fungi. Thimerosal is made of an organic form of mercury known as ethylmercury, a safe compound that usually only stays in the blood for a few days.

This is different from the standard mercury that can cause illness in large doses, and from the mercury found in seafood (called methylmercury), which can stay in the body for years.

6. Is it possible to receive a preservative-free vaccine?

Preservatives are only used with multi-dose vials. If you would like to receive a preservative-free flu shot, check with a pharmacy or doctor’s office for the type they have available.

7. If the flu shot doesn’t guarantee 100 per cent immunity from the flu, why should I even bother getting it?  

If you get the flu shot, your risk of getting the flu or flu-related complications is between 40-70 per cent lower. The flu shot doesn’t give 100 per cent immunity because the flu virus mutates and changes as the year goes along. But when it comes to becoming infected with a potentially fatal infection, or transmitting that infection to those you love, 40-70 per cent lower risk is not something to dismiss.

At a population level, the flu vaccine campaign each year prevents thousands of hospitalizations for flu in Ontario alone. The more people get vaccinated, the better our “herd immunity,” which keeps our community safe. We all need to do our part to reduce the burden of flu every year.

8. Can you receive the flu shot if you’re feeling under the weather (cough, runny nose)?

If you have a mild cold, you may still receive a flu vaccination. Vaccination won’t be given if you have a serious, acute illness, such as anything with a fever or requiring antibiotics. Some people choose to wait until they are feeling “100%”; however, as we get in to colder weather and longer days, this may not happen and receiving the vaccination will keep being postponed.

9. Is it safe to get the flu shot while pregnant?

Yes, pregnant women should absolutely be getting the flu shot. In fact, the flu shot is recommended for pregnant women at all stages of pregnancy, as well as those who are breastfeeding. The flu itself, not the flu shot, can harm pregnant women seriously enough to land them in hospital and cause death. The flu poses a major threat to fetuses, too.

Another reason for pregnant women to get the shot: flu vaccination causes the body to produce infection-fighting antibodies. When a pregnant woman receives a flu shot, her antibodies get passed on to the developing fetus, providing protection to the newborn in the first months of life. A baby can also acquire antibodies through a vaccinated mother’s breast milk. This is particularly important since infants can’t receive the flu shot, and are at higher risk of complications if they do get the flu.

10. The flu doesn’t seem that bad. Why can’t I just take my chances and not get the shot?

You’re not only getting the flu shot for yourself, it’s offering protection to those around you.

While the flu may not seem like a big deal, it can have deadly consequences for many people. The flu can be a serious illness and cause hospitalizations and deaths, especially in people over 65 and young children like Jude, who was a healthy two-year-old when he died from Influenza B.

This year’s vaccine is quadrivalent, meaning it provides some immunity to four strains of the flu virus.

11. When someone gets the flu, how could it actually cause them to die?

The flu can be fatal for different reasons, including (but not limited to):

• The flu can cause severe inflammation of vital organs, which is when the immune system attacks itself. This could leads to failure of vital organs and requires supportive treatment in the critical care unit
• The flu can progress into a secondary bacterial pneumonia or other respiratory conditions, which could then become fatal
• A person could have other medical conditions that can become unmanaged or more complicated when sick with the flu, such as exacerbation of lung disease, heart failure, kidney failure, or delirium. There is also evidence that flu can increase your risk of a heart attack, especially within the week after the infection 

12. Is my immunity lowered after the flu shot? Three years in a row, I got a cold right after the flu shot.

No, the flu shot does not lower your immune system – it boosts it.  You likely became ill with something else, but due to the timing it is common for people to think it was caused by the vaccine.

13. I live a healthy lifestyle (eat well, exercise, etc.) and consider myself to be a healthy person. I never get sick. Do I still need to get the flu shot?

Yes. You do. Public health agencies from around the world recommend everyone over the age of 6 months get the flu shot every year.

A flu shot not only protects you against the flu, it also helps protect your loved ones, colleagues, strangers on the street. By getting the shot, you are reducing your chance of spreading the illness. Even if you’re healthy, you should still get the flu shot.

14. I got the flu shot so that’s all I have to do to stop spreading the flu, right? Or can I spread the flu even if I feel well?

