Ontario Tech University researcher sets the record straight on vaccine facts and myths

From a global health and wellness standpoint, it’s unlikely that history will look back fondly on the early years of the 2020s. The arrival of SARS-CoV-2, the virus that causes COVID-19, has disrupted almost every aspect of our daily lives.

Navigating the health emergency over the past 18 months has not been easy. As of early September 2021, there have been more than 219 million identified cases of COVID-19 and more than 4.55 million deaths. In North America, there have been three distinct COVID-19 ‘waves’, and most experts concur a fourth wave is gathering steam.

One major societal difference in 2021 vs 2020: many people, including a majority of Canadians, have heeded the advice of health experts and are now fully vaccinated against COVID-19. While vaccines do not fully guarantee one won’t still become ill to a certain degree, they dramatically reduce the risk of infection and limit the chance for further virus spread. Vaccines lessen the impact on our overall health-care system. History and medicine have proven this with a host of other diseases.

Despite the availability of vaccines and their proven capacity to curb COVID-19, there are pockets of society, in Canada and elsewhere, still pushing back against the notion of vaccination.

While a small percentage of immunocompromised patients may not be eligible for the shots, vaccine hesitancy or refusal threatens to limit the overall effectiveness of vaccination programs. Competing opinions over the merits, and even safety of, vaccines continue to swirl in social media channels.

Dr. Wally Bartfay of the Faculty of Health Sciences at Ontario Tech University looks to break down the facts in a myth-busting discussion (data current as of August 28, 2021).

Questions and answers 

• How do vaccines actually work?

  I would like to begin by explaining that vaccinated individuals are not the ones propagating this pandemic: it is the unvaccinated who are putting themselves and others at risk of serious illness, hospitalization and even death.

  Currently messenger-based RNA (mRNA) vaccines like Pfizer and Moderna do not contain any live virus per se or harmful chemicals or ingredients, despite such claims by anti-vaxxers.

  mRNA-based vaccines basically teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies, which produces antibodies. This is what protects us from getting infected if the real COVID-19 virus enters our bodies.

  It is also noteworthy that so-called ‘breakthrough’ infections occurring in vaccinated individuals is extremely rare, accounting for less than 0.5 per cent of all hospitalized cases in Canada (i.e. fewer than one in 200).

• Can you still get COVID-19, even after being vaccinated?

  If you are vaccinated and happen to develop or test positive for COVID-19 as one of these very rare breakthrough cases, the good news is that the symptoms are typically less severe, infection is milder and you have less viral load in your nasal passages. In comparison to non-vaccinated individuals, patients recover quicker and typically don’t require hospitalization or ICU care.

• There are so many things pushing and pulling at vaccine uptake. Hardcore anti-vaxxers are fighting about perceived ‘rights’ to not get vaccinated. At the same time, there’s as a rising chorus of pro-vaxxers saying their ‘rights’ to live in the healthiest society possible take priority. What risks does this battle of opinion pose?

  This parallels the fight we had back in the 1970s to make the wearing of seat belts mandatory, and also the banning of smoking on airplanes and in work and public places like shopping malls and bars. Many argued then that their individual rights to choose were being violated by government laws. With the passage of time however, these once very contentious issues seem pointless and ridiculous in nature today.

  Time is our greatest enemy in terms of fighting the COVID-19 pandemic, because viruses are constantly mutating. The current Delta variant is alarming because it is not only affecting vulnerable individuals such as the elderly and immunocompromised individuals, but also young adults and children.

• What about the battle of misinformation in social media?

  There is, unfortunately, a growing chorus of myths being perpetuated by the Internet and social media. These include false claims that COVID-19 vaccines alter your DNA, result in birth defects and fertility issues; contain egg proteins that many are allergic to, or contain harmful chemicals and preservatives, to name but a few.

