Immune Health by Karthik

Dr. Vivien Brown Family Physician & Assistant Professor, Faculty of Medicine, University of Toronto

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IMMUNE HEALTH Q&A

Q&A with Dr. Vivien Brown Why is it important for Canadians to continue to follow public health measures this fall, regardless of whether or not they’re fully vaccinated against COVID-19? We’ve learned that wearing a mask, physically distancing, and handwashing are effective in reducing viral spread. Despite vaccination, people can carry and spread the virus, particularly the infectious Delta variant. Thus, it makes good sense to decrease transmission regardless of your own status, to help protect others.

Should people still consider getting the flu shot this year? Yes, as the flu is very contagious, it can mimic COVID-19, and can spread easily. We don’t want to clog up hospital ERs with viral infections we can prevent. And although you may still

get the flu when you’ve had a flu shot, you’re much less likely to end up in the hospital with influenza.

What are some ways that people can build up immunity to prevent infection from viruses like the flu and COVID-19? Healthy eating, proper sleep, and exercise all have an impact on the immune system. Decreasing and managing stress, which we know can affect many aspects of immunity, is also important.

After being fully vaccinated against COVID-19, what precautions should Canadians still consider while travelling? Follow public health guidelines, wear masks, wash hands, and practise physical distancing. Wear that

mask and shield on a plane and in the airport. Get tested and, if needed, retested to be sure that you’re not at risk of infecting your loved ones.

Slowly but surely, those who have been working from home will be returning to shared work spaces. Why is it important that they take sick days if they’re feeling unwell and what can employers do to ensure that employees feel comfortable doing this? This is really important. If you come to work sick, whatever virus, you place your colleagues at risk by being in close quarters. When in doubt, stay home, work from home, and get tested. Hopefully employers will support the need for sick days and encourage honest reporting of symptoms, regardless of the workload.

What You Need to Know About the Flu Lucie Marisa Bucci, Senior Manager, Immunize Canada

o you remember last year’s flu season? You don’t? Well, there’s a good reason for that. With all of the public health measures in place to protect each other from COVID-19, a welcome consequence was the reduction in seasonal influenza circulating in Canada. With increased COVID-19 vaccination rates and some loosening of public health restrictions, however, we can expect that seasonal influenza (and other vaccine-preventable diseases) will start to make a reappearance. The words “it’s time for your flu shot” aren’t exactly what Canadians like to hear, but influenza is a serious disease usually accompanied by fever, headaches, cough and fatigue for most healthy adults and more severe symptoms that can lead to hospitalization or even death in people with high risk conditions. Even for healthy people, influenza infection can be debilitat-

ing and has been described as feeling like you’ve been hit by a bus. To make matters worse, the symptoms are very similar to those of COVID-19, so if you do get sick, you’ll likely have to quarantine and be tested for COVID-19. Many Canadians don’t know that the very young, those under five years of age, and older adults over the age of 65 are at high risk of severe influenza illness and related complications. These groups are at risk because they don’t respond as well to the influenza vaccine. Many also don’t know that in a given year an estimated 12,200 hospitalizations related to influenza occur and as many as 3,500 Canadians die from influenza and its complications, making flu prevention by healthy individuals who can pass it on to those at high risk for severe disease or complications a necessity. Healthy individuals can shed the

influenza virus and transmit influenza before they develop symptoms, and while handwashing, proper flu etiquette (coughing and sneezing into your sleeve), and staying away from others when you’re sick are important to decrease the spread of influenza, the most effective way to prevent influenza is to be vaccinated. Other people who need protection from their annual flu shot are adults and children with underlying health conditions such as asthma and diabetes, pregnant people, Indigenous peoples, and residents of long-term care facilities. The seasonal influenza vaccine is safe and your best choice to reduce your risk of getting sick. It’s free and conveniently available at your doctor’s office, local pharmacy, or local public health clinic. There’s no better benefit than protecting the ones you love by not taking chances with the flu.

