Answers about vaccines from the Base Surgeon

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  • Thu, Dec 02, 2021 - 06:57pm

    #1
    Kira Yakimovich

    Kira Yakimovich

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    Answers about vaccines from the Base Surgeon

Hi all

In order to push back, I’ve told my Chain of Command that I could not reach informed consent.  Although, I am still mad at them not recognizing my bodily autonomy, of which I am grieving, hopefully up to the Supreme Court of Canada.  I did make an effort to see what information would be provided to Canadian Armed Forces members and this is what I got back from our Base Surgeon.  I am surprised to see all of the items we are NOT given in the case we do have a bad case of COVID.  Here is his response:

1.     How are these vaccines different from smallpox or polio vaccines?  When I looked into polio, it took 10+ years to come out with something safe.  I am wondering how that differs now.  Also, polio offers lifelong immunity.

In brief, the concerted efforts of many varied nations and research centres in response to the pandemic allowed this to occur. I think it was just a different time in the 50s, it took much longer to get anything done. The process to bring a pharmaceutical agent to market is now much more rigorous in Canada than it has ever been in the past.

2.     What is the difference between Pfizer and Moderna, including dosage?

Both are mRNA vaccines, 0.5ml for Moderna, 0.3mL for Pfizer. Differences can be viewed in the Canadian drug monographs:

https://covid-vaccine.canada.ca/info/pdf/pfizer-biontech-covid-19-vaccine-pm1-en.pdf

https://covid-vaccine.canada.ca/info/pdf/covid-19-vaccine-moderna-pm-en.pdf

3.     What is offered for CAF members?  Is this common across the forces?

Moderna, common across all CAF clinics, this is currently the only vaccine stocked by the CAF

4.     How come just Moderna?

One vaccine had to be chosen, and there was no compelling reason to stock others. Similar risk profiles across both mRNA vaccines available in Canada, and the mRNA vaccines are safer and more effective. Some reasonable/light patient-focused info here: https://www.yalemedicine.org/news/covid-19-vaccine-comparison

5.     Did Canada have a pandemic response plan in place before COVID-19?  Was it followed?

This is not my area of specialty, not sure how this relates to vaccine efficacy or safety.

6.     Are you aware that Ontario and Alberta have stopped giving Moderna to males under 30? Is BC thinking about this at all and is this for CAF members?

This is due to “mild risk” of inflammation of the heart muscle or lining around the heart, 1/28k for Pfizer, 1/5k for Moderna for males <30yo. For the total population it is closer to 3/100k for Moderna. Here is a good resource for some breakdowns of likelihood of complications: https://health-infobase.canada.ca/covid-19/vaccine-safety/#a5

I encourage you to compare that against the likelihood of complications with COVID infection.

7.     How is the list of side effects updated for people who give vaccinations?

The list in this link is updated every Friday with new stats (drawn from CAEFISS): https://health-infobase.canada.ca/covid-19/vaccine-safety/#a5

8.     What are the adverse side effects short term, long term?

See these links:  https://health-infobase.canada.ca/covid-19/vaccine-safety/

https://covid-vaccine.canada.ca/info/pdf/covid-19-vaccine-moderna-pm-en.pdf

https://health-infobase.canada.ca/covid-19/vaccine-safety/#a5

9.     Do you think they are effective? How do you explain the need for a booster?  Will we be needing more boosters?  I understand our PM bought a lot of shots so I suppose we will be required to take more.

They are definitely effective in reducing likelihood of infection (>90%, although Omicron may change this), and so far 100% in eliminating severe expressions of the disease. Immune response diminishes over time for many vaccinations, e.g. Tetanus; our immune system responds to demand. Here is an interesting article that discusses affinity maturation of B cells in the immune system: https://www.nature.com/articles/d41586-021-02158-6

10.  Have you seen people coming in blood clots?

No, this was observed with some vaccines (not Pfizer or Moderna), but as far as I know we have not had any cases within the military. The average rate of blood clots

11.  Is there any concern that we are not testing for antibodies more regularly?  Isn’t natural immunity better and last longer?  I’ve seen studies from Israel, Gibraltar, Sweden that show interesting insights into natural immunity vs vaccine immunity.

Natural immunity is not better, does not appear to last longer, and to get there you have to endure an infection. To a degree, the worse your infection the better your long-term immunity. The immune system is not perfect, it will develop a response to the markers it is exposed to, so while it may develop a good response to a particular marker on the Delta variant, this does not necessarily mean that it will have chosen the “best” marker for response, so it may have a less effective response against other variants. As far as I know all health authorities recommend vaccination even after prior infection: https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/vaccine-induced-immunity.html

12.  Are there any markers or indicators for those who do suffer adverse effects?

Age, sex, existing medical conditions all impact likelihood of adverse events. You are not in a high-risk group.

13.  Have you been told to not support or care for unvaccinated patients including mental health?

Absolutely not, we continue to provide the same care to all CAF members regardless of vaccination status, and we will continue to do so while they are our patients. This is the same in the civilian system. I would think it inappropriate to not provide care to someone based on their medical decisions.

