Sunday, January 23, 2022

Is it Time to End Vaccine Passports? Experts are divided on whether they’re still useful

The Wax Divide: ‘We’re starting to look at our fellow citizens in a way that they’re not the same citizens as us… and I think that’s a very dangerous thing’

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Psychologist and McMaster University professor emeritus David Streiner is of two minds on the vaccine passport.

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He is willing to consider doing anything to persuade people to get COVID shots, even charging for a hospital stay without vaccinations.

“But passports? They might be a good stick,” he said, “but I’m not sure how effective they are at slowing transmission.” He also worries that passports are creating an “I-them” environment that can only worsen if the pandemic persists. “We’ve seen it affecting families, tearing families apart.” Once vaccines became polarized, “all reason went out the window.”

The power of vaccines has always been rooted in their ability to prevent serious illness, hospitalization, and death in vulnerable adults. The debate was, do they reduce the risk of transmission?

They do this for a short period of time, according to a new and yet-to-be peer-reviewed Canadian study. But two doses are unlikely to protect against infection by Omicron. Six months after the second dose, “it decreases to, eg, zero,” said lead author and Toronto family physician and epidemiologist Dr. Jeff Kwang said.

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His team’s updated data shows that after the third dose with the mRNA vaccine, the effectiveness against infection is around 60 percent. Higher, yes, “but still not great,” and not as high as Delta.

Vaccine passports were based on two objectives: to prevent transmission, and to help keep people alive and out of hospitals. On the latter, the shots are catching on their own. But it is becoming increasingly clear that they do not completely prevent transmission and infection, especially the wildly infectious Omicron, which has led some to question whether passports are still relevant, and that the issue should be addressed solely by governments. Why is it not being addressed?

“We haven’t separated in our messaging what we’re trying to achieve,” said Dr. Martha Fulford, infectious disease specialist at McMaster Children’s Hospital. “And that’s part of the whole illusion.”

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Kwang said passports promote the vaccine by making life less convenient for those who intentionally reduce shots. Bookings for the first dose quadrupled after Quebec expanded its vaccine certification scheme to cannabis and liquor stores.

But Kwang, a senior scientist at ICES, said that, at this point in time, vaccine passports are working to protect unvaccinated people. It can be a little difficult to explain why, exactly. But with most of the population with two doses, a lot of people can do Enter places with a vaccine passport. “Given the low/no effectiveness of the two doses, when was the last dose, these people are at risk of contracting the infection, perhaps unintentionally, and transmitting it to someone else in such a setting,” Kwang said.

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Vaccines are more likely to get mild illness because of their shots. “So they may be more likely to be outside and around even if they are infected,” he said. “By excluding all unvaccinated people from these locations, we are in essence protecting them from vaccinated people who may be asymptomatic or pre-symptomatically infected with COVID, but are still capable of transmitting, especially when every Somebody is masked.”

“If we drop vaccine passports, the unvaccinated are going to go to those places. Right now, they are probably living the life of a monk, and thus have managed to stay safe. But if we get rid of vaccine certificates, they are like sitting ducks. ,

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Others believe that vaccine certificates may still be harmful, “because it makes people think they’re in a safe place—they were pre-omicrons, but not now,” said Toronto infectious disease specialist Dr. . Andrew Morris wrote in one of his COVID weekly emails.

“Vaccine certificates may prove valuable again at some point,” Morris wrote, “but the two main purposes – to motivate people to get vaccinated and to protect people by limiting the chances of infection – are clear. are no longer relevant.”

There is also a question of how many people need to be excluded to prevent a single transmission of SARS-CoV-2.

Quebec’s Vaccine Passport plan will eventually require three doses to be taken when shopping at government-run liquor and cannabis stores, dining indoors or entering gyms, concerts and other venues. Israel has begun offering a fourth dose for people 60 and older. There is talk of annual shots, as with the seasonal flu. Strainer, a professor in the Department of Psychiatry and Behavioral Neuroscience at McMaster, looks at the risk of push backs. “I think we’re at this stage of creating fatigue about it: OK, I have my two shots, my booster. Enough. Let me get on with my life.”

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Streiner is the senior author, “Excellence Gris”, of a pre-print study that estimated, in the pre-Omicron era, that it would take at least 1,000 unvaccinated people to prevent a SARS-CoV-2 transmission event in most types. needs to be taken out. of settings.

“In the fall, when people were talking about implementing the mandate, and some of my colleagues who were without vaccinations were facing termination, I thought to myself, really, non-vaccinated health. What is the risk reduction achieved by terminating personnel,” said lead author Dr. Aaron Prosser, a psychiatric resident at McMaster. “And behind it came extensive exploration for the real numbers.”

The study looked at home settings, social gatherings (meaning more close contacts between friends and families), casual close contacts (the “type of transient, transitory contacts in public areas or buildings,” Prosser said), work and study settings, and travel. . transportation. For comparison purposes, “going to a restaurant is probably a mix of a social gathering and a public sector risk,” he said.

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The analysis was done when infection rates were fairly stable in Canada and around the world. “We were in these middle stages of the waves,” Prosser said. “Obviously now the risk of infection is increasing. It’s a completely different situation.”

“But I think we should think very carefully about how, in a pluralistic democracy, we are sure that the gains we can get from (vaccine mandates and passports) outweigh the disadvantages of making a class of citizens There is more, who are totally not allowed to participate in society,” said Prosser.

We are starting to look at our fellow citizens as if they are not citizens like us, because they have made decisions we don’t agree with

Dr. Aaron Prosser

“We’re starting to look at our fellow citizens in a way that they’re not the same citizens as us, because they’ve made decisions we don’t agree with. And I think that’s a very dangerous thing to do.”

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New federal modeling released on Friday shows an increase in the number of daily hospitalizations in the coming weeks. But there are also signs that the Omicron wave may be peaking in Ontario and Quebec, just as it appears in Britain and the US. Variants may be running out of people to become infected, according to the Associated Press. “It’s going to come down as fast as it goes up,” Ali Mokdad, a scientist at the University of Washington in Seattle, told the AP.

The other good news: “Vaccines protect against serious consequences,” Kwang said. “That’s what we need to hang our hats on.”

Unaffected by Canada’s numbers

Eligible Canadians 5 and over who have not been vaccinated (zero dose): 12%

Eligible Canadians 5 years of age and older who have not been vaccinated in each province and territory:

Alberta: 15.8%

Saskatchewan: 14.1%

Manitoba: 12.6%

Ontario: 12.5%

BC: 11.6%

Nunavut: 11.6%

Quebec: 10.2%

New Brunswick: 9.7%

Yukon: 9%

Nova Scotia: 8.4%

Prince Edward Island: 7.2%

North West Zone: 5.6%

Newfoundland and Labrador: 2.5%

Males not vaccinated (as of 8 January): 18.3% (of the total population)

Women who have not been vaccinated (as of 8 January): 16% (of the total population)

Ratio of illiterate by eligible age group:

5-11: 60.5%

12-17: 13%

18-29: 14.3%

30-39: 12.2%

40-49: 10%

The National Post, with additional files by Tom Blackwell

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