Shingles: It’s Not Just a Rash

f you’re 50 years of age or more, odds are that you’ve heard of shingles or know someone who has experienced this notoriously painful condition. About 90 percent of people over 50 are at risk due to having chickenpox as children.1 Shingles, known medically as herpes zoster, occurs when the varicella zoster virus that causes childhood chickenpox is reactivated.2 While people of any age can develop shingles, the likelihood of being affected increases sharply after 50, as our immune defences weaken and resistance to the inactive chickenpox virus decreases. 2,3 About half of all cases occur in people aged 60 or over.4 Risk of shingles is also higher in people with weakened immune systems — for instance, due to cancer,

immune-suppressing medications, or even severe stress. Pain that persists for 90 days or more after the shingles rash first developed is known as postherpetic neuralgia (PHN), and may affect up to 30 percent of individuals who have shingles. 3

lowers shingles risk and may help to prevent complications such as extended nerve pain from PHN.2,3 If you’re 50 years of age or older,ask your health care professional if shingles vaccination is right for you.7

Shingles symptoms vary

Disclaimer: This information should not be used as a substitute for the medical care and advice of your doctor. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.

Shingles causes a painful, blistering rash — typically the blisters scab over in 7 to 10 days and the rash clears in 3 to 5 weeks.4 Mild shingles may be simply itchy and inconvenient. When severe, pain may interfere with daily activities, like putting on a shirt or bathing.5

Get vaccinated! There are two shingles vaccines approved in Canada.6 Vaccination

Note: the hyperlinks that direct to other sites are not continuously updated. It is possible that some links become untraceable over time. Thank you. 1. National Advisory Committee on Immunization. Statement on the Recommended use of Herpes Zoster Vaccine. January 2010, 36(ASC1):1-19. 2. Kawai K, Gebremeskel BG, Acosta CJ. Systematic review of incidence and complications of herpes zoster: towards a global perspective. BMJ Open. 2014 Jun;4(6):e004833. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC4591524/ 3. Johnson RW. Herpes zoster epidemiology, management, and disease and economic burden in Europe: a multidisciplinary perspective. Ther Adv Vaccines. 2015 Jul; 3(4): 109–120. 4. NIH National Institute on Aging (NIA). Shingles. https://www.nia.nih. gov/health/shingles 5. US Centers for Disease Control and Prevention. Shingles (Herpes Zoster): Overview. https://www.cdc.gov/shingles/about/overview.html 6. Shapiro M. “Consider getting the shingles vaccine before 65: Doctors’ Notes.” The Toronto Star. 29/01/2018. https://www.thestar.com/ life/2018/01/29/consider-getting-the-shingles-vaccine-before-65doctors-notes.html 7. US Centers for Disease Control and Prevention. Shingles (Herpes Zoster): Prevention & Treatment. https://www.cdc.gov/shingles/about/ prevention-treatment.html

Strategic Account Managers: Anna Sibiga, Madison Trajkovski Strategic Account Director: Jessica Golyatov Country Manager: Nina Theodorlis Content and Production Manager: Raymond Fan Designer: Kylie Armishaw Web Editor: Karthik Talwar All images are from Getty Images unless otherwise credited. This section was created by Mediaplanet and did not involve Toronto Star or its editorial departments. Send all inquiries to ca.editorial@mediaplanet.com. @MediaplanetCA

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How Moderna’s mRNA Technology Is Revolutionizing Health Care In the fight against COVID-19, Moderna stays ahead of the science with its mRNA platform, while also developing vaccine technology in other therapeutic areas. Anne Papmehl

T Dr. Vivien Brown Family Physician & Assistant Professor, Faculty of Medicine, University of Toronto

Dr. Beverly Francis Director of Scientific Leadership — North America, Moderna

he fall season is upon us and with it brings a lot of unknowns about the ever-changing COVID19 variants. In this climate of uncertainty, vaccination will be key to staying healthy and fighting our way out of the pandemic. “Generally, when the public is well-vaccinated, whether for flu, meningitis, pneumonia, or shingles, we see less disease and less burden on the health care system,” says Dr. Vivien Brown, a family physician in private practice in Toronto and Assistant Professor in the Faculty of Medicine at the University of Toronto. “With COVID-19 specifically, the vaccines have had a significant impact on driving down the number of hospitalizations and deaths, and in helping to create a cocooning effect to protect people who can’t be vaccinated,” she says.

