COVID Corner | The Ismaili Canada
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COVID Corner

The COVID Corner is the Jamat's easily accessible page for information relating to the COVID-19 pandemic. As updated information is received, it will be made available to the Jamat on this page. Please check back regularly for the most up-to-date COVID-19 related content. 

 

General Information About Vaccines

Emerging evidence shows that all COVID-19 vaccines authorized for use in Canada protect against severe disease, hospitalization and death due to COVID-19.  Free vaccines for COVID-19 are available to everyone above age 5 who lives in Canada. Based on the Talika received by Mawlana Hazar Imam on March 18, 2021 and December 13 2021, the Jamat is encouraged to benefit from the protection these vaccines provide without hesitation or delay, as indeed the Imam has done already. In particular, the Jamat should not give credence to any misinformation regarding vaccines.

 

To help support the Jamat with the COVID-19 vaccination process, we have compiled a list of Frequently Asked Questions regarding the vaccine. This information has been prepared by a multidisciplinary team including specialists in medicine, nursing, pharmacy and public health, based on the most recent evidence available.

Vaccinations - Frequently Asked Questions
What do we currently know about the Omicron variant?

On November 24, 2021, a new variant of COVID-19, now known as the Omicron variant of concern, was reported to the World Health Organization. On November 28th, the first two cases of the Omicron coronavirus variant were confirmed in Canada.

It is clear that the Omicron variant of concern is going to have a significant impact on COVID-19 disease in Canada [1]. Omicron transmits very quickly. Early evidence suggests it can produce severe disease. It is quickly becoming the dominant strain globally.

Although South Africa is cited as evidence of Omicron’s lower severity, there has been a rise in hospitalizations, intensive care unit occupancy, and in-hospital deaths despite a younger population with some immunity [2]. 

It will be important to optimize protection over the long term. Vaccines are only one part of a dynamic public health response, and it is important to maintain recommended public health measures over the coming weeks and months while the Canadian population strengthens immunity through booster shots.

Manufacturers are currently working on Omicron-specific mRNA boosters, which may become available in the summer of 2022. At this time, vaccines and vaccine boosters are an important and effective line of defence against severe coronavirus disease.

How effective are the vaccines (and vaccine boosters) against the Omicron variant?

There is uncertainty around how the vaccines’ effectiveness for Omicron mutations, however, preliminary data show that the effectiveness of a two-dose regimen (primary regimen) without booster is reduced. According to a press release from a South African private health system, two doses of the Pfizer COVID-19 vaccine were associated with 33 percent effectiveness against any infection and 70 percent effectiveness against COVID-19-associated hospitalization during the Omicron surge [4].

Although vaccines are less effective against Omicron infection, boosters can substantially increase protection. Even 2 doses likely provide strong protection against severe illness. Remaining unvaccinated dramatically increases the chance of severe illness.

Unpublished laboratory reports suggest that individuals without boosters have up to 127-fold lower immune activity against the Omicron variant than against the original strain of the virus [5]. However, these studies also suggest that previously infected individuals who are vaccinated and individuals who receive booster vaccination retain adequate neutralizing antibodies against Omicron. The clinical implications of these findings are uncertain, in part because there are other mechanisms of vaccine immunity not accounted for in these laboratory experiments.

 

Is the flu shot important this year and if so, what are the benefits?

It is safe to receive the COVID-19 vaccine and the flu shot at the same time.

If you are receiving your flu shot and are eligible for a COVID-19 immunization (or vice-versa), now is the time to get them. Last year, uptake of the flu vaccine was the highest in recent history across many provinces. Getting the flu vaccine will help keep us healthy this flu season and will help prevent unnecessary visits to the hospital during the fourth wave of COVID-19.

Flu vaccination prevents millions of illnesses and flu-related doctor’s visits each year. During seasons when flu vaccine viruses are similar to circulating flu viruses, the flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40 percent to 60 percent [6]. Additionally, among adults, flu vaccination was associated with a 26% lower risk of intensive care unit admission and a 31% lower risk of death from flu compared to those who were unvaccinated. Furthermore, a study in 2017 showed that flu vaccination can significantly reduce a child’s risk of dying from flu [7].

 

Where and how can I get the vaccine?

COVID-19 vaccines are approved for use in Canada are free of charge. Where and how to get your vaccine may differ depending on where you live in Canada. For information on the vaccination rollout plans in your province or territory, please refer to your provincial or territorial website:

Are the vaccines safe and what are possible side effects?

All COVID-19 vaccines authorized for use in Canada help reduce severe disease, hospitalizations and deaths from COVID-19.

