Coronavirus Update #16 & Flu Shot

Dear patients,

RETURN TO SCHOOL/WORK GUIDANCE

As colder weather arrives we are seeing more minor illnesses with symptoms that overlap those common with COVID-19. For children attending school who are exhibiting symptoms compatible with COVID-19 (as defined by this screening tool) and have a negative COVID-19 test or alternate diagnosis from a health care provider; they may return to school when:

• they are afebrile for more than 24 hours AND

• vomiting and diarrhea have been resolved for 48 hours AND

• other symptoms have been improving for at least 24 hours AND

• they have not been told to self-isolate or a healthcare provider AND

• they have not had a high risk exposure to a case of COVID-19

If symptoms persist, they should remain home from school./work and consider a repeat COVID test. If you do not get tested and have not been given an alternate diagnosis, you must self-isolate for 10 days from symptom onset. Medical notes or proof of negative tests should not be required for staff/students to return to school/work

THIRD DOSES FOR COVID-19 IMMUNIZATION

Eligible populations for a third dose include:

• Those undergoing active treatment for solid tumours;

• Those who are in receipt of chimeric antigen receptor (CAR)-T-cell therapy;

• Those with moderate/severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich
  syndrome);

• Stage 3 or advanced untreated HIV infection and those with acquired immunodeficiency syndrome;

• Those undergoing active treatment with the following categories of immunosuppressive therapies: anti-B
  cell therapies (monoclonal antibodies targeting CD19, CD20 and CD22), high-dose systemic
  corticosteroids, alkylating agents, antimetabolites, or tumor-necrosis factor (TNF) inhibitors and other
  biologic agents that are significantly immunosuppressive;

• Transplant recipients (including solid organ transplant and hematopoietic stem cell transplants);

• Patients with hematological cancers (examples include lymphoma, myeloma, leukemia) on active treatment
  (chemotherapy, targeted therapies, immunotherapy);

• Recipients of an anti-CD20 agent (e.g. rituximab, ocrelizumab, ofatumumab); and

• Additionally, Halton Region’s mobile teams are providing third doses to residents of long-term care and
  high-risk retirement homes. The Province has identified the settings and not all retirement homes are
  eligible at this time

If you are eligible for a third dose you must contact the office to have a physician referral form completed. Alternatively, you may show a prescription bottle with one of the medications listed in this document in order to receive your immunization at the pharmacy or clinics.

COVID IMMUNIZATION IN PREGNANCY

COVID-19 infection during pregnancy results in a heightened risk of serious illness and death; 7-15% of pregnant women with COVID-19 require hospitalization. The Society of OBGYNs and NACI as well as the Ministry of Health recommend pregnant or breastfeeding individuals get complete series with an mRNA COVID-19 vaccine. Large observational studies in the US and in Ontario show no safety concerns with COVID-19 vaccination during pregnancy or at birth. There is also no evidence that COVID-19 vaccination impacts male or female fertility.

FLU SHOTS

Flu shots are now available at our office. We will holding a parking lot clinic, similar to the previous year on Wednesday November 3rd, 2021. Please call the office to book your appointment. We have a limited supply of the high-dose immunization and therefore have to reserve doses for patients with specific medical indications. If you are >65 years of age and wanting a high-dose flu shot, you may have to go to local pharmacies to receive your dose.

Dr Priestner & Dr Archibald