14.  Have there been a number of people that have requested a medical exemption? Were they supported?

There have been a few, and those with medical reasons for exemption or deferral were supported from our clinicians. This is not a large number of members since there are very few reasons for medical exemption.

15.  Where you told to not support medical exemptions?

Absolutely not, we will support medical exemptions for approved conditions/situations.

16.  Would I have the option of getting a medical done including blood work before taking the vaccine?  I am currently on the waiting list.

There is no medical recommendation to require general bloodwork prior to this vaccine, but I am curious what you would like to investigate?

17.  Do you think there is enough data available to achieve informed consent? I understand that health care professionals take this very seriously so don’t understand how a vaccine that is used for the first time (mRNA) can be mandated without a full clinical trial, where we only have 1 year of data. Also considering that both Moderna and Pfizer say you can request their full data set from the clinical trials but if you do, they say it is not available at this time on in the near future. The FDA recently said Pfizer data won’t be available until 2076 after a FOIA request.  Doesn’t seem right.

I did hear that about a Pfizer FOIA request in the US, I imagine the FDA will do something to improve that response time.

The mRNA vaccines have now been approved through the regular process: https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-treatments/authorization/applications.html

The vaccines were never experimental when they were released to the public. They met all regulatory standards for effectiveness and of safety. The interim order process simply streamlined the administrative steps towards authorisation. For example, companies were able to send in their data as it became available, rather than having to follow a fixed schedule. They were also able to submit based on approvals from other trusted regulatory agencies. This made the vaccines available more quickly but did not change the standards. All the standards for effectiveness and safety are no different from other vaccine development as they enter the market for the first time.

Therefore I think the standard to be able to achieve informed consent has been met.

Pregnancy or breastfeeding are not medical contraindications to vaccination. The COVID-19 vaccine is actually protective to both the baby and the mother. It does not cause infertility. NACI and the Society of Obstetricians and Gynaecologists of Canada  recommends vaccination in pregnancy.

18.  Have any CAF members had serious cases after catching COVID? Any deaths or ICUs?

Not as far as I am aware. Many CAF members have residual symptoms after infection, and these can significantly impact quality of life.

19.  Why don’t we have a have a vaccine for other SARS viruses? Or Flu or common cold? My understanding is they are similar to the COVID virus.

COVID-19 has caused more infections and deaths than others in recent history (not counting the 1918 pandemic), and it spread more quickly. We do get about 300k-600k global deaths from the seasonal flu each year, but we do have a vaccine for the flu, and many people have residual partial natural immunity to it from prior infections and vaccinations (again, not that natural immunity is better, but the flu tends to cause less severe infection). There are also vaccines available for SARS/H1N1/Ebola etc, but they are not causing widespread infections currently so the efforts of health systems are focused elsewhere.

20.  Is there anything people can do to help prevent or less the effects of being infected by COVID? To aid our bodies fight an infection?  Why isn’t the focus on becoming healthier and tracking immunity?  Can I have my antibodies tested?

The current PHMs and other travel/gathering restrictions all support prevention. Certainly remaining healthy overall will improve your body’s response to infection, and specifically avoiding smoking, minimizing alcohol, and ensuring adequate sleep and dietary intake are important. These things should always be part of the repertoire of medical advice for all patients regardless of the status of the pandemic, but none are as effective as the vaccine (100% effective in eliminating severe disease). You can likely pay to have your antibodies tested through a private lab, but since there is no medical reason or recommendation for this test it would not be covered by CFHS. If antibody levels demonstrate a likely prior infection then vaccination is still recommended. https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/vaccine-induced-immunity.html

21.  Is their early treatment for COVID patients?  How do CAF members get treated?

For most patients the most appropriate treatment is general supportive care, but the full list of BCCDC recommendations are available here: http://www.bccdc.ca/health-professionals/clinical-resources/covid-19-care/clinical-care/treatments

CAF members would be treated in accordance with this guidance and in line with their medical condition.

22.  What is the deal with ivermectin?  Why is it considered dangerous? Is it available in Canada, to CAF members?

Ivermectin does not actually treat COVID-19 infection and it is not authorised for this use in Canada (Ivermectin not authorized to prevent or treat COVID-19; may cause serious health problems (canada.ca)). There is misinformation and disinformation being shared promoting these drugs to treat COVID-19 infection. In fact studies that purported to show benefit of these drugs have been retracted, e.g. Flawed ivermectin preprint highlights challenges of COVID drug studies (nature.com); Viruses | Free Full-Text | Retraction: Samaha et al. Effects of a Single Dose of Ivermectin on Viral and Clinical Outcomes in Asymptomatic SARS-CoV-2 Infected Subjects: A Pilot Clinical Trial in Lebanon. Viruses 2021, 13, 989 | HTML (mdpi.com)

23.  What about monoclonal antibodies? Is it available in Canada, to CAF members?

This is covered in this resource: http://www.bccdc.ca/health-professionals/clinical-resources/covid-19-care/clinical-care/treatments

These treatments are available in Canada, but in general are not recommended, and are not a replacement or superior solution to vaccination since the efficacy is lower, and the risk of significant side effects are much higher, as is the cost.