lar to that observed previously for dose two of the vaccine,” says Dr. Francis. Finally, to ensure a steady supply, Moderna has been working closely with the Government of Canada to secure supply for up to 105 million doses of the COVID vaccine and its booster candidates, when authorized, for delivery through to 2024. 5

Ongoing efficacy, adolescent approval, booster shots

The Moderna COVID-19 vaccine is the first mRNA vaccine that the company has brought to market. mRNA technology is built on the foundation that our bodies can create their own defence mechanisms. mRNA-based vaccines are designed to deliver the instructions to our cells to create proteins that help activate the immune response against the virus. “It’s like giving the cell a recipe to follow, in this case a recipe to produce a spike protein, which then stimulates the antibodies,” says Dr. Brown. Moderna’s COVID-19 mRNA vaccines build on more than a decade of basic and applied mRNA science, delivery technology, and manufacturing. The precision, speed, and flexibility of the platform enabled Moderna to respond quickly to the COVID-19 pandemic, providing an effective vaccine in just under a year. “It’s such an elegant and precise platform,” says Dr. Brown. “It’s just so fortuitous that it was ready at a time when we urgently needed it.” Moderna’s mRNA platform and approach will enable the company to research, develop, and manufacture medicines in new and potentially ground-breaking ways that can help single patients with individualized therapy, or millions of patients with infectious diseases. “We’re essentially industrializing mRNA technology and scaling the scope of therapeutic targets to address diseases, viruses, and pathogens in ways that were previously considered unimaginable,” says Dr. Francis.

Moderna’s efforts are critical in the global fight against COVID-19. To date, almost 146 million doses of Moderna’s COVID vaccine have been administered in the U.S.1 and over 7.2 million have been administered in Canada.2 As the pandemic evolves, Moderna is staying ahead of the science with mRNA technology. Though the variants, waning immunity, and breakthrough infections are concerning, new data published in Science reported that the majority of individuals vaccinated with the Moderna COVID-19 vaccine maintained antibodies against SARSCoV-2 variants for six months after the second dose. 3 On August 27, 2021, Moderna’s COVID-19 vaccine was authorized by Health Canada for use in adolescent populations aged 12 and above. “We see that as a major win in the fight against COVID-19,” says Dr. Beverly Francis, Director of Scientific Leadership — North America at Moderna. “Vaccinating as many eligible Canadians as possible limits the human pool that serves as a viral reservoir, limits the spread of this virus, and greatly limits the virus’ ability to evolve and mutate into more transmissible or infective strains.” Anticipating the combination of the force of the current Delta variant, waning immunity, and pandemic fatigue will require further defensive action. Moderna is already preparing by advancing its mRNA-1273 vaccine as a booster candidate.4 “Initial research has found it to be effective in boosting responses broadly against both the ancestral and major variant strains of the virus, and the safety profile of the booster was simi-

mRNA-based vaccines are designed to deliver the instructions to our cells to create proteins that help activate the immune response against the virus. mRNA technology as the future of medicine

Robust R&D investments lead the way to new ways to treat diseases In 2020, Moderna invested $1.37 billion on R&D6 — and it has invested $2.3 billion over the past three years.