Health Canada has conducted a rigorous scientific review of the available medical evidence to assess the safety of the COVID-19 vaccines. The National Advisory Committee on Immunization is an independent scientific advisory group of experts that also reviews all of the evidence and makes recommendations on the use of COVID-19 vaccines [1]. These COVID-19 vaccines are safe and effective, and the benefits outweigh any potential risks for the populations in whom the vaccines are recommended. Groundwork for a safe and effective vaccine had already been laid after the first SARS coronavirus outbreaks in 2002-2004 and the Middle East Respiratory Syndrome coronavirus outbreaks in recent years [8]. Canada is recognized around the world for its high standards in reviewing, approving, and monitoring medications and vaccines. These high standards have not been compromised for the COVID-19 vaccines. 

The side effects that followed COVID-19 vaccine administration in clinical trials were mild or moderate and went away in 1-2 days. These included things like pain at the site of injection, body chills, joint pain, muscle aches, swollen lymph nodes, feeling tired and feeling feverish [1].  If you experience these side effects, you can put a cold compress on the injection site and move your arm around to reduce pain and swelling, rest, drink fluids, and take acetaminophen or ibuprofen AFTER vaccination.

The Ismaili Imamat and its institutions have a long history of supporting and promoting vaccination to improve health. In 1897, Imam Sultan Muhammed Shah played a major role in stopping the spread of Bubonic Plague in Bombay. He was immunized in front of a large crowd to show people that vaccinations are nothing to be afraid of. To this day, educating people about vaccination is an important part of the work of The Aga Khan Health Services and The Aga Khan Health Boards. 

A small number of cases of myocarditis and/or pericarditis following immunization with mRNA COVID-19 vaccines (Pfizer and Moderna) have been reported in Canada and internationally. Internationally, cases have been reported more frequently in adolescents and younger adults under 30 years of age, more often in males than in females, and more frequently after a second dose. The majority of cases have been mild and individuals have recovered quickly. There are many potential causes of myocarditis and pericarditis, including viral infections. It can also occur as a complication in people who are infected with COVID-19. The benefits of the COVID-19 immunization program continue to outweigh the relatively small risk for all people, including adolescents.

Should I still wear a mask after getting the vaccine?

Yes. The vaccines are effective in preventing COVID-19 disease, but it is still unknown whether they prevent infection. So, you may still be able to spread infection to others even after you are vaccinated. Also, the evidence on how long protection from the vaccines lasts is still being collected. Mutations in the SARS-CoV-2 virus have been identified, some of which make the virus more infectious and transmissible.  These “variants of concern” may also affect the severity of disease and the level of protection offered by vaccines against them. There is evidence that wearing a mask, physically distancing, and handwashing are effective in protecting against COVID-19 infection, so you should continue to do these things even after getting the vaccine to protect yourself and those around you.

As Mowlana Hazar Imam stated in the Talika Mubarak received on July 11, 2021: “The success of a range of vaccines in affording significant protection against the Coronavirus is most encouraging, and my Jamat around the world should show no hesitancy in getting vaccinated as soon as that opportunity is made available by the health authorities. However, my spiritual children should also remain mindful that being fully vaccinated does not diminish the requirement for ongoing personal care and vigilance in the face of the unexpected threats that new variants of the virus will continue to pose.”

Is it safe to get the COVID-19 vaccine if I have an underlying condition?

Yes. The authorized vaccines are similarly safe and effective in those with one or more underlying conditions (for example, obesity, chronic pulmonary disease, diabetes mellitus, cardiac disease).[1] Also, since those with underlying conditions are more susceptible to severe COVID-19 disease, individuals with underlying conditions benefit most from protection against the disease offered by vaccines. There is strong evidence that individuals with certain medical conditions (e.g., Type 1 and 2 diabetes, down syndrome, end-stage kidney disease, epilepsy, and neurologic disorders such as motor neuron disease, multiple sclerosis, myasthenia gravis and Huntington’s disease) have at least a 2-fold increased risk of death from COVID-19.[1] It is especially important for individuals with these medical conditions get vaccinated.

