Canadians overseas ramp up COVID-19 vaccines despite health unknowns

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As most Canadians celebrate after their second dose of COVID-19 vaccine, many expatriate Canadians living and working abroad are opting for the third and fourth vaccines.

They say they have had no choice but to revaccinate if they want to return to Canada in the future and avoid Canada’s 14-day hotel and quarantine provisions.

“I don’t want to be quarantined at the hotel anymore,” said Monique Horvath, a 49-year-old Canadian teacher from Nanaimo, British Columbia, who has lived and worked in Moscow for 14 years.

She and her husband Brendan each received two doses of a COVID-19 vaccine in the spring – but it was Russia’s Sputnik V vaccine, the only vaccine available to them, not approved for use in Canada. This means they should still be quarantined if they come home.

“If there’s an emergency and we have to come back to Canada… that’s an important thing on my mind when you’re overseas and away from your family,†Horvath said of their decision to undergo two. other doses of vaccine each.

WATCH | The Prime Minister of Canada on the reopening of the Canada-US border:

Effective today, fully vaccinated Canadians entering the country can forgo the 14-day quarantine. But Prime Minister Justin Trudeau is sticking with a large-scale approach to ease border restrictions – and non-essential travel between the United States and Canada remains limited until July 21. 1:32

After making the return trip to British Columbia in June, Horvath said she and Brendan rolled up their sleeves for Moderna after their two weeks in isolation was over.

They expect to get Moderna’s second shot before they return to Moscow.

The rules

Earlier this week, the Canadian government dropped its controversial hotel quarantine and 14 days of isolation for “fully vaccinated” Canadians entering the country.

But that means having a vaccine approved by Health Canada – and the list is limited to the single-dose vaccine Pfizer-BioNTech, Moderna, AstraZeneca-Oxford, COVISHIELD, or Johnson & Johnson.

Russian Sputnik V, Chinese Sinopharm and Indian Covaxin are not on the list, although hundreds of millions of people around the world have already taken them or are in the process of doing so.

Horvath said more than 20 of his colleagues, now on vacation in the United States, Canada and Europe, posted photos of themselves on Facebook getting the vaccine again – choosing to revaccinate even though there is virtually no research on the implications of doing so.

“People I know went to their doctors and they said everything was fine,†she said.

‘It’s probably ok’

Several Canadian vaccine experts agreed that taking extra doses of the vaccine was probably “fine” – but with caveats.

“From a health point of view, it’s hard to know what the benefit or the downside is – it’s probably OK, but I can’t look you in the eye and tell you with any degree of confidence that it does, â€said Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital.

Bogoch, who is a member of the Ontario Scientific Advisory Table on COVID-19, has so far said that there is no official guidance from any of the major international health organizations on the implications of the taking additional COVID-19 vaccines. The problem is only beginning to emerge.

Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta, said this is a significant problem that will grow exponentially as more expats travel and repatriate .

“I think there is a real need to rectify this as it creates a condition where people go into completely untested doubling regimes to meet regulatory requirements,†she said.

Members of the Welbes family, expats living in Moscow, opted to receive two doses of the Pfizer COVID-19 vaccine in the United States after initially receiving the Sputnik V vaccine in Russia. That way, they can enter Canada without quarantine for 14 days. (Submitted by Kirsten Welbes)

Saxinger said she was recently asked to give advice on revaccination by a Canadian living in the Middle East after already taking two doses of a vaccine not approved in Canada.

The topic is widely discussed on expat social media sites, including a Facebook page where Canadians share stories about attempts to bypass border restrictions.

The last census taken in 2009 shows that 2.8 million Canadians live and work outside of Canada and many, if not most, do not have access to COVID-19 vaccines approved by Health Canada.

Thousands of international students en route to Canada could face challenges if they have received vaccines that are not approved here.

“People [Canadians abroad] who took those vaccines did the right thing at the time, â€Bogoch said.

“COVID was rife and you must take whatever vaccine is available in times of crisis. It was then – what are you doing now? “

An experiment

Kirsten and Todd Welbes faced a similar dilemma.

They too received the two doses of Russian Sputnik V at home in Moscow, where they are teachers.

But in the face of Canadian border restrictions and other travel restrictions in Europe, the dual Canada-US family designed their summer around getting two doses of the Pfizer vaccine in the US, which would allow them to travel to Canada later.

Dr. Lynora M. Saxinger, an infectious disease specialist at the University of Alberta, said taking two different vaccine schedules can create a stronger immune response because the second course acts as a booster. (John Ulan / Ulan Photography)

“New situations stand in our way and then we have to resolve them,” said Welbes, 45.

“Would I have chosen to receive two different vaccines in two different countries? Probably not.”

Like Horvath, Welbes said revaccinating means they will now hopefully be able to visit family in Canada and Europe without restrictions, especially in emergencies.

It also means they’ll be able to take their 16-year-old daughter to visit a potential college in British Columbia during a short Christmas break.

But if they’re comfortable with the health implications of their decision, Todd Welbes said it felt a bit like a human lab experiment.

“There is a very real possibility that I am completely wrong and that it is a terrible idea and that I have put our health at risk.”

Risks

Health Canada has yet to weigh in on the issue of revaccination.

In an e-mailed statement, the ministry said “that it has not issued any recommendations on this subject yet.”

Saxinger, the infectious disease expert at the University of Alberta, said taking two different vaccine schedules can create a stronger immune response because the second course acts as a booster.

But she said there have been very rare situations where taking a particular booster vaccine on too short a time may actually “dull” the immune response.

Some of the revaccinated Canadians who gave interviews for this story also complained of intense reactions after their first dose of the second round of vaccines.

“I had more side effects with Moderna than with my second Sputnik hit,†Horvath said.

“Headache, nausea, chills, fever, muscle pain, awful feeling. Brendan was exactly the same.”

Saxinger said this type of reaction is not surprising.

“It’s entirely possible that you have a more vigorous immune response because of the antibodies in your system,” she said.

Another expert in immunology, Rod Russell, said vaccines are “safe on their own”. But the professor of virology at Memorial University of Newfoundland said it might be better to mix mRNA vaccines, such as Pfizer and Moderna, with viral vector vaccines such as Sputnik V.

Issac Bogoch, the Toronto General Hospital expert, said it was understandable that people wanted to be revaccinated to avoid “being on the losing side of vaccine passports.”

But he said it is likely that countries will – and should – eventually accept vaccines approved by the World Health Organization, so the need to revaccinate could eventually become unnecessary.

Too slow

The Government of Canada ships vaccines to its embassies around the world where vaccines approved by Health Canada are not available, helping diplomats and other staff avoid this dilemma. But not for other Canadians working abroad.

Kirsten Welbes, the teacher from Moscow, said the world is not moving fast enough to find a comprehensive solution. So she had to find one in the meantime.

“I just have to be pragmatic,†she said. “What is happening to me and what is the best decision I can make based on this small amount of information?” You are just doing your best. “


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