1/ #COVID19BC - Age 5-11 Vax Rollout

Vax program announced today.

Some background:
Cases down w/ 457 new cases in past week, 15,917 total since beginning.

~20% new cases now in under 12 yo.

Most kids mild illness, but CAN get #MISC (19 in BC so far, average age 9)

2/ Age & Vaccination

This graph shows that children under 12 years‐old are
generally at lower risk of infection than other age groups, even after returning to school in September.

Lower # of cases among fully vax individuals compared to unvaxxed across all age groups & time.
3/ Clusters & Schools

2975 exposure notifications, in 830 schools.
45% of schools had one (until Nov 13)
382 clusters (>2 cases w/in 14 days) in 217 schools.
Clusters identified in 12% of schools, so 88% of schools have had NO transmission events.
Median cluster size is 3 cases.
4/ COVID 19 vs Vaccine Risks - Age 12-17

Risk of getting COVID 19 is ~12-13x higher if unvaccinated.

0 people have been hospitalized if they have had 1 OR 2 doses.

509,806 vaccines given since May, 2021.

133 adverse events following vax reported (14 serious, ie anaphylaxis)
5/ Health Canada Approval & NACI

@GovCanHealth approved it through independent review assessing safety and efficacy.

The direct benefit is to increasing the child's protection, family confidence, but also the indirect benefit is to rest of is society in reducing transmission.
6/ Kids 5-11, 🔑Elements.

~25% kids registered so far.

10 µg dose, why?

Study looked at both 10 & 30 µg doses & found similar immune response w/ less side effects.

Kids immune systems respond well to less antigen (stimulation).

NACI recommends 8 weeks interval, so will BC.
7/ Steps.

Can register your child now, invitation for booking appointments will start coming out on Monday.

Clinics will start on Monday, multiple options.

If parent is unable to be present with their child, they can give written consent by proxy with adult accompanying child.
8/ Multiple clinic types.

Family Clinics - will not be doing boosters or dose 1s. Priority will be kids and immediate family members

12+ Clinics - will be done in large pharmacies (pediatric vaccines won't be don here).

What's missing?

@BCFamilyDoctors as usual.
9/ Getting information

Estimate that 55-60% of parents are now ready to vaccinate kids, w/ 15-20% wanting to wait for now and the rest not supportive.

~3 million kids in this age range in USA have been vaccinated with no new safety signals identified.

Lots of data will come.
10/ Resources

A collection of resources has been made available by @BCGovNews & @ImmunizeBC.

Info at: www2.gov.bc.ca/gov/content/co…

FAQ at: immunizebc.ca/COVID-19-vacci…

Cool app to help support children with anxiety getting vaxxed: respiire.com/COVID-19.html


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More from @BirinderNarang

9 Nov
1/ Last week there was a @UBCCPD Webinar "Addressing Anti-Indigenous Racism in the B.C. Health Care System"

I found it super insightful.

The summary will be available soon on the CPD website, but want to share a few highlights/takeaways.

Photo from Dr. James Liu.

2/ Avoid Pathologizing Indigenous Peoples

This was a theme that came up a few times.

Dr. Evelyn Voyageur shared this thought:

“The lifestyle they have chosen is a defence mechanism to the trauma they experienced” as a reflection to residential school survivors.
3/ Pitfalls

One of the most enlightening pearls were pitfalls people who have seemingly good intentions may encounter while doing Anti-Racism Work and promoting Indigenous Cultural Safety & Humility

This was presented by @LenPierre2 - an Indigenous Cultural Safety Consultant
Read 9 tweets
4 Nov
1/ Wishing everyone who celebrates a Happy Diwali & Bandi Chhor Divas.

To those who do not know the historical significance, I will briefly share what I have learned about it through the years.