 

Immunosuppression and Autoimmune Conditions

 

The Canadian National Advisory Committee on Immunization (NACI) preferentially recommends that a complete three-dose vaccine series with an mRNA COVID-19 vaccine (Pfizer-BioNTech or Moderna) should be offered to individuals in the authorized age group, including those who are immunosuppressed or have an autoimmune condition. If they are not able to receive an mRNA vaccine, for example because of an allergy, another authorized COVID-19 vaccine should be offered.[1]

Over time, we have seen very encouraging evidence for COVID-19 vaccines (primarily mRNA vaccines – Pfizer-BioNTech and Moderna) in populations with immunosuppression or autoimmune conditions who were not included in the original clinical trials, but who have now been included in subsequent real-world studies. Studies of mRNA vaccines in individuals receiving immunosuppressive therapy, solid organ transplant recipients, cancer patients and individuals with chronic inflammatory diseases have shown that these vaccines are safe in these individuals. Studies of mRNA and AstraZeneca COVID-19 vaccines suggest that the immune response may be lower in these populations. Therefore, it is especially important that individuals who are immunosuppressed due to disease or treatment be especially careful to reduce their risk of infection by wearing masks, physically distancing, and washing their hands even after vaccination.

Given the ongoing risks of COVID-19 exposure and severe disease in Canada, NACI is strongly recommending vaccination for people with autoimmune or immunosuppressive conditions, along with the rest of the population.[1] COVID-19 vaccination in these populations is especially important because of evidence suggesting that people who are immunosuppressed (e.g., those with cancer) or have certain autoimmune conditions (e.g., diabetes, multiple sclerosis) are at an increased risk of hospitalization or death from COVID-19.

What about adolescents?

While adolescents are at lower risk than adults, some adolescents may still develop severe COVID-19, or may require hospitalization because of COVID-19. Two of the vaccines, Pfizer and Moderna, are approved for people 12 years of age and older and have been shown to prevent severe illness and hospitalization in adolescents. The availability of COVID vaccines for adolescents in Canada will allow them to resume the activities that are so central to their health and wellbeing, including in-person schooling, events with friends and family, and extracurricular activities, in accordance with local public health measures [1].

According to the National Advisory Committee on Immunizations, in people aged 12 years old and older, COVID-19 vaccines may be given at the same time as, or anytime before or after, other vaccines, including the influenza (flu) vaccine.

See also “​​What should I do if I or my loved ones have a fear of needles?”

What about children?

In November 2021, Health Canada approved the use of the Pfizer vaccine for children five to 11 years of age. This is a lower dose of the vaccine than the one used in individuals age 12 and older.

Although severe illness due to COVID-19 infection is less frequent in children compared to adults, children can still be hospitalized and even require admission to an intensive care unit due to COVID-19. Some children can also develop other complications from COVID-19 beyond the infection itself, including a condition called multisystem inflammatory syndrome (MIS-C). While highly treatable and rare, approximately one in three children hospitalized with MIS-C will require ICU care. Further studies will be needed to assess how well the vaccines protect against such complications from COVID-19 [9].

Over 3,000 children aged five to 11 received the vaccine through the clinical trial and no serious side effects have been detected in the ongoing study after more than three months of follow-up. The vaccine was shown to be 91 percent effective against symptomatic COVID-19 with mild side effects like those seen in adults and older children. These side effects include arm tenderness, fatigue, headache, muscle pain, joint pain, chills and fever, which can also be seen with other vaccines recommended for children. Rare side-effects that have been seen in older teens and young adults are expected to be extremely rare in children [9].

Another benefit of vaccination in children is that it can help get them back to school and back to extracurricular activities more quickly. The pandemic has had a major impact on the wellbeing of children. Vaccination will help return children to their regular activities and thus help improve the mental health and psychosocial wellbeing of children.

COVID-19 vaccines for children 5-11 years old should not routinely be given concomitantly (i.e., same day) with other vaccines (live or non-live). In the absence of evidence, it would be prudent to wait for a period of at least 14 days before or after the administration of another vaccine before administrating a COVID-19 vaccine to prevent erroneous attribution of an AEFI to one particular vaccine or the other. This suggested minimum waiting period between vaccines is precautionary at this time.

For children ages six months to four years, full clinical trial results are expected to be submitted to Health Canada sometime in 2022, after which the full Health Canada review process will take place [9].

See also “​​What should I do if I or my loved ones have a fear of needles?”

What if I am pregnant or breastfeeding?

International real world data (mostly with mRNA vaccines – Pfizer-BioNTech and Moderna) showed that COVID-19 vaccines are safe in pregnant and breastfeeding women. 

