I am trying to understand the logic of his request.

There are about 80,000 doctors who are available and who have medical records on their patients. Doctor’s offices have fridges. They have systems for storing vaccines. The public health folks certify their fridges as being appropriate for vaccine. They know how to dispose of syringes.  They will get paid for doing the injections. They will record the injections in the medical records.

Why the midwives?

What does COVID vaccine have to do with delivering babies?

There are at least 3000 pharmacies in Canada with many thousands of pharmacists trained to give injections.

So why do we call on midwives to volunteer.  Doctors and pharmacists should be paid for doing the injections.

Are we trying to save money by asking for midwives to volunteer. This is disrespectful to the midwives profession.

The image of the midwives who are hard working and competent professionals giving the vaccines at the Air Canada centre is a good photo op but not really a smart plan.

I vote for employing the 80,000 doctors and the thousands of pharmacists as one strategy to get jabs in arms once we have supplies of vaccine.

Time to think again about our strategy for the vaccine roll out.

Raymond Rupert patient advocate.

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• Medicago, a biopharmaceutical company headquartered in Quebec City, is pleased to report interim results of the Phase 1 clinical trial of its plant-derived vaccine for COVID-19.  The results of the trial demonstrated that 100 per cent of subjects developed a promising antibody response after two doses of Medicago’s COVID-19 adjuvanted vaccine candidate. Medicago is a biopharmaceutical company and pioneer in plant-derived therapeutics. Founded in 1999 with the belief that innovative approaches and rigorous research would bring new solutions in healthcare.

• Providence Therapeutics (Toronto): Similar to that of Pfizer and Moderna, this vaccine uses mRNA tech, which prompts the body to make proteins that can ward off the virus. 

• Entos Pharmaceuticals (Edmonton): A DNA-based vaccine that delivers genes from SARS-CoV-2 into the body, inducing a strong antibody response, as well as a potent, balanced T cell response.
• Immunoprecise Antibodies (Victoria): Pieces of viral protein are injected, teaching the immune system to recognize them; this technique is also being used by Novavax. 
• IMV (Halifax): Another protein-based vaccine using peptides, which are tiny pieces of protein that can be produced artificially.
• Mediphage Bioceuticals and the University of Waterloo (Toronto/Waterloo): Administered as a nasal spray, this candidate mimics the route of infection of SARS-CoV-2 and targets the right cells in the lungs and lower respiratory tract. 
• Symvivo (Burnaby): Another DNA solution that doesn’t require a needle, this medicine would be swallowed like the oral polio vaccine.
• Symvivo is a clinical-stage gene therapy company developing oral DNA vaccines for the treatment of life-threatening infectious diseases. In rapid response to the COVID-19 global health crisis, the company began research and development efforts leveraging its novel bacTRL Gene Therapy Program to study the protective potential of oral DNA vaccine candidate, bacTRL-Spike, for the prevention of COVID-19.

Source: Mars, Impact Week Publication. Barry Chong.

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I’m a clinical trials geek. I keep hearing people talk about the seven to 10 years it takes to make a vaccine and how dangerous speeding this up might be. The word that keeps popping up is “rushed”, and it is making the average person nervous about vaccine safety. So, as a clinical trials doctor, I am going to tell you what I do for most of those 10 years – and it is not very much.

I’m not lazy. I submit grants, have them rejected, resubmit them, wait for review, resubmit them somewhere else, sometimes in a loop of doom. When I am lucky enough to get trials funded, I then spend months on submitting to ethics boards. I wait for regulators, deal with personnel changes at the drugs company and a “change of focus” away from my trials, and eventually, if I am very lucky, I spend time setting up trials: finding sites, training sites, panicking because recruitment is poor, finding more sites. I then usually have more regulatory issues and, finally, if my big pot of luck is not used up, I might have a viable therapy – or not.

At this point, it might get delayed because of questions over profitability or any number of other obstacles. I’m not even going to go into the years it normally takes to get the “preclinical” studies, the ones before the human trials, done.