As per @SikhRI, Bandi Chhor Divas represents "Emancipation Day" Image
2/ Sikh Gurus

Sikhi is guided by the teachings of 11 Gurus (leaders who guide us from darkness to light) from Guru Nanak Sahib to the Guru Granth Sahib (our scriptures in homes/Gurduaras).

Guru Hargobind Sahib was our 6th Guru; Bandi Chhor Divas remembers his imprisonment.
3/ What Happened?

Guru Sahib was imprisoned by Emperor Jahangir at the Gwalior Fort for months-years (uncertain how long exactly)

Alongside Guruji, were 52 imprisoned political prisoners, the Hindu Rajahs (Kings/Princes)
Read 10 tweets
2 Nov
1/ New Opportunities

For the new people here, a brief bio/background.

A Sikh Family Doc, grandson of a 2x refugee Physician.

To be a Sikh is not only an articulation of Faith, but also to me means one who is always learning/unlearning.

Same applies to medicine.

2/ Training

I grew up in the UK, Halifax & BC.

Completed undergraduate at @SFU, Medicine at @Sydney_Uni in Australia.

Returned to Canada as an #IMG completing my residency in @umanitoba

Now work in Long Term Care & Longitudinal Family Medicine at @REACHCHC inc. Addictions.
3/ Academic

I am a Clinical Assistant Professor with @UBCFamPractice

This involves mainly teaching 1st year med students & precepting residents, OSCE evaluating, interviewing

With @UBCCPD I help summarize #COVID19 Webinars & have facilitated Cannabis Education Sessions
Read 10 tweets
31 Oct
1/ Booster Doses - 9/12 later

Worth it? Rationale?
With global vaccine inequity - should we feel guilty?
Why I chose to mix...

Also co-incidentally this is my Halloween costume:

"Government Agent"
"Big Pharma Shill"

Take your pick.

Some thoughts ahead.

#BCPoli Image
2/ Why Now?

First dose Dec 20 & second dose Jan 31st.
At the time we weren't sure what optimal dosing interval was & had ongoing supply issues, so many got 2 doses at varying shorter intervals.

Now we know ~12 weeks is a good interval, but also are seeing waning immunity.
3/ Waning Immunity

Data is showing our antibody levels to #COVID19 are decreasing, but that doesn't mean our overall immunity is, as we are seeing by our vaccine effectiveness data in BC.

But, in BC we still are losing too many ppl, almost 50 have passed in last week.
Read 14 tweets
10 Oct
1/ #COVID19BC - Vaccines in 5-11 year old - Thoughts

This morning it was announced (by media) that 5-11 yo can now be registered.

A friend asked me if I had a child in that age range, would I be getting them vaccinated?

I said probably, but that isn't good enough...

2/ #COVID19BC - Questions

Before we get into whether it makes sense yet, why do we keep hearing this stuff from anywhere but Public Health?

Another "soft launch" of systems? Like vax bookings, card registration & now this kid vax reg system, @BCGovNews announces after launch.
3/ #COVID19BC - Questions

This may be done intentionally, but why do it on a long weekend, when people aren't available to answer questions about it officially?

Communication from PH has been my biggest issue throughout the entire pandemic & it seems to continue.
Read 14 tweets
28 Feb
1/ Vaccines in Canada:

We all heard that #AstraZenecaVaccine was approved for use in Canada on Friday.

We now have 3 #COVID19 vaccines, but with that there are discussions re: "Which one is the best vaccine for me?"

Docs say "the best vaccine, is the one in your arm".

2/ Some thoughts:

But AstraZeneca is only ~62% effective against COVID? That's not good enough, right?

We need to examine & reflect on where we were, and where we are going.

March 11, 2020 - @WHO declares global pandemic.

Within 1 year, we have 3 vaccines (in Canada).


1 year ago, we would NOT have thought we would be in this place now.

It's a testament to a concerted global commitment to scientific excellence, that we have these available to us now.

It has definitely been a struggle, but we are making tremendous progress.

Also... -->
Read 10 tweets

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