The Canadian National Advisory Committee on Immunization (NACI) preferentially recommends that a complete vaccine series with an mRNA COVID-19 vaccine (Pfizer-BioNTech or Moderna) should be offered to individuals in the authorized age group who are pregnant or breastfeeding. If they are not able to receive an mRNA vaccine, for example because of an allergy, another authorized COVID-19 vaccine should be offered. NACI's recommendation to receive a COVID-19 vaccine for those who are pregnant or are breastfeeding are now the same as the recommendations for the general adult population.[1]

A recently published preliminary analysis of 35,691 pregnant women in the United States who received an mRNA COVID-19 vaccine did not reveal any obvious safety signals [10]. Also, analysis of data collected through international COVID-19 immunization registries to date have not revealed any maternal or infant safety signals.[3] Vaccination of pregnant women has been strongly supported by physician groups because in areas of the country where “variants of concern” are circulating, there has been increased concern about the severity of COVID-19 among pregnant women who are getting extremely sick, very quickly, and being admitted to ICUs in increased numbers.[11]

COVID-19 mRNA vaccines are not live vaccines and, based on their biologic mechanism, mRNA vaccines are not hypothesized to be a risk to breastfeeding infants. One small study found that mRNA from COVID-19 vaccines was undetectable in breastmilk 4-48 hours post-vaccination.[1] 

 

What if I have a history of severe allergy (e.g. anaphylaxis)?

Individuals with common allergies to medications, foods, inhalants, venoms, and latex are no more likely than the general public to have an allergic reaction to the COVID-19 vaccines.[3] People with severe allergies (e.g. anaphylaxis) to an ingredient in a given COVID-19 vaccine should not receive it. These cases are rare. If you are a person who has a history of severe allergic reactions (e.g. if you carry an epinephrine auto injector), speak with your health professional before receiving the vaccine. 

 

The list of ingredients for each vaccine is available at the links below:

Pfizer-BioNTech

Moderna

AstraZeneca 

Janssen

 

The potential non-medicinal ingredients in the vaccines known to cause allergic reactions (ranging from mild skin reactions to severe anaphylactic reactions) are as follows [3]*. If you are a person who has a history of severe allergic reactions (e.g. if you carry an epinephrine auto injector), speak with your health professional before receiving the vaccine:

Pfizer-BioNTech COVID-19

  • Polyethylene glycol (PEG), which is also found in over the counter products (e.g., cough syrup, laxatives), prescription medications, medical bowel preparation products for colonoscopy, skin care products, dermal fillers, cosmetics, contact lens care solutions, and products such as ultrasound gel.

Moderna COVID-19

  • PEG, which is also found in over the counter products (e.g., cough syrup, laxatives), prescription medications, medical bowel preparation products for colonoscopy, skin care products, dermal fillers, cosmetics, contact lens care solutions, and products such as ultrasound gel.

  • Tromethamine (trometamol or Tris), which is also found in contrast media, oral and intravenous medications.

AstraZeneca COVID-19

  • Polysorbate 80, which is also found in medical preparations (e.g., vitamin oils, tablets, and anticancer agents), and cosmetics.

Janssen COVID-19

  • Polysorbate 80, also found in medical preparations (e.g., vitamin oils, tablets, and anticancer agents), cosmetics

 *This may not be a complete list

Should I get a vaccine if I have already had COVID-19 and recovered?

Yes. Receiving a vaccine after you have already had COVID-19 can help to prevent a second COVID-19 infection, which has been reported in several cases.

Although some areas with limited vaccine supply may first vaccinate those who have not had confirmed COVID-19 infection previously, the vaccine can and should be administered to people who have had COVID-19.[1] 

I can get natural immunity to COVID-19. Why should I get a vaccine?

Getting COVID-19 might offer some natural protection. Current research suggests that reinfection with COVID-19 is uncommon in the 90 days after initial infection. However, experts don’t know for certain how long this protection lasts, and the risks of death, severe illness or long-term lingering symptoms from COVID-19 far outweighs any benefits of natural immunity. COVID-19 vaccination will help protect you by creating an antibody response from your immune system without having to experience COVID-19 sickness.

Can mRNA vaccines alter genes or change DNA?

No, mRNA vaccines do not change your DNA. The mRNA is like a post-it note with a recipe. The recipe has instructions to create the spike protein found on the surface of the virus that causes COVID-19. Once the protein is made, the mRNA or 'recipe' is destroyed by the enzymes in our cells. This is why mRNA doesn't stay in our body for long. The spike protein created by the mRNA will allow your immune system to build a response and begin making antibodies to protect you.

What are myocarditis/pericarditis and how are they related to mRNA COVID-19 vaccines?

Myocarditis is inflammation of the heart muscle and pericarditis is inflammation of the lining around the heart. There are many potential causes of myocarditis and pericarditis, including viral infections. It can also occur as a complication in people who are infected with COVID-19. A small number of cases of myocarditis and/or pericarditis following immunization with mRNA COVID-19 vaccines (Pfizer and Moderna) have been reported in Canada and internationally. Internationally, cases have been reported more frequently in adolescents and younger adults under 30 years of age, more often in males than in females, and more frequently after a second dose. The majority of cases have been mild and individuals have recovered quickly.

