COVID-19 Questions & Answers
There is a lot of material about COVID-19 circulating online. To ensure that correct information for those living with cystic fibrosis is available, we spoke with clinicians and Dr. John Wallenburg, CF Canada Chief Scientific Officer, to prepare the following list of questions and answers relating to COVID-19 vaccines, guidance and relevant resources for people impacted by cystic fibrosis.
In addition to the following Q&As Cystic Fibrosis Canada hosted a series of Ask the Experts webinars to help answer questions from the community about COVID-19 and CF. You can watch the webinar recordings here.
General guidance
In addition to notifying your CF clinic team as soon as possible, follow your local public health authority’s recommendations for quarantine and isolation. The federal government has developed a tool to help Canadians check their provincial and territorial quarantine and isolation period requirements. You can learn more and use the tool at https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms.html#_Getting_tested. Health Canada notes that people of any age with chronic medical conditions, including lung diseases like CF, or that are immunocompromised are at an increased risk of severe illness from COVID-19. Anyone who is not fully vaccinated, including people that have undergone transplantation, is also at increased risk of severe illness from COVID-19. The main way to reduce the spread of COVID-19 is for the entire community to get fully vaccinated and take a third vaccine or booster shot when possible. Additionally, with restrictions easing across the country, it is important that you continue to follow infection prevention and control measures and practice social distancing. Questions about your personal risk factors should be directed to your clinic team, who can help you determine if you should take additional precautions and provide specific advice. Learn more about who is most at risk and how to reduce your risk at https://www.canada.ca/en/public-health/services/publications/diseases-conditions/people-high-risk-for-severe-illness-covid-19.html Health Canada has provided information on how to reduce your risk of COVID-19. This includes: If going out, think about the risks before going out and make informed decisions. In general, people with CF and those close to them should continue with their usual infection prevention precautions to keep healthy. Learn more about how to reduce your risk of COVID-19 at https://www.canada.ca/en/public-health/services/publications/diseases-conditions/people-high-risk-for-severe-illness-covid-19.html The Government of Canada has created a tip sheet on How to Care for a Person with COVID-19 at Home-Advice for Caregivers. Please contact the clinic the person you are caring for attends if you have any CF-related medical concerns. If you are caring for a person with COVID-19 and need to wear a mask, please ensure you use proper technique to protect yourself and others. For reference on how to wear a mask properly, visit the World Health Organization website for a video demonstration and further information. The Canadian government has developed a tool to help you find financial help during COVID-19. Using the tool linked below you will be asked a few questions that will help create a list of benefits that you may be eligible for and identify supporting resources. Check out the tool at https://covid-benefits.alpha.canada.ca/en/start The Public Health Agency of Canada advises that individuals follow all recommended public health measures including mask wearing. A mask can help contain your respiratory particles and prevent or reduce the amount of infectious respiratory particles you inhale, particularly when wearing a well-constructed, well-fitting mask. Public Health recommends a medical mask or respirator for those who are at a higher risk of more severe disease or outcomes from COVID-19. No matter which type of mask you choose, proper fit is a key factor in its effectiveness. People living with cystic fibrosis should continue to maintain their regular daily care regimens. CF clinics maintain a high standard of care and follow isolation precautions to ensure your health and safety. As the situation evolves, if clinic scheduling needs to change, your clinic team will contact you to make alternative arrangements for your care. You can also talk with your clinic team about options for postponing routine clinic visits during this time. You should continue to follow CF Infection Prevention and Control Guidelines which recommend that people with CF wear a surgical mask in health care settings to reduce the risk of cross-infection from CF germs. The federal government has advised that for best protection against COVID-19, it is important to receive a primary series of the vaccine, as well as a booster dose. The federal government also advised that anyone who has not completed a COVID-19 vaccine series should continue to avoid non-essential travel to all destinations. If you must travel, regardless of your vaccine status, be sure to check travel requirements from the province/territory you are departing AND the city, country of your destination. Be sure to also consider testing and quarantine requirements. Learn more about travel within and outside Canada at https://travel.gc.ca/travel-covid If you have been in contact with someone who has a confirmed case of COVID-19, you should self-isolate per Canada Health guidelines, and let your clinic team know so that they can monitor you closely. If you start having symptoms, consult with your public health authority and let your clinic team know. The processes and guidelines for COVID-19 testing vary by region. Information on testing sites and procedures continues to evolve and is made available through most provincial government websites. Most provinces also have an online COVID-19 symptom self-assessment tool to get you started. . Here are links to public health authority websites for each province and territory: British Columbia (BC Centre for Disease Control)
VACCINATION
Given the already heavy health burden on people with cystic fibrosis, we believe it necessary to shelter people with cystic fibrosis in Canada from any additional risks that could be caused by COVID-19 related infections, and that people with cystic fibrosis should be prioritized for vaccination.
