N.B. COVID-19 roundup: 2 new cases, province predicted to reach green phase by Aug. 2

New Brunswick reported two new cases of COVID-19 on Thursday and is now on track to reach its second-dose COVID-19 vaccination threshold for the green phase of recovery by Aug. 2, as scheduled, according to one data cruncher.

A total of 12,457 second doses were administered Wednesday, a new single-day record, said Oliver Dueck, a software developer based in Fredericton who has been tracking the province's vaccine data for the past few months.

That bumped the seven-day average to 9,092 doses, up from 8,602, and shaved a full three days off when he predicts the province will hit its path to green target of having 75 per cent of New Brunswickers aged 12 and older fully vaccinated.

Under the green phase of COVID recovery, all Public Health restrictions will be lifted, provided hospitalizations remain manageable, the government has said

Nearly 162,000 New Brunswickers, or 23.3 per cent of the eligible population, have now received two doses, the COVID-19 dashboard shows.

People are eligible for a second dose once at least 28 days have passed since their first dose.

The percentage of those people who are now fully vaccinated is 40.1 per cent, up from 37.9 per cent on Wednesday, said Dueck.

More than 1,500 first doses were also reported Thursday, the highest in a week, he said.

The province's single-dose vaccination rate now stands at 76.7 per cent.

New Brunswick has now administered 693,708 vaccine doses — approximately one dose for every person who is eligible to be vaccinated, Dueck noted.

More than 91,000 people have booked an appointment online through the Horizon or Vitalité health network clinic in the past week, Public Health said in a news release.  This does not include people who have booked appointments through a participating pharmacy.

For second doses, they're asked to bring a copy of the record of immunization they received after getting their first dose, a signed consent form and their medicare card.

Wording of vaccine reactions memo 'poorly chosen'

The wording of a Department of Health memo that advised health-care providers involved in the COVID-19 vaccination campaign of "many" adverse vaccine reactions being reported, was "poorly chosen," says a spokesperson.

In a June 22 memo, obtained by CBC News, Shelley Landsburg, the director of the disease prevention and control branch, wrote about adverse events following immunization, or AEFIs.

"We are receiving many reports of AEFIs and a wide range of types of AEFIs for the COVID vaccines including 'new' symptoms," she wrote.

She cited as examples delayed rashes, VITT, or vaccine-induced immune thrombotic thrombocytopenia, a condition that causes blood clots combined with low platelets, and myocarditis in young adults, which is an inflammation of the heart muscle.

In situations where people suffered adverse reactions to their first dose and the medical officer of health recommends they get their second dose in a "controlled setting," Landsburg refers immunizers to the procedures for making arrangements with the local regional health authority for a "high-risk immunization in a hospital setting."

"Please note that the process may be different in each region therefore please contact Public Health in your area who will then either set up [a] special clinic at a setting such as the local hospital."

Department spokesperson Shawn Berry said it's "a normal practice" to issue such memos. But "the word 'many' was poorly chosen and shouldn't have been used."

 As of June 12, more than 580,000 doses of vaccine had been administered in New Brunswick, said Berry.

At that date, there had been 191 AEFIs reported in New Brunswick  — 0.032 per cent of all doses administered, he said.

Of those, 53 were classified as serious and 138 were considered non-serious.

An adverse event is defined by the Public Health Agency of Canada as "any untoward medical occurrence which follows immunization." It isn't necessarily causally related to the usage of the vaccine.

An event is considered serious if it:

• Results in death.
• Is life-threatening, such as anaphylaxis, a severe allergic reaction.
• Requires in-patient hospitalization or prolongation of existing hospitalization.
• Results in persistent or significant disability/incapacity.
• Results in a congenital anomaly/birth defect.

Examples of non-serious events include injection site pain or swelling, diarrhea and slight fever.

New Brunswick, like other provinces, tracks and reports all adverse events weekly. 

"Over the previous seven days, three new AEFIs had been reported," Berry said.

"As you can see, like all jurisdictions, there have been some cases of AEFIs in the province and the purpose of the memo was to remind immunizers of the procedures for people who had an AEFI from their first dose and the arrangements that should be made for their second dose."

Asked how many people are being sent to controlled settings for their second shots, Berry said he didn't have that data, as of Thursday evening.

He did not immediately explain why VITT was listed as a new symptom when New Brunswick has had at least five reported cases involving the AstraZeneca-Oxford vaccine, including two deaths, while other provinces, such as Quebec and Alberta, have also had deaths from the rare blood clot disorder associated with AstraZeneca.

But he did say no new cases of VITT have been reported, and there are no "confirmed" cases of myocarditis/pericarditis.

He did not say how many cases are still under investigation, or how many of the adverse events resulted in hospitalization.

Asked what other new symptoms have been reported, Berry replied: "We work with our colleagues across Canada to track adverse events following immunization. Two adverse event types — VITT and myocarditis/pericarditis — are currently being monitored at the national level."

Berry did not immediately respond to a request for a breakdown of which vaccines New Brunswick's adverse events were related to.

A report from a U.S. Centers for Disease Control and Prevention (CDC) advisory group Wednesday suggested mRNA vaccines "may be a new trigger" for myocarditis and that the risk increases with the second shot of Pfizer or Moderna, but that the benefits of vaccination still outweigh any risk from heart inflammation.