Moderna’s mRNA pipeline includes 23 projects in development and 15 clinical study programs currently underway.5 Within the infectious disease modality, Moderna currently has nine vaccines in development for major unmet needs, including next-generation vaccines for COVID-19, influenza, cytomegalovirus (CMV), respiratory syncytial virus (RSV), human metapneumovirus (hMPV), parainfluenza (PIV3), and Zika. It has an additional 12 medicines in development across four therapeutic areas — immuno-oncology, rare diseases like propionic acidemia, cardiovascular diseases, and autoimmune diseases.7 “The breadth of the mRNA platform and its capabilities are really energizing,” says Dr. Francis. “If you understand what mRNA is at its core and figure out how to deliver it, as we’ve done, you can see we’re just at the beginning.” Clinical trials are underway to assess two of Moderna’s new respiratory vaccine candidates — one is a quadrivalent mRNA seasonal flu vaccine candidate, and the other aims to protect against RSV. 8 “Our vision is to develop a combination respiratory vaccine for adult and older adult populations, combining seasonal flu, RSV, and COVID-19 booster all in one shot,” says Dr. Francis. “Doing many things in parallel to protect against three serious respiratory viruses at once is typical of the spirit and boldness of Moderna.”

To explore how mRNA science is being used in vaccines, visit modernacovid 19global.com/ca. This article was made possible with support from ModernaTx.

IN THE PIPELINE Cancer Vaccines

Intratumoral Immuno-Oncology

Localized Regenerative Therapeutics

Prophylactic Vaccines

IMPORTANT SAFETY INFORMATION Health Canada has authorized the sale of this COVID-19 vaccine under an Interim Order. COVID-19 Vaccine Moderna is a vaccine used to prevent the coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 virus. It can be given to individuals aged 12 years and older. As with any vaccine, COVID-19 Vaccine Moderna may not fully protect all those who receive it. Even after you have had both doses of the vaccine, continue to follow the recommendations of local public health officials to prevent the spread of COVID-19. Individuals may not be optimally protected until after receiving the second dose of the vaccine. The most common or very common side effects of COVID-19 Vaccine Moderna are pain at the injection site, tiredness, headache, muscle ache and stiffness, chills, fever, swelling or redness at the injection site, nausea and/or vomiting and enlarged lymph nodes. Allergic reactions may also occur. Vaccination may not be suitable for everyone, so ask your health care professional if COVID-19 Vaccine Moderna is right for you. Full product information can be found on https://www.modernacovid19global.com/ca/. To report an adverse event, please call 1-866-MODERNA (1-866-663-3762).

Systemic Intracellular Therapeutics

REFERENCES 1. Centers for Disease Control and Prevention. COVID-19 vaccinations in the United States. U.S. Department of Health & Human Services: September 2, 2021. https://covid.cdc.gov/covid-data-tracker/#vaccinations 2. Public Health Agency of Canada. Canadian COVID-19 vaccination coverage report. Ottawa: Public Health Agency of Canada; August 21, 2021. https://health-infobase.canada.ca/covid-19/vaccination-coverage/ 3. Moderna press release, August 12, 2021. https://investors.modernatx.com/news-releases/news-release-details/moderna-announces-new-study-showing-its-covid-19-vaccine 4. Moderna press release, September 1, 2021. https://investors.modernatx.com/news-releases/news-release-details/moderna-announces-submission-initial-data-us-fda-its-covid-19 5. Moderna press release, August 16, 2021. https://investors.modernatx.com/news-releases/news-release-details/moderna-announces-supply-agreement-canada-expanded-supply 6. Moderna press release, February 25, 2021. https://investors.modernatx.com/news-releases/news-release-details/moderna-reports-fourth-quarter-and-fiscal-year-2020-financial 7. 2Q2021 Moderna Earnings Call Business Update presentation, August 5, 2021. https://investors.modernatx.com/static-files/d427592c-dab4-4715-a568-31207d9832ab (slide 9). 8. 2Q2021 Moderna Earnings Call Business Update presentation, August 5, 2021. https://investors.modernatx.com/static-files/d427592c-dab4-4715-a568-31207d9832ab (slide 34).