Getting vaccinated remains one of the most effective ways to help protect yourself and others against COVID-19. Everyone is strongly encouraged to become fully vaccinated against COVID-19. You are also encouraged to get booster doses as they become available.
You can book your vaccine appointment through your local health authority. To learn more about vaccination in your region visit: https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/vaccines/how-vaccinated.html
The government of Canada has emphasized that vaccination is one of the most effective ways to protect our families, communities and ourselves against COVID-19. Evidence indicates that vaccines are very effective at preventing severe illness, hospitalization and death from COVID-19, including against Alpha and Delta variants of concern.
Having as many people vaccinated as possible may also reduce the risk of ongoing circulation of the virus and the appearance of future variants. Current evidence suggest that COVID-19 vaccines in Canada are effective at providing protection against the current known variants in Canada. However, there is a small percentage of the population who are vaccinated that may become infected, with or without symptoms, if they are exposed to the virus. The effectiveness of COVID-19 vaccines on new variants of concern such as Omicron is being assessed by health authorities in Canada.
It is recommended that everyone become fully vaccinated for the best protection against infection. We strongly encourage people living with cystic fibrosis (CF), their families, and others in the CF community to follow the government’s recommendation and become fully vaccinated for the health and safety of everyone. It is also important for you to maintain your usual infection prevention precautions and to get booster shots if they become available to you.
In general, you are considered fully vaccinated for COVID-19 once you’ve received the complete number of doses in the series of the vaccination you have:
- For Pfizer-BioNTech Comirnaty or Moderna Spikevax vaccines - 2 weeks after your second dose in a 2-dose series
- For Johnson & Johnson’s Janssen vaccine - 2 weeks after a single-dose vaccine
If you have received 1 dose of a 2-dose series, you are considered partially vaccinated and are encouraged to schedule an appointment as soon as possible to receive your second dose. The effectiveness of a 2-dose vaccine series increases after the second dose.
The Government of Canada has announced that current evidence shows it takes 2 weeks or more after the first dose to provide good protection and up to 2 weeks after the second dose to provide even higher protection. It is extremely important to return for your second dose at the time advised by your local health authority for longer-lasting protection against COVID-19.
Becoming fully vaccinated helps reduce your risk of serious illness; reduce the risk of other people catching the virus from you; and increase your likelihood of protection against infection.
Most provinces and territories are also providing a third vaccine shot or booster shot for additional protection against COVID-19. It is recommended that individuals moderately or severely immunocompromised due to disease or treatment get an additional vaccine dose or booster shot as they become available. Consult your local health authority as booster shot eligibility may differ by region. Find out more about booster shots online.
Learn more at: https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/vaccines/how-vaccinated.html#a2
Most provinces and territories issue and use the Canadian COVID-19 proof of vaccination, which can be used to access services and facilitate travel within and outside of Canada.
Your vaccination status changes your risk of catching COVID-19 and becoming ill, but it does not change your risk of exposure to the virus out in the community. It is important to maintain your infection prevention precautions as restrictions are eased.
You can learn more and follow the steps to get your proof of vaccination from your specific province or territory at: https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/vaccines/life-after-vaccination/vaccine-proof.html
Health Canada is closely monitoring genetic variants of the virus that causes COVID-19, including the newest variant of concern called Omicron, as well as any potential future variants.
The federal government is working with manufactures and international regulators to assess the impact of the emerging variants on the effectiveness of approved vaccines and treatments. Canadians will be informed if a risk is identified.
Learn more about COVID-19 variants of concerns at https://www.sac-isc.gc.ca/eng/1615991390358/1615991423624.