Your chance of spreading the flu is significantly reduced if you have been vaccinated. But whether you’re vaccinated or not, you can be a carrier of the flu even without symptoms. About 20 to 30% of people carrying the influenza virus have no symptoms at all. So, wash your hands after every contact you have with other people.

There are a number of steps you can take to protect yourself during flu season besides vaccination. Avoid contact with people who have the flu, wash your hands often, cover your mouth when you cough or sneeze, avoid touching your face, stay home when you are sick, clean and disinfect surfaces and shared items.

This article was posted November 21, 2018.

The post 14 answers to your questions about the flu and the flu shot appeared first on Your Health Matters.

When she went to wake the boys up, Jude was unresponsive. Jill called 911. Emergency personnel descended on her street and home. They took Jude to the nearest hospital.

An hour later, Jude was pronounced dead.

Jill’s healthy toddler was gone. And she didn’t know why.

Months later a pathologists report indicated how Jude died: influenza B.

Influenza A and B — known as the flu — are responsible for 13,000 hospital admissions a year in Canada. The flu kills more than 3,500 people a year in Canada alone. That makes the flu one of the top 10 causes of death in the country.

“The young, the old, and people who are pregnant or chronically ill are more at risk for complications from the flu,” Dr. Jerome Leis, medical director of infection prevention and control at Sunnybrook, says. “But no one is entirely protected; healthy people can become very ill with the flu.”

The respiratory flu can cause fever, chills, headache, body aches, cough, sore throat and more. This isn’t to be confused with the winter vomiting bug (also nasty, but not what we are talking about here).

“And the flu is not the same as the common cold,” Dr. Leis says. “It’s a real public health challenge. There’s often talk like, ‘it’ll be a mild season,’ but make no mistake: the flu leads to hospitalizations and deaths every year. So rather than focus on predicting if it’ll be a ‘mild’ or ‘severe’ year, which may make some people let their guard down, let’s instead focus on what everyone can do to help minimize the effect of the flu.”

Jill and Jude and the rest of the family had received the flu shot in 2016. Jill says she knows she did everything she could to prevent Jude’s death. She has now become a fierce advocate for the annual vaccine.

“How many homes was that flu in before it got to mine? What steps can we take to stop the spread of flu in our communities?” Jill asks. “I don’t see the flu shot as a personal choice. It’s a public choice.”

There are many misconceptions about the flu and the flu shot, Jill and Dr. Leis agree. Here, they dispel some of those common myths.

Myth 1: The flu shot gave me the flu.

No. It didn’t. The flu shot contains dead virus. You can’t get the flu from the flu shot. Maybe you have rhinovirus (common cold). Maybe you were in contact with the flu before vaccination (takes 2 weeks for full immunity). Maybe you have a different strain of the flu than the vaccine targets. The flu shot doesn’t provide 100 per cent immunity, so you can still get the flu if you get the flu shot. But the shot doesn’t give you the flu.

Common symptoms of the flu shot are red, tender arm, swelling at injection site, headache, muscle ache for 1 to 2 days. Tylenol can help reduce these symptoms.

Myth 2: I’m healthy so I don’t need the flu shot.

Yes. You do. Public health agencies from around the world recommend everyone over the age of 6 months get the flu shot every year.

A flu shot not only protects you against the flu, it also helps protect your loved ones, colleagues, strangers on the street. By getting the shot, you are reducing your chance of spreading the illness. Even if you are healthy as an ox, or however that old saying goes, you should still get the flu shot.

If you get the flu shot, your risk of getting flu or flu-related complications is between 40-70 per cent lower. The flu shot doesn’t give 100 per cent immunity because the flu virus mutates and changes as the year goes along. But when it comes to becoming infected with a potentially fatal infection, or transmitting that infection to those you love, 40-70 per cent lower risk is not something to dismiss.

Myth 3: Once I get the shot, I’ve done my part to avoid the flu.

Wash your hands and wash them often. Avoid contact with the flu by trying not to touch your face (droplets go into mouth, eyes, nose). Wipe down surfaces. You can be a carrier even without symptoms, so wash your hands.

Dr. Leis says flu immunization rates have been on the rise in Ontario, but we can do better.

This year, go get your flu shot #ForJudeForEveryone

The post Get the flu shot — for Jude appeared first on Your Health Matters.