Systemic Secreted Cell Surface Therapeutics

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The Expanding Role of Pharmacists in Vaccinations and Immune Health As the pharmacy model changes, pharmacists play an increasingly critical role in the COVID-19 vaccination campaign and the public’s overall immune health. Anne Papmehl

Tim Brady Chair, Ontario Pharmacists Association & Pharmacy Owner

Sandra Hanna CEO, Neighbourhood Pharmacy Association of Canada

Sherif Guorgui Co-CEO & Chief Strategy, Stakeholder, & Government Relations Officer, OnPharm-United

he pandemic has cast a spotlight on the unique expertise of pharmacy professionals. “I think this current situation has helped the public see the value we bring to the health care system and their daily lives, rather than just seeing us as people who put pills into bottles,” says Tim Brady, Chair of the Ontario Pharmacists Association and pharmacy owner. During the COVID-19 vaccine rollout, pharmacy professionals played a key role in administering vaccines efficiently and effectively. As of August 2021, pharmacy professionals had administered over 3.5 million doses of COVID-19 vaccines through Ontario pharmacies, and the number continues to grow. In the past, pharmacists didn’t have injection authority for all types of vaccines, though they’ve long had the training and desire for it. The pandemic has highlighted the significant role that pharmacy professionals play in the health care system and their ability to be versatile and to assist in a crisis. Additionally, it has shown the depth and breadth of pharmacists’ capabilities, not only in delivering immunizations but in supporting public immune health.

Accessible and convenient “As the most accessible and flexible of all health care practitioners, our goal is to remove the barriers that prevent people from getting vaccinated,” says Brady. “The ability for people to sit down and have a five-minute conversation with a knowledgeable professional in their own community to ask questions, and to have their fears dispelled or information clarified, is

something we pharmacy professionals are well-situated to provide.” Since pharmacists were granted authority to administer flu vaccines in 2012, yearly doses administered in pharmacies have been approximately one million. Last fall, Ontario pharmacists administered 1.8 million flu shots. Also, in December 2020, the government expanded pharmacists’ scope of practice to allow the administration of flu vaccines to patients two years of age and older (the age for flu administration by pharmacists was previously set to five years of age and older). As trusted health care providers, pharmacists can protect communities through immunization and educate patients. “I think it’s just a natural progression when COVID-19 happened and I think it’s just the convenience factor, people trying to get injections and the ability of pharmacists to do so,” says Brady. Pharmacists have the training and expertise to relieve the burden on a highly-stressed health care system. “People have always seen us as knowledgeable and trustworthy, but now with COVID-19, they see how convenient and accessible we are as well,” says Brady. Throughout the pandemic, pharmacies continued to operate and to assist patients while also navigating new responsibilities and the complexities of the pandemic.

Pharmacy has the capability to support vaccination campaigns It’s important for pharmacy associations, foundations, and other professional bodies to align their messaging about immunization and to empower pharmacy professionals through advocating for government regulations to better

protect the public. The Canadian Foundation for Pharmacy has raised millions of dollars for pharmacy research since its establishment in 1945. It has helped make the case for pharmacist immunizations and other important issues such as prescribing for minor ailments, and current projects explore the pharmacist’s role in mental health, medical cannabis, and virtual care. The Ontario Pharmacists Association (OPA) has been advocating with the Ontario provincial government to leverage pharmacy to get more vaccination campaigns completed. “I think we’ve shown that we’ve been able to increase the rate of vaccinations by removing barriers,” says Brady. In Essex County alone, where Brady runs his pharmacy, 35,000 shots were administered in under three weeks by the end of March. “When you look at the number of independent pharmacies around, even if you do just 20 to 30 shots per day, that gets into the thousands when you add them up,” he says. The OPA advocates on behalf of pharmacy professionals for the government to implement policies and regulations that protect all Ontarians and improve the efficiency and effectiveness of our health care system. “At the end of the day, our focus is on the patients and the people of Ontario and what’s best for them, and we think that we can be part of that solution,” says Brady.

To learn more about the impact of pharmacists and the future of the pharmacy profession, visit readyfor whatsnext.ca. This article was supported by the Ontario Pharmacists Association and the Canadian Foundation for Pharmacy.