Yes, you are encouraged to become fully vaccinated. The risk of re-infection with a variant is not clear at this time. Vaccination remains one of the most effective ways to prevent severe illness, hospitalization and death from COVID-19.
Learn more at: https://www.canada.ca/en/health-canada/services/video/ask-experts-covid-19-vaccines/benefits-effectiveness.html#a18
It has been determined by the federal government that, with the return of measures such as in-person school and activities, COVID-19 is having a greater impact on children and youth than earlier in the pandemic.
While children and youth are generally less likely to get sick from COVID-19, they can still be infected and not have symptoms, spread COVID-19 to others, experience longer-term effects if they do get infected and develop a rare but serious complication called multisystem inflammatory syndrome in children. Children and youth with certain underlying medical conditions may have a higher risk for severe illness from COVID-19.
Like adults, it is recommended that children and youth become fully vaccinated for the health and safety of everyone. If you have concerns about vaccinating your child/youth with CF, contact your CF clinic team or a COVID-19 testing center clinician to further inquire.
There are several videos, posters and infographics about COVID-19 vaccines:
- The facts about COVID-19 vaccines: https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/awareness-resources/know-vaccine.html
- COVID-19: How vaccines are developed: https://www.canada.ca/en/public-health/services/video/covid-19-how-vaccines-developed.html
- Vaccine development and approval in Canada: https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-treatments/vaccines/development-approval-infographic.html
- COVID-19 vaccines questions – Monitoring safety after approval: https://www.canada.ca/en/health-canada/services/video/ask-experts-covid-19-vaccines/monitoring-safety-after-approval.html
- How do we know that COVID-19 vaccines are safe? https://www.canada.ca/en/health-canada/services/video/ask-experts-covid-19-vaccines.html#a1
Several provincial public health authorities and school boards have developed resources on the importance of COVID-19 vaccines for children. In addition to the resources listed below, contact your relevant school board.
- A Parent’s Guide to Vaccination: Information about vaccinating your children, how vaccines work and vaccine safety.
- Not Just for Kids: An adult guide to vaccination: Facts about COVID-19 vaccines and their importance, for adults and children.
- Teens, meet vaccines
On April 23, 2021, CF Canada sent a letter to Premiers and Provincial Ministers of Health across the country asking them to ensure the people in their province diagnosed with cystic fibrosis and their caregivers are vaccinated now. Please see here for a copy of that letter.
On April 19, 2021, Cystic Fibrosis Canada co-authored a letter to the editor in the Journal of Cystic Fibrosis, along with the The Global Registry Harmonization Group explaining why people with cystic fibrosis should be prioritized for the vaccine. Cystic Fibrosis Canada has shared this letter with Health Ministers with a call to ensure those with CF and caregivers can get the vaccine now.
In January 2021, Cystic Fibrosis Canada joined forces with The Canadian Thoracic Society and other members of its COVID-19 Respiratory Roundtable, which represents and works closely with Canadians living with lung disease to issue a joint statement. The statement asks federal, provincial, and territorial governments to prioritize people living with lung disease who are at higher risk for more serious COVID-19 complications in the vaccination rollout.
In December of 2020, Dr. John Wallenburg, Chief Scientific Officer at Cystic Fibrosis Canada sent a letter to provincial Health Ministers urging provinces to prioritize Canadians living with cystic fibrosis and their caregivers, as they determine priority groups for the COVID-19 vaccination. Dr. Wallenburg stressed that given the already heavy health burden on Canadians living with CF, it is necessary to shelter them from any additional risks that could be caused by SaRS-CoV2 infection. Cystic Fibrosis Canada followed up on this letter to urge provinces who have not committed to prioritizing Canadians with CF to do so.
The specifics on the efficacy and safety of the vaccines in transplant recipients continue to emerge. The Canadian Society of Transplantation published a National Transplant Consensus Guidance on COVID-19 Vaccine Q&A, and has compiled resources for people post-transplant that you can view here.
Most provincesare prioritizing organ transplant recipients for the COVID-19 vaccine. You can learn more about eligibility in your province by checking your provincial and local health websites.
As with all vaccines, everyone needs to consider benefits and risks. If you have specific health questions regarding the vaccine, consult your CF and transplant care teams.