The advisory committee on immunization practices (ACIP) said early data from its database shows a rate of 4.4 reported cases of heart inflammation per million first doses given of any mRNA vaccine in the 21 days following vaccination. For second doses, that rate increased to 12.6 reported cases per million.

Available data suggests a likely link between myocarditis and mRNA vaccination in adolescents and young adults, where the occurrences have been most noted, the group said. Young men are more likely to develop the symptoms than women.

Symptoms can include chest pain and shortness of breath, but a sizable majority of the inflammation cases tracked so far did not require hospitalization, it said. Of those that did, just a handful of patients required intensive care treatment.

Across Canada, 53 cases of myocarditis/pericarditis have been reported, as of June 11, according to the Public Health Agency of Canada website. Forty of the cases had received Pfizer, eight got Moderna, four had AstraZeneca and in one case the vaccine name was not specified.

"Health Canada and PHAC are not seeing higher rates than would normally be expected in the general population," the agency's most recent federal vaccine safety update states.

"To date, no clear association has been established between myocarditis/pericarditis and COVID-19 vaccines."

Three vaccines are typically offered in the New Brunswick: Pfizer-BioNTech, Moderna and AstraZeneca-Oxide.

But a delayed shipment of 49,140 doses of Pfizer this week prompted Public Health to switch most people who had second-dose Pfizer appointments this week through Horizon and Vitalité health network clinics to Moderna instead.

The two mRNA (messenger ribonucleic acid) vaccines are "completely interchangeable," Dr. Jennifer Russell, the chief medical officer of health, has said.

"They work the same way and are equally effective, regardless of which one is used as a first or second dose," she said in a statement Monday.

The National Advisory Committee on Immunization updated its recommendations last week to say that people who received Pfizer or Moderna as their first shot should get the same product for their second shot, unless "the same product is not readily available, or the product used for the first dose is unknown."

In a news release Thursday, Public Health said Pfizer and Moderna work the same way and have "similar levels of safety and effectiveness."

Berry did not say how many doses of Pfizer the province has left, when the delayed shipment is expected to arrive, or if next week's 49,140-dose shipment is still on schedule.

Pfizer is the only vaccine approved for use in Canada for anyone under the age of 18.

Public Health recommends people under the age of 55 who received AstraZeneca as their first dose get Pfizer or Moderna as their second dose, unless contraindicated. People 55 or older can choose to have a second dose of AstraZeneca, with informed consent, or opt for Pfizer or Moderna instead.

NACI also changed its recommendations for people who received AstraZeneca for their first dose. It now says an mRNA vaccine is "preferred" as the second dose and mitigates the rare risk of vaccine-induced immune thrombotic thrombocytopenia (VITT) — a condition that causes blood clots combined with low platelets, the committee said.

40 active cases

New Brunswick has 40 active cases of COVID-19, Public Health reported Thursday.

The two new cases include:

• A person 40-49 in the Moncton region, Zone 1. This case is under investigation.
• A person 70-79 in the Fredericton region, Zone 3. This case is a contact of a previously confirmed case.

Wednesday marked the first day in more than 223 days the Moncton region had no known active cases of the respiratory disease, according to Ray Harris, a Fredericton-based data analyst, who has been tracking daily data since Oct. 28.

Wednesday also marked one of only four days during that period that four out of the seven health zones had no known active cases, according to Harris.

Six people are hospitalized in the province, including two in intensive care.

A total of 359,298 tests have been conducted, including 608 on Wednesday.

New Brunswick has had 2,322 confirmed cases of COVID-19 since the pandemic began, with 2,236  recoveries so far and 45 COVID-related deaths.

Atlantic COVID roundup

Nova Scotia reported five new cases of COVID-19 Thursday. The province has 59 active cases.

Newfoundland and Labrador has no new cases and seven active cases. 

Prince Edward Island has reported no new cases since June 3, and has no active cases. 

Latest public exposures

Public Health has identified new potential public exposures to the virus in the following regions:

Saint John region, Zone 2:

• Needs Fast Fuel, 100 Main St., Sussex, June 13, between 2 p.m. and 4 p.m.

Fredericton region, Zone 3:

• Holy Rosary Church Hall, 26 Father Dysart Lane, Minto, June 15, between 10 a.m. and 1 p.m.
• Pentecostal Gospel Lighthouse Church, 283 Slope Rd., Minto, June 6 to June 18.

Public Health is offering COVID-19 testing to anyone who has been in a public exposure area, even if they are not experiencing any symptoms. Residents may request a test online or call Tele-Care 811.

People experiencing one or more symptoms are also encouraged to get tested.

Previous public exposures

Public Health has identified numerous potential public exposures to the coronavirus in many communities across the province, so many that it has stopped listing them individually in its daily news release.

A detailed list of the potential exposures, including the locations and dates, is available on the government's COVID-19 website. It is updated regularly.

What to do if you have a symptom

People concerned they might have COVID-19 symptoms can take a self-assessment test online. 

Public Health says symptoms shown by people with COVID-19 have included:

• Fever above 38 C.

• New cough or worsening chronic cough.

• Sore throat.

• Runny nose.

• Headache.

• New onset of fatigue, muscle pain, diarrhea, loss of sense of taste or smell.

• Difficulty breathing.

In children, symptoms have also included purple markings on the fingers and toes.

People with one of those symptoms should:

• Stay at home.

• Call Tele-Care 811 or their doctor.

• Describe symptoms and travel history.

• Follow instructions.