Unlocking Pharmacy’s Potential to Prevent a Secondary Public Health Crisis

his month, students returned to the classroom following a school year that was anything but normal. While many parents are excited for their children to be back in class, they remain concerned that their child may get sick while in school. For the past two years, COVID-19 has required the sustained attention of government and health care systems. This critical focus has created unintended consequences, including the inability to administer routine child and adult immunizations aimed at preventing viruses such as measles, hepatitis B, and HPV for students and shingles and pneumonia for adults and seniors, amongst others. This lapse in vaccines has the potential to result in

a secondary, entirely avoidable public health crisis. Throughout the pandemic, over one third of Canadian parents cancelled or postponed scheduled vaccinations for their children. Many school-based public health programs also faced delays or pauses due to limited public health capacity. Fortunately, during the pandemic pharmacies across the country have proven that they have the expertise, capacity, and public confidence needed to safeguard our communities. Last year, pharmacies across Canada administered a record 5.6 million flu shots and over 40 percent of COVID-19 vaccinations. This was done by offering Canadians access

to care closer to home, with flexible appointment options and extended hours. Research shows that nearly 90 percent of Canada’s pharmacies routinely administer immunizations and 87 percent of Canadians would be comfortable receiving a vaccine in pharmacies. Despite these facts, pharmacy’s ability to create capacity in public health and to support broader immunization efforts in Canada is under-utilized. It’s critical that we act now to protect our children, seniors, and all Canadians from another potential public health crisis that can easily be avoided through routine vaccinations. Pharmacies are ready to lead the way in these vital, ongoing vaccination efforts.

To learn more, visit neighbourhood pharmacies.ca.

This article was supported by the Neighbourhood Pharmacy Association of Canada.

Pharmacies Offer Ontarians Increased Access to Vaccination Ontarians’ immune health and access to immunization have become more important than ever and pharmacies are playing a vital role. Tania Amardeil

n the early days of the pandemic, our health care system was stretched thin. Line-ups for COVID-19 testing snaked around buildings, hospitals started filling, and many doctors began working from home. “Fortunately, Ontario pharmacies were available to help ease the increased constraints on the health care system,” says Sherif Guorgui, Co-CEO and Chief Strategy, Stakeholder, and Government Relations Officer at OnPharm-United, a network of more than 600 independent pharmacy owners across Ontario. Pharmacists and pharmacy staff were on the front lines, conducting COVID-19 tests as soon as they could.

This year, they’ve been administering COVID-19 vaccines since March. “Over 1.8 million flu shots and over 3.3 million COVID-19 shots have been administered in Ontario pharmacies this year,” says Guorgui, adding that “offering the vaccine at pharmacies is a convenient, safe, and effective way to make sure that Ontarians’ needs are met.”

Taking pressure off our health care system These numbers highlight the extent to which pharmacies play a significant role in alleviating the pressure on Ontario’s health care system. Ontario pharmacists have been administering

flu vaccines for nearly a decade and can also provide a variety of other vaccines, from travel vaccines to vaccination against HPV, shingles, and more. “As the government continues to look for effective ways to get more Ontarians vaccinated, it’s imperative that it includes pharmacy as part of the solution,” says Guorgui. To sustain that viability and alleviate the pressures our health care system is under, expanding pharmacists’ and pharmacy technicians’ scope of practice is an important next step to keep our communities healthy and safe. Guorgui also notes the importance of adopting a fair and equitable funding model.

To learn more about OnPharm-United, visit onpharm united.ca. This article was supported by OnPharmUnited.

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It Takes a Community to Keep Everyone Safe

Inclusive Health Care Is Crucial for this Year’s Flu Season

Ian Culbert, Executive Director, Canadian Public Health Association

Zahir Hirji, President, Infection Prevention & Control Canada (IPAC Canada)

References 1. Public Heath Ontario Learning Exchange: COVID-19 vaccine uptake and equity considerations 2. Public Health Ontario Health Equity and COVID-19 3. Eissa, A., Lofters, A., Akor, N., et al Increasing SARS-CoV2 vaccination rates among Black people in Canada. CMAJ 2021 Aug 9: 193(31):E1220-E1221. 4. Quach, S et al. Influenza vaccination coverage across ethnic groups in Canada. CMAJ 2012 Oct 16: 184(15): 1673-1681.