  Moreover, many individuals are prone to follow the advice of anti-vaxxer celebrities that carry public influence, such as Robert F. Kennedy Jr., Jessica Biel, Alicia Silverstone, Jenny McCarthy, Jim Carrey, Bill Maher, Rob Schneider, Lisa Bonet, Toni Braxton, Charlie Sheen, and Robert DeNiro. These are individuals who are greatly respected and admired by the general public. Hence, certain individuals are more likely to follow the advice of these misinformed and misguided celebrities than scientists and health-care professionals. This is a huge ongoing and uphill social media battle in Canada and abroad.

• How effective has Canada’s vaccination program been so far?

  It is notable that the World Health Organization declared the outbreak a Public Health Emergency of International Concern on January 30, 2020, and a pandemic on March 11, 2020.

  There are still more than 5.7 million people over the age of 12 who have chosen to forgo a shot altogether, or to wait for a later date. This number alone should be a real wake-up call.

  Based on the epidemiology, we have technically already entered the fourth wave of this pandemic in Canada because the virus effective reproduction number or (R) factor as of August 12 in Ontario was 1.44. Anything greater than 1 is of concern because this means that every infected person with COVID-19 can infect another person in the community.

  This is both puzzling and alarming from a public-health perspective given that COVID-19 has killed more than 2.1 million individuals to date globally, and we have recorded more than 1.43 million cases in Canada alone and more than 26,600 deaths to date.

• This is both puzzling and alarming from a public-health perspective given that COVID-19 has killed more than 4.55 million individuals to date globally, and we have recorded more than 1.56 million lab-confirmed cases in Canada alone and more than 27,330 deaths to date.

  I wish to draw attention to what is happening in the United States, in states such as Florida, where vaccination rates are very low. The Delta variant is a highly contagious and nasty strain that is not only affecting vulnerable individuals like the elderly but young children also. On August 9 for example, Texas reported 142 pediatric patients admitted to hospital with confirmed COVID-19, and Florida had 135 children, all with the highly infectious Delta variant. This is very alarming indeed because the numbers keep rising in these states and also in Canada. Children under 12 are most vulnerable because we don’t have an approved vaccine for them as of yet. The number of cases and hospital admissions will without doubt increase in the next few months with the start of school.

• Will people ultimately need ‘boosters’ down the road?

  We have to keep in mind that viruses are constantly evolving. It is certainly conceivable that new and stronger strains of the virus will emerge and may require further booster shoots. A growing number of studies demonstrate that immunity against COVID-19 wanes over time.

  We know that booster shots are one effective public-health strategy to deal with this phenomenon and the Delta variant. For example, the U.K.-based Zoe COVID Study found that protection against infection after two shots of the Pfizer/BioNTech decreased from 88 per cent at one month to 74 per cent at five to six months. Moreover, protection against infection after two Oxford/AstraZeneca fell from 77 per cent to 67 per cent at four to five months.

  It is noteworthy that Pfizer and its partner BioNTech have asked U.S. and European regulators to approve a third booster dose based on evidence of greater risk of infection six months after inoculation. The U.S. government is gearing-up to roll out third-dose booster shots of Pfizer starting in mid-September for those who completed their initial vaccination course more than eight months ago, pending final approval from the U.S. Food and Drug Administration and the U.S. Centers for Disease Control and Prevention.

  Israel has already started rolling out third-dose Pfizer boosters in early August to seniors, and has expanded the vaccine campaign to now include individuals as young as 30 years due to the highly infectious Delta variant circulating globally. Similarly, the U.K., France, Germany, Sweden, and the United Arab Emirates have already implemented third-dose booster-shot programs for vulnerable patients.

  There is preliminary evidence to suggest that individuals who are immunocompromised, such as transplant patients, have significantly lower levels of antibodies even after two complete doses.

  By contrast, the World Health Organization is calling for a halt to COVID-19 vaccine boosters until at least the end of September to allow for the inoculation of at least 10 per cent of the population of every country and to address vaccine inequity issues between wealthy and poor countries. This is vital given that more than 85 per cent of these poor-nation people — some 3.5 billion people globally — haven’t had a single dose administered yet.