Here are my tips for pregnant women:

1. You’re protecting yourself and your baby: Whatever stage of pregnancy you’re at, the flu vaccine keeps you and your baby healthy. Pregnant women are at a much higher risk of hospitalization from influenza – four times more likely to land in a hospital ward than a non-pregnant person. When you’re vaccinated, you develop antibodies to protect your body from the virus. In turn, you also pass along these antibodies to your baby, so she will be protected during her most vulnerable months after birth.
2. Don’t delay (it’s free and easy to access): There are so many places to receive the flu vaccination. From local pharmacies, to your doctor’s office, to public health flu clinics, it is free and easily available. Add it to your list of errands.
3. “But I’m really healthy”: Even if you have a healthy diet, exercise, take your vitamins and get lots of rest, changes in your immune, heart and lung functions during pregnancy make you more likely to get seriously ill from the flu.
4. No link between flu vaccine and autism: Some of my patients are determined to have a “natural” pregnancy and feel anxious about being vaccinated. There is no link between vaccines and autism, in fact there have been several scientific studies refuting this claim. Speak with your doctor if this is a concern.
5. Don’t take a chance: Severe illness in a pregnant mother can be dangerous to your fetus, and increases the chance for serious problems such as premature labour and delivery.

What if…you get the flu when you’re pregnant?

If you do find yourself with the telltale symptoms – fever, chills, cough, sore throat, headaches, muscle and body aches and fatigue – call your doctor right away. There are antiviral drugs that can treat the flu and help prevent serious flu complications. These drugs are safe for pregnant women. Your fever can cause problems with your unborn baby, speak to your doctor about reducing your fever with Tylenol.

Every day, I see mothers agonize over decisions related to their pregnancy. Receiving the flu vaccination should not be one of them. It’s a no-brainer: get vaccinated to protect yourself and your baby. And don’t forget the usual steps you should take every year, like cleaning your hands regularly to combat any viruses you may come into contact with.

Stay healthy and enjoy your pregnancy!

The post Should I get the flu shot when I’m pregnant? appeared first on Your Health Matters.

1) HPV causes cancer in men, too

When Michael Douglas candidly revealed his oral cancer was caused by HPV earlier this year, many people expressed surprise.

Even though HPV has traditionally been thought of as a disease that affects women and mainly causes cervical cancer, men are actually at higher risk of being diagnosed with certain types of HPV-positive cancers than women.

“It’s not well understood why men are at higher risk for HPV-positive oral cancer, but it does point out that vaccination in men is even more important than we may have previously thought,” says Dr. Durand. Physicians are learning more and more that HPV can also cause other cancers in both women and men, such as anal cancers and head & neck cancers (cancers of the base of the tongue, tonsils and soft palate).

2) Not all HPV infections lead to cancer

You’ve probably read some of the (slightly scary) statistics about HPV: 3 in 4 Canadians will get HPV in their lifetime. It can lead to a variety of cancers and cause genital warts, and there is no cure. But should this keep you up at night, worrying about the potentially deadly consequences of HPV?

Hardly, says Dr. Durand. “Most people who are infected with this virus will clear it- probably 80% of people. It’s the other 20% of people with a persistent infection who may be at risk of cancer, and it’s still only a very small percentage of those people who may go on to develop cancer,” she says.

Many people never even realize they’ve had an HPV infection, as there are usually no symptoms, and the infection often goes away on its own.

3) You’re never too old to get the HPV vaccine

What if you didn’t get the HPV vaccine back in middle school, and now you think it’s too late to get it?

[pullquote align=”right”]”Regardless of your age and your onset of sexual activity, we can vaccinate both men and women, and we can see a reduction in disease,” says Dr. Durand.[/pullquote]It’s actually not too late- the vaccine can still be effective, even in adults who’ve already been sexually active. “Many people think vaccination can only be done before the onset of sexual activity. But regardless of your age and your onset of sexual activity, we can vaccinate both men and women, and we can see a reduction in disease,” says Dr. Durand.

Anyone, male or female, over the age of 9 can be vaccinated. So, if you’ve put off getting the vaccine because you thought you were too old, it’s not too late!

The post 3 things you might not know about HPV appeared first on Your Health Matters.