Chief medical officer of health COVID-19 update – November 23, 2021
2021-11-23

Check against delivery.

Thank you, Minister, and good afternoon everyone.

Before I get to today’s update, I’d like to share a change to the recommended interval for mRNA vaccine doses for adults.

Based on emerging evidence, the Alberta Advisory Committee on Immunization has recommended extending the interval between first and second doses of mRNA vaccine to a minimum of 8 weeks for all those who are currently eligible for vaccine. Evidence shows that a longer interval between doses can result in higher vaccine effectiveness that may also last longer. This means if you have just received your first dose, it is strongly encouraged that you wait until 8 weeks have passed before you receive your second dose.

The interval between second and third doses for those who are eligible remains the same at 6 months after the second dose.

The other information I want to share before getting to today’s numbers is a recommendation we have received from the Alberta Advisory Committee on Immunization regarding use of the Moderna vaccine in those ages 12 to 29. We have been closely watching our vaccine data and the data from other jurisdictions, and at this point, it seems clear that, while still low, the risk of myocarditis following Moderna vaccine is higher than following Pfizer vaccine in those who are 12 to 29.

As I mentioned, the risk of this outcome is still very small, with approximately one case per 7,000 doses in 12 to 17 year old males – that’s with Pfizer – and one case per 2,000 second doses with Moderna. Risks following vaccination are even lower for those age 18 to 29, and it is also important to remember that myocarditis after COVID-19 infection is more common than after any vaccine. As a precaution, however, starting today we will be advising that anyone between the ages of 12 and 29 receive Pfizer vaccine rather than Moderna. For those in this age group who have already had Moderna vaccine, there is no ongoing risk. If myocarditis happens after vaccine, it typically happens in the first one to 2 weeks, and after that, again, there is no ongoing risk.

We know there may be some who would still like to choose Moderna, as our data indicates it is slightly more effective, and this informed choice is still possible. However, at this point we do preferentially recommend Pfizer vaccine for adolescents and young adults.

On to today’s update, over the last 24 hours, we have identified 253 new cases of COVID-19, and completed about 5,300 tests. 

Our positivity rate was about 5.2%.

There are currently active alerts or outbreaks in 133 schools.

Two of these schools have had 10 or more cases who were infectious in the school within the last 14 days.

As you heard, there are currently 475 people being treated for COVID-19 in hospital, including 94 in the ICU.

Sadly, 10 new deaths have been reported to Alberta Health in the last 24 hours. I am saddened to share that this includes the death of a child under 2 years of age where COVID-19 was a contributing cause. While I will note that this child had complex pre-existing medical conditions that played a significant role, this does not diminish the tragic loss of one so young.

My thoughts are with the loved ones left to mourn this individual and all others, including anyone who has had to say goodbye to someone they cared about, no matter the cause of death.

I want to assure Albertans that before we publicly report any COVID deaths in someone under the age of 18, we complete a thorough review process.

These reviews are also done in any cases where there is uncertainty in cause of death for those of any age, so the overall COVID numbers we are reporting are as accurate as possible.

Again, I offer my sympathies to everyone who has suffered loss from every cause. Every life matters and every death matters.

We know that the most effective way to limit transmission of COVID-19 and prevent serious outcomes like hospitalization and death is widespread immunization in people of all ages. That fact makes the approval of the Pfizer vaccine for those aged 5 to 11 even more important.

After a thorough and independent scientific review of the evidence, as you know, Health Canada has determined that the benefits of this vaccine for children aged 5 to 11 outweigh any potential risks.

The clinical trial data show that the vaccine was 90.7% effective at preventing COVID-19 in children aged 5 to 11 and importantly, no serious side effects were identified. The trial also showed that the immune response in children 5 to 11 years of age was comparable to the immune responses of people aged 16 to 25. This is wonderful news.

Already in the U.S., over 2 million doses of vaccine have been administered to children ages 5 to 11 with few adverse events reported, and no safety signals.

Children between the ages of 5 to 11 will be offered a pediatric dose, which is 10 micrograms. This is one-third the dose of 30 micrograms given to children aged 12 and over, and to adults.

Not only has the pediatric dose in children been found to result in a similar immune response as the dose for older adolescents and adults, the pediatric dosing has been shown to reduce the risk of side effects for those in this age group.

In addition to the Health Canada announcement, the National Advisory Committee on Immunization released its recommendations on extending the interval between first and second doses for children to at least 8 weeks.

This is based on the evidence in adults, as I spoke about earlier, that suggests a longer interval between doses can result in higher vaccine effectiveness that lasts longer. It’s also based on evidence that suggests that it may reduce the risks of the very rare potential side effect of myocarditis.

My team and I have thoroughly reviewed all of the data and recommendations from Health Canada, NACI, and the Alberta Advisory Committee on Immunization, and this has formed the basis of our guidance on immunization for 5 to 11 year olds in Alberta. This includes ensuring that there is at least 8 weeks between first and second doses, and encouraging parents to consider the benefits of offering immunization to children in this age group.

If your child was recently immunized with another vaccine, such as influenza, it is also recommended to wait 14 days before having your child receive the pediatric COVID vaccine. This is a precaution.

While we have seen with older age groups taking other vaccines with the COVID vaccine – this has been safe and effective. However, this spacing for 5 to 11 year olds is recommended to allow us to watch more closely for any potential adverse effects.

While most children who’ve been infected with COVID-19 have had only mild disease, a small number have experienced severe disease resulting in hospitalization. In the past 120 days:

  • 13.4% of all cases in Alberta were in children aged 5 to 11, and in that time period,
  • 26 were hospitalized, including 3 in the ICU.

As with all COVID-19 vaccinations, we will carefully monitor the administration of doses in Alberta for any adverse events and will report those publicly as we have been doing since our vaccination program began.

As a parent of children in this age range, I join in the relief of many parents, now that there is an effective vaccine available for use.

I also understand that some families may have questions or feel uncertain about getting their young children vaccinated. It’s only natural to want to do the best thing for your kids.

To help answer these questions, I will be hosting a telephone town hall next Tuesday joined by other physicians to answer questions about vaccines and children. This town hall will be open to anyone who is interested in this topic.

A registration link will be available online. It’s free for anyone who wants to call in and ask a question about this issue.

I also urge you to speak to a health-care professional for information about the pediatric vaccines. They can answer your questions and help make sense of the data.

This is another milestone day in our fight against COVID-19. I believe that the expansion of vaccine eligibility to these young children will help us further limit the spread of the virus, which will in turn help prevent Albertans of all ages from experiencing serious outcomes from COVID-19.

If you’re eligible for vaccination against COVID-19 and you haven’t yet been fully vaccinated, please do so today to help protect you, your loved ones and your community.

Thank you and we are happy to take questions.