• Where does Canada need to be in order to achieve so-called ‘herd immunity’?

  A certain percentage of the population must be capable of getting a disease in order for it to spread, and we call this the ‘threshold proportion’, which varies for all communicable disease. If the proportion of the population that is immune to the disease is greater than this threshold, the spread of the disease will inevitably decline over time. We call this the ‘herd immunity threshold’. Typically, this number is in the high 80s to 90s percentiles.

  Canada’s Chief Public Health Officer Dr. Theresa Tam is aiming for a two-dose vaccination rate of 80 per cent for eligible Canadians. This will go a long way in preventing community-based spread.

  Herd immunity is also critical to protect vulnerable individuals such as those who cannot receive the vaccine due to allergies, those who are immunocompromised, individuals receiving chemotherapy, and transplant patients, to name but a few.

  Vaccination is really an unselfish thing to do. It benefits not only yourself, but also your family and your community. So, lets all roll up our sleeves if we haven’t done so already!

• Will vaccine passports become a reality in Ontario and/or Canada? Can they be made mandatory from a legal standpoint?

  Ontario Premier Doug Ford in Ontario first indicated his government will not require vaccine passports because it would create a ‘two-class society’. However, as of August 27, the Ontario government announced it will, in fact, be introducing ‘vaccine certificates’ in the near future. Quebec and B.C. already have created smartphone-based vaccine passports. These can be used in commercial and public spaces such as bars and restaurants to bowling alleys and hockey rinks—where provincial law will soon require proof of a vaccination before entry.

  Similarly, Manitoba has also announced plans for a vaccine mandate that will restrict restaurants, fitness centres, theatres and ticketed sporting events to only fully vaccinated individuals.

  Immigration Minister Marco Mendicino announced on August 11 that Canada will be getting a national vaccine passport for international travel. This passport or certificate will be available in the fall and will be common across all provinces. It will include the individual’s COVID-19 vaccination history, dates administered, type(s) of COVID-19 vaccines received and location of administration. It will be available to all citizens, permanent residents, and temporary residents living in Canada who are fully vaccinated. It is inevitable that vaccine passports will be required in the near future for travel to several countries.

  There is also a growing call from professional health-care organizations such as the Canadian Medical Association, Canadian and Ontario Nurses Association, and the Ontario Long-term Care Homes Association to make the COVID-19 vaccine mandatory for all health-care professions. Several countries have already made this mandatory, including Australia, Britain, Fiji, France, Greece, Indonesia, Italy, Hungary, Poland, Russia and the United States.

  On August 17, Dr. Kieran Moore, Ontario's Chief Medical Officer of Health, issued a directive to hospitals, community and long-term care settings to have a strict policy in place by September 7 for all employees and staff. Ontario's public education and several key health-care settings will need to have COVID-19 vaccination policies in place for staff in the coming weeks. However, this directive doesn't make COVID-19 vaccination compulsory in these settings for staff: those who decline the shots will need to undergo regular antigen testing for the virus.

  Similarly, the Ministry of Education announced that it intends to implement a vaccination status disclosure policy for publicly-funded school board employees and other educational settings. In my professional opinion, vaccines should be mandated for all eligible health-care professionals, teachers, and staff who regular interact with the public and children alike. This is especially important given that children under the age of 12 still do not have a vaccine approved by Health Canada, and the ongoing ferocity of the Delta variant.

  This would not be a huge extension for most health-care professionals such as physicians and nurses because the vast majority of organizations and hospitals already require proof of vaccines for several major communicable diseases, such as hepatitis A and B; measles, mumps and rubella (MMR); tuberculosis, etc.

  Transport Minister Omar Alghabra announced on August 13 that the federal government will soon require all public servants to be vaccinated. This mandate will also be implemented by Crown corporations and other federally regulated businesses in the coming weeks, and will also include air, train and cruise ship staff and travellers.

  The bottom line is that vaccinations provide the firewall necessary to finally put a stop to this global pandemic.