24.  Are these treatments offered?

As above, the available treatments will be tailored for a patient’s specific condition/situation and in line with the best available evidence.

From your questions yesterday:

Risk of Guillain Barré Syndrome and neurologic effects after COVID vaccination: Here is an interesting case study that discusses some evidence relevant to this question: https://www.cmaj.ca/content/193/46/E1766 The balance of evidence points to COVID vaccinations in general not having a significant impact on the likelihood of developing GBS or other neurological effects. The larger an effect is (the more likely an adverse event) then the more easily it would be observed. Thus far, across many millions of doses there has not been an observed effect on the rate of new diagnoses of GBS. Also some info here: https://www.cdc.gov/vaccinesafety/concerns/guillain-barre-syndrome.html

Impact on menstrual cycle? There is a fairly good explanation here: https://covid19.nih.gov/news-and-stories/covid-19-vaccines-and-menstrual-cycle there is no evidence of impact on fertility and the Society of Obstetricians and Gynaecologists of Canada  recommends vaccination.

Canadian adverse events reporting process: https://www.canada.ca/en/public-health/services/immunization/canadian-adverse-events-following-immunization-surveillance-system-caefiss.html

DFHP feeds into this surveillance system, and all CAF clinics follow a strict protocol for reporting vaccine-associated events (any medical event after any immunization – this is not new for COVID).

Cancer risks? There is no evidence suggesting that COVID vaccines increase risk of cancer.

Hospitalization rates? I forget the specifics of your questions about this, but here is a reliable article comparing the different vaccines: Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations Among Adults Without Immunocompromising Conditions — United States, March–August 2021 | MMWR (cdc.gov)

And info here: http://www.bccdc.ca/Health-Info-Site/Documents/COVID_sitrep/2021-11-11-Data_Summary.pdf

  • Thu, Dec 02, 2021 - 08:45pm

    #2
    Mike from Jersey

    Mike from Jersey

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    Reply To: Answers about vaccines from the Base Surgeon

There is a lot of misinformation in that response. The claim that there is 90% efficacy, that Ivermectin does not work, that there are minimal side effects and so on.

All of this is nonsense.

That is the problem in writing to “authorities.” They respond with pre-programmed rubbish and then consider the matter closed.

It is not closed, it is just evaded.

  • Thu, Dec 02, 2021 - 09:30pm

    #3

    Jim H

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    Answers about vaccines from the Base Surgeon

11. Is there any concern that we are not testing for antibodies more regularly? Isn’t natural immunity better and last longer? I’ve seen studies from Israel, Gibraltar, Sweden that show interesting insights into natural immunity vs vaccine immunity.

Natural immunity is not better, does not appear to last longer, and to get there you have to endure an infection. To a degree, the worse your infection the better your long-term immunity. The immune system is not perfect, it will develop a response to the markers it is exposed to, so while it may develop a good response to a particular marker on the Delta variant, this does not necessarily mean that it will have chosen the “best” marker for response, so it may have a less effective response against other variants. As far as I know all health authorities recommend vaccination even after prior infection: https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/vaccine-induced-immunity.html

This is not just wrong, it is egregiously wrong.  Your body doesn’t “pick one marker” for it’s immune response in the case of natural infection.. that’s not how it works.  That is how it works with the vaccines since they present only the spike protein, receptor binding region of the virus as the antigen.  In fact, the accepted means by which natural immunity is differentiated from vaccinal is through ID of antibodies to the N-protein, or nucleocapsid shell protein.  In this sense, natural immunity is more long lived since many of the antigenic sites are more readily conserved over time vs the S-protein site.

Vaccination over natural infection will hobble your natural immunity and make you MORE prone to re-infection;

https://igorchudov.substack.com/p/vaccine-destroying-and-preventing

  • Thu, Dec 02, 2021 - 11:32pm

    #4
    James99

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    Answers about vaccines from the Base Surgeon

I think the criteria for being able to obtain informed consent have been met.

_

  • Fri, Dec 03, 2021 - 02:26am

    #5
    Canuckian

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    Answers about vaccines from the Base Surgeon

The denial of natural immunity is truly bizarre. How on earth do the vaccines work other than triggering the immune system? How did we survive before vaccines were discovered?

  • Fri, Dec 03, 2021 - 10:43am

    #6
    Kira Yakimovich

    Kira Yakimovich

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    Answers about vaccines from the Base Surgeon

I think the response about the natural immunity surprised me the most and also when I looked at how they treat COVID patients in Canada, all the recommendations from Chris and doctors like him are not offered. Good thing I’ve ordered my own IVM.

Happy that the Base Surgeon achieved informed consent – I have not yet and he’s helped me become more skeptical.  The medical instruction regarding informed consent also says patients have the right to refuse or accept, free of duress or coercion.

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