hile Canadians are grappling with increasing COVID-19 cases across the country, during this enervating time many health care workers are already wondering and planning for what the impending influenza season will be like. The overwhelming focus on health care over the past 18 months has highlighted many health care inequities and disparities across Canada. As a country, we will be remiss if we don’t learn and apply the lessons from COVID-19 vaccine distribution, uptake, and acceptance and apply them to the flu campaign. Specifically, we must focus on the polarizing effects of COVID-19 on Black and Indigenous communities in Canada. Influenza vaccine has traditionally had lower effectiveness than what has been achieved with the current COVID-19 vaccines. With current surveillance systems that don’t track influenza cases with the same clarity and the lack of race-based information, many questions remain. The minimal influenza season of 2020 to 2021 may leave a higher level of susceptibility in Canadians, further supporting the rationale to get vaccinated. The value of being vaccinated has been well-illustrated in some of Canada’s most vulnerable populations, like long-term care residents. Great work is being done in many jurisdictions to develop equity-centered health care practices that are informed by culturally-safe guidance. In particular, building trusting relationships requires time and patience. Health care workers need to be aware of and acknowledge past traumatic experiences. In a 2012 study researchers reported lower vaccinations rates amongst Black people in Canada compared to other ethnic groups. In 2021, the situation remains unchanged. A recent report from Public Health Ontario highlights the disproportion in COVID-19 cases amongst Black people in Canada compared to the overall population. We have a unique opportunity, right now while Canadians are listening, to offer access to resources, to leverage local successes with COVID-19 vaccine programs to bolster influenza vaccination initiatives, and to build structures that will continue to prioritize the health care needs of Black, Indigenous, and people of colour in Canada. We know that flu vaccinations remain one of the best ways to protect yourself and your loved ones against flu and its potentially serious complications.

Disclaimer: The IPAC Canada Diversity, Equity and Inclusion Working Group have collaborated on this article.

n every community, there are individuals such as infants, older adults, and organ transplant recipients who rely on the immunity of others to keep them healthy and safe from disease. You may have already come across the term “community immunity.” Community immunity happens only when a large number of individuals in a community are immune to a disease through vaccination and/or prior illness. The most safe and efficient way to achieve community immunity is through vaccination, which is the introduction of a weakened or dead virus or bacteria into the body aimed at priming your immune system without making you ill. The aim of vaccination is to limit or stop the spread of contagious diseases by reducing the ability of viruses and bacteria to be transmitted from one person to another. The exact number of individuals needed to achieve community immunity varies. Canada’s National Immunization Strategy has established vaccination coverage goals of 95 percent for all childhood vaccines by two and seven years of age. Vaccination coverage of 80 percent is the objective for seasonal influenza and has been established based on the importance of protecting Canadians at high risk for influenza-related complications, hospitalizations, and death. Community immunity is always important to keep contagious vaccine-preventable diseases under control. During the COVID-19 pandemic, however, reaching immunity that benefits others is more challenging because of new variants, vaccine hesitancy and refusal, and the fact that children under the age of 12 are currently ineligible for vaccination. Despite these challenges, early reports on achieving community immunity against COVID-19 estimated that approximately 70 percent of the population would need to be vaccinated. More recently, estimates have set the goal closer to 80 to 90 percent for vaccinated communities. Community immunity is still within our grasp. As of August 31, 2021, 67.8 percent of Canada’s population was fully vaccinated. That means we’re well on our way to community immunity. But until we reach our goal, there are individuals in every Canadian community who remain at risk of COVID-19 and need our help to stay protected. We must continue to limit the spread of COVID-19 by encouraging vaccination and following public health measures.

Dyson’s Purifier Technology Is a Breath of Fresh Air Modern homes can trap dangerous air pollution indoors. Here’s how Dyson technology helps tackle the invisible threat.