So next time somebody expresses concern at the astonishing speed the vaccine trials have happened at, point out to them that 10 years isn’t a good thing, it’s a bad thing. It’s not 10 years because that is safe, it’s 10 hard years of battling indifference, commercial imperatives, luck and red tape. It represents barriers in the process that we have now proved are “easy” to overcome. You just need unlimited cash, some clever and highly motivated people, all the world’s trial infrastructure, an almost unlimited pool of altruistic, wonderful trial volunteers and some sensible regulators.

With all of this and the clock ticking on a global pandemic killing people by the second, it turns out we can do amazing things. The vaccine trials have been nothing short of a miracle. A revolution in how we do trials that when you think about it is perhaps not that surprising given our ability to innovate when we really need to.

Three vaccines have already broken cover and demonstrated efficacy higher than we had hoped

And we really need to – necessity being the mother of invention. Safety has not been compromised. All trials have been through the correct “phases” or process of any normal drug or vaccine. Hundreds of thousands of the very best of us volunteered and had an experimental vaccine. The world watched so closely that when a single person fell ill, we were all debating it.

To date, there has not been a single associated death related to Covid vaccines and only a handful of potentially serious events. Just imagine watching everybody in a small city for six months and reporting every single heart attack, stroke, neurological condition or anything that might be judged serious. How astonishing is this? It has been a triumph of medical science.

I haven’t even touched on the lucky confluence of timing that meant this all happened at a time when sequencing all the genes in a person or virus is so routine nobody bats an eyelid. This turbocharged the early preclinical science needed as the foundation stone of several new technologies at the right point to be exploited.

At this time, three vaccines have already broken cover and demonstrated efficacy higher than we had ever hoped. The bar was set by regulators at around 50 per cent. Both Moderna and Pfizer reported 95 per cent efficacy, and Oxford University reported 90 per cent efficacy for a particular dosage regimen. Safety data is still to follow, but the track record of vaccines is excellent, and I am an optimist.

None of this is to downplay the challenges still ahead. It is also not to say vaccines are without safety questions still to be answered. It has been, however, a triumph of good process and great people. I am confident that when regulators pore over the safety and efficacy data, closely followed by every interested scientist in the world, that vaccines will only be used if their benefits clearly outweigh the risks – and you should be confident too.

Mark Toshner is a director of translational biomedical research at the University of Cambridge. This article first appeared on The Conversation

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Hundreds of heads of state and global health leaders made an unprecedented commitment to work together to accelerate the development and production of new vaccines, tests and treatments for COVID-19 and assure equitable access worldwide.

“We will only halt COVID-19 through solidarity,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Countries, health partners, manufacturers, and the private sector must act together and ensure that the fruits of science and research can benefit everybody.”

Health leaders from the Coalition for Epidemic Preparedness Innovations (CEPI), GAVI-the Vaccine Alliance, the Global Fund, UNITAID, the Wellcome Trust, the International Red Cross and Red Crescent Movement (IFRC), the International Federation of Pharmaceutical Manufacturers (IFPMA), the Developing Countries Vaccine Manufacturers’ Network (DCVMN), and the International Generic and Biosimilar Medicines Association (IGBA) committed to come together, guided by a common vision of a planet protected from human suffering and the devastating social and economic consequences of COVID-19, to launch this groundbreaking collaboration.

They are joined by two Special Envoys: Ngozi Okonjo-Iweala, Gavi Board Chair and Sir Andrew Witty, former CEO of GlaxoSmithKline.

Gavi’s impact draws on the strengths of its core partners, the World Health Organization, UNICEF, the World Bank and the Bill & Melinda Gates Foundation, and plays a critical role in strengthening primary health care (PHC), bringing us closer to the Sustainable Development Goal (SDG) of Universal Health Coverage (UHC), ensuring that no one is left behind.

The fact that Canada, as a high income country, has entered into early contracts for preferred access to vaccines is being perceived to be two tier healthcare by the members of GAVI and the world community.

This is a wicked problem for the leaders in Canada as they exercise their duty to protect all Canadians.

We respect the challenge inherent in this wicked problem.

Raymond Rupert, patient advocate and healthcare consultant.

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