People who are offered an mRNA COVID-19 vaccine should be informed of the very rare risk of myocarditis and/or pericarditis following immunization and should be advised to seek immediate medical attention if they develop symptoms, which may include chest pain, shortness of breath, or the feeling of a fast, pounding or fluttering heartbeat. Cases typically occur within a week after the receipt of an mRNA vaccine dose, more commonly after a second dose. Any potential cases should be investigated with medical assessment regardless of timing from vaccination to onset.

The Canadian National Advisory Committee on Immunization (NACI) has been closely monitoring the evolving situation of rare cases of myocarditis and/or pericarditis following mRNA vaccination among younger people. NACI is encouraged to see that the clinical presentations appear mild and resolve quickly.

The benefits of the COVID-19 immunization program continue to outweigh the relatively small risk for all people including adolescents. As a precaution, anyone who experiences myocarditis or pericarditis after the first dose should wait for NACI to learn more before getting a second dose.

We continue to see risk from COVID-19 in our communities, and although adult vaccine coverage is growing daily, there have been recent outbreaks among adolescents in Canada and internationally. It is important for adolescents to continue getting vaccinated, particularly in the context of the Delta variant emerging in Canada.

What should I do before and after my immunization appointment?

Recommendations before your immunization appointment:

  • Wear a short-sleeve shirt
  • Eat and drink water before your appointment
  • Wear your mask
  • Bring required ID (e.g. Health card)
  • Bring your immunization record and/or download the CANImmunize app to keep track of your doses
  • Tell the provider if you have felt faint with other procedures – they may ask you to lie down

 

Recommendations for after your immunization appointment:

  • Wait 15 minutes, or 30 minutes if there are concerns about severe allergic reactions. If you are feeling unwell – inform a health care provider
  • Call 911 if you develop serious symptoms, like an allergic reaction. This can include: hives, swelling of face/tongue/throat, or difficulty breathing
  • Call your healthcare provider or clinic if feeling unwell when you go home
  • Drink water
  • Put a cold compress on the site of injection if you have swelling or pain
  • Take anti-fever or anti-pain medication if you need to for side effects
  • Schedule your 2nd dose
  • Keep following public health recommendations (e.g. wear a mask, physically distance, wash your hands, avoid international travel)
  • Wait 28 days before getting a non-COVID-19 vaccine
  • Wait 28 days before getting pregnant
What do I do if I or my loved ones have a fear of needles?

It is normal to have a fear of needles – this can be common in both children and adults. In some people, the fear of needles can be excessive and may prevent them from getting vaccinations done. To help support Jamati members who might have a fear of needles, a list of strategies is available here.

Where can I find COVID-19 information and resources in other languages?

Please visit the following links to access COVID-19 information in different languages:

Multilingual Resource Websites:

  1. Government of Canada COVID-19 Awareness Resources (Arabic, French, Farsi, Urdu, Tamil and more)
  2. Public Health Ontario Multilingual COVID-19 Resources (French, Gujarati, Hindi, Tamil, Urdu and more)
  3. COVID-19 Resources from the Canadian Muslim COVID-19 Task Force (Arabic, Farsi, French, Gujarati, Turkish, Urdu and more)
  4. COVID-19 Resources from the Immigrant Education Society (Arabic, Farsi, French, Hindi, Tamil, Urdu and more)
  5. COVID-19 Myths Answered from the British Islamic Medical Association (Arabic, French, Gujarati, Tamil, Urdu, Kurdish and more)
  6. Multilingual Information on COVID-19 Vaccinations from City of Toronto (French, Gujarati, Dari, Arabic, Urdu, Hindi)
  7. Alberta International Medical Graduates Association COVID-19 Video Resources (Arabic, Hindi, Urdu and more)

Urdu Resources:

  1. COVID-19 Factsheet from the Government of Alberta
  2. What is COVID-19? (video)
  3. How to Prevent COVID-19? (video)
  4. Signs and symptoms of COVID-19? (video)
  5. How do I protect myself from COVID-19? (video)
  6. Enhanced public health measures in Alberta as of November 24th (video)

 

Gujarati Resources: 

  1. COVID-19 Myths Answered from the British Islamic Medical Association 
  2. COVID-19 Vaccine Information from City of Toronto

 

Farsi Resources:

  1. What is COVID-19? (video)
  2. What is Physical Distancing and why is it important? (video)
  3. When to seek medical treatment? (video)

Disclaimer: The content provided here is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment related to COVID-19, or any other medical condition. Always consult your physician or other health care provider before making any health care decisions related to COVID-19 or any other medical condition to better understand the risks related to prevention and treatment. 

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