Veronica Stephenson

Karen Holeyman Microbiology Research Manager, Dyson

arring clouds of smog you might see in especially polluted cities, air pollution is often invisible — and likewise, often overlooked. Unfortunately, its inconspicuousness doesn’t make it any less harmful. According to the World Health Organization, long-term exposure to air pollution can dampen your immune system and significantly elevate your risk of chronic diseases and premature death.1 And while many believe it’s strictly an outdoor problem, according to the U.S. Environmental Protection Agency, the concentration of certain pollutants can be two to five times higher indoors than outdoors.2

Common sources of indoor air pollution Sam Taylor Engineer, Dyson

Air pollution is not a single substance. Rather, it’s the presence of harmful particles small enough to inhale — like lead, H1N1 influenza virus, nitrogen oxide, benzene, and formaldehyde, to name a few — generated by any number of sources, inside and out. To some extent, we can seal out particles that come from city traffic and industrial plants, but from dust mites to harmful gases, there’s more going on inside your home than you think. “Many of us live in well-sealed, closed environments, so we often don’t get adequate ventilation and pollution can get trapped inside,” says Karen Holeyman, Microbiology Research Manager at Dyson. “For instance, formaldehyde is a processing aid in many carpets and furnishings. When you come indoors from the outside, you release dust into

your home. Indoor plants produce pollen. And environmental conditions seriously affect the presence of certain pollutants. In high humidity, some viruses composed entirely of nucleic acids and proteins, like adenoviruses and the coxsackieviruses, are more likely to survive and thrive.”3

Indoor pollution is no match for modern purifiers Fortunately, while pollution outside our front door is also outside our control, there are highly effective ways to maintain indoor air quality. Regular vacuuming and dusting is a great start, but investing in a good-quality air purifier should be considered to make a significant difference. Modern technology has made it possible for researchers to closely study the particles air pollution consists of and to find innovative ways to filter them out before they can affect your health. “Dyson purifiers are engineered to capture 99.97 percent of pollution as small as 0.3 microns. Air is drawn in through the base of the machine and then passes through a series of filters that capture pollutants such as from allergens, mould, formaldehyde, nitrogen dioxide, benzene, VOC’s and more,” says Sam Taylor, a Dyson engineer. “The clean air is then projected out of the amplifier, ensuring that the purified air reaches every corner of the room.”4 Thanks to a fully-sealed filter system that incorporates HEPA and activated carbon filters, Dyson purifiers have even been scientifically tested to capture particles as small as allergens and viruses, including the H1N1 influenza virus.5 This

is an important distinction as we head into allergy and cold and flu season. Some purifiers even go well beyond the call of duty. Dyson’s Purifier Hot+Cool Formaldehyde HP09 model automatically detects and continuously breaks down formaldehyde into water and carbon dioxide.6 It also doubles as a space heater in the winter, and in the summer, it releases an even stream of air to make your space more comfortable and cool. For added peace of mind, it even features a handy display. “To make invisible air pollution visible, Dyson purifiers include an LCD screen on the front of the machine that shows you in real time when pollution is sensed and captured,” says Taylor. 1 C40 Cities Climate Leadership Group, C40 Knowledge Hub. (2019). Why clean air is vital for your city’s health and prosperity. 2 United States Environmental Protection Agency. (2021). The Inside Story: A Guide to Indoor Air Quality. 3 Arundel A., Sterling M., Biggin J., Sterling T.(1986). Indirect Health Effects of Relative Humidity in Indoor Environments. Environmental Health Perspectives, Vol.65. 4 Tested for air projection (DTM801) and purification coverage in a 2860 ft3 room (TM-003771). 5 Whole machine tested by independent third-party laboratory for capture of Influenza A (H1N1) 6 Third party full machine testing based on GB/T 18801-2015 formaldehyde cumulative clean mass testing with continuous injection until plateau of formaldehyde CADR is achieved. Results may vary in practice.

To learn more about air purifiers, visit dysoncanada.ca/ en/air-treatment/ air-purifiers . This article was sponsored by Dyson Canada.