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Pfizer study suggests COVID-19 vaccine is safe, protective in younger teens

Pfizer announced Wednesday that its COVID-19 vaccine is safe and strongly protective in kids as young as 12, a step toward possibly beginning shots in this age group before they head back to school in the fall.

Most COVID-19 vaccines being rolled out worldwide are for adults, who are at higher risk from the novel coronavirus. Pfizer’s vaccine is authorized for ages 16 and older. 

In a study of 2,260 U.S. volunteers ages 12 to 15, preliminary data showed there were no cases of COVID-19 among fully vaccinated adolescents compared to 18 among those given dummy shots, Pfizer reported in a press release on Wednesday.

It’s a small study, that hasn’t yet been published, so another important piece of evidence is how well the shots revved up the kids’ immune systems. Researchers reported “robust antibody responses,” the release said. 

Kids had side effects similar to young adults, the company said. The main side effects are pain, fever, chills and fatigue, particularly after the second dose. The study will continue to track participants for two years for more information about long-term protection and safety.

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Pediatric studies underway for other vaccines 

Pfizer and its German partner BioNTech in the coming weeks plan to ask the U.S. Food and Drug Administration and European regulators to allow emergency use of the shots starting at age 12.

“We share the urgency to expand the use of our vaccine,” Pfizer CEO Albert Bourla said in a statement. He expressed “the hope of starting to vaccinate this age group before the start of the next school year” in the United States.

Pfizer isn’t the only company seeking to lower the age limit for its vaccine. Results also are expected soon from a U.S. study of Moderna’s vaccine in 12- to 17-year-olds.

But in a sign that the findings were promising, the FDA already allowed both companies to begin U.S. studies in children 11 and younger, working their way to as young as six months old.

AstraZeneca last month began a study of its vaccine among 6- to 17-year-olds in Britain. Johnson & Johnson is planning its own pediatric studies. And in China, Sinovac recently announced it has submitted preliminary data to Chinese regulators showing its vaccine is safe in children as young as three.

While most COVID-19 vaccines being used globally were first tested in tens of thousands of adults, pediatric studies won’t need to be nearly as large. Scientists have safety information from those studies and from subsequent vaccinations in millions more adults.

One key question is the dosage: Pfizer gave the 12-and-older participants the same dose adults receive, while testing different doses in younger children.

U.S. FDA timeline not clear

It’s not clear how quickly the FDA would act on Pfizer’s request to allow vaccination starting at age 12. Another question is when the country would have enough supply of shots — and people to get them into adolescents’ arms — to let kids start getting in line.

Supplies are set to steadily increase over the spring and summer, at the same time states are opening vaccinations to younger, healthier adults who until now haven’t had a turn.

Children represent about 13 per cent of COVID-19 cases documented in the U.S. And while children are far less likely than adults to get seriously ill, at least 268 have died from COVID-19 in the U.S. alone and more than 13,500 have been hospitalized, according to a tally by the American Academy of Pediatrics. That’s more than die from the flu in an average year. Additionally, a small number have developed a serious inflammatory condition linked to the coronavirus.


Caleb Chung, seen in this December 2020 photo as he gets his first dose of either the Pfizer vaccine or a placebo, says the study was, ‘was really somewhere that I could actually help out.’ (Richard Chung/The Associated Press)

Caleb Chung, who turns 13 later this week, agreed to volunteer after his father, a Duke University pediatrician, presented the option. He doesn’t know if he received the vaccine or a placebo.

“Usually I’m just at home doing online school and there’s not much I can really do to fight back against the virus,” Caleb said in a recent interview. The study “was really somewhere that I could actually help out.”

His father, Dr. Richard Chung, said he’s proud of his son and all the other children volunteering for the needle pricks, blood tests and other tasks a study entails.

“We need kids to do these trials so that kids can get protected. Adults can’t do that for them,” Chung said.


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Families eager for results as drug companies test vaccines for use on children, teens

On an unusually warm spring morning, a class of seventh and eighth graders exits the doors of Charles Gordon Senior Public School in Scarborough, Ont. They walk single file through the yard, masked and distanced from each other by a strict two metres — a sign of the times in Toronto, where kids only recently returned to in-person schooling after another lockdown.

The day’s lesson is about COVID-19 vaccines, and appropriately, it was being held at an outdoor classroom. Students had been asked to read up on the vaccines and present questions they would like to ask Canadian officials about the inoculations and their distribution.

As vaccines roll out among older adults, many of the questions from this group of students focused on the fact that children aren’t on the current inoculation schedule. Of the vaccines approved in Canada so far, only the Pfizer vaccine has been cleared for people as young as 16 years old, and the other three are currently meant for ages 18 and up.

Their teacher, Tracey Toyama, said the lesson was a natural extension of current events. “They see it every day on social media; they come in, they ask questions,” she said.

“Why are children not more prioritized in terms of receiving the COVID-19 vaccine?” asked one girl.

“Why wouldn’t we vaccinate children so that they don’t put those who are vulnerable at risk?” asked another.

Indeed, since most children tend to experience milder cases of COVID-19, they weren’t prioritized in international vaccine trials. Still, kids do get sick and they can pass on the virus.

In fact, more than 157,000 Canadians aged 19 or younger have caught COVID-19. So until both adults and children are inoculated against the virus, it’s unlikely society will be able to go back to normal.


Students at Charles Gordon Senior Public School in Scarborough, Ont., hold some of their classes outdoors during the pandemic. During this lesson, students discuss the questions they would like to ask Canadian officials about the vaccines and their distribution. (Sarah Bridge/CBC)

In recognition of this, a number of vaccines are now being tested on younger people.

Drug maker Sinovac submitted data to the Chinese government this week saying its vaccine is safe for children between the ages of three and 17.

Pfizer, Moderna, AstraZeneca, and Johnson & Johnson are now testing their COVID-19 vaccines on younger kids, too. Moderna’s trial includes children as young as six months old. Early data from Pfizer on its trials for children aged 12 years and older is expected soon.

Quebec-based Medicago, which is working through Phase 3 adult trials for its plant-based COVID-19 vaccine, says it has plans to move on to younger age groups as data emerges.

According to Nathalie Charland, a senior director with Medicago, the trials will be similar to those they’ve conducted with people aged 18 and up, though children will likely receive half the vaccine dosage.

Along with monitoring each of the test cases to make sure they’re safe, she said, “We will be looking at the immunogenicity of the vaccine candidate to see if what we saw in adults is the same that we see in children.”


Medicago has been conducting clinical trials of its plant-based COVID-19 vaccine on people aged 18 years and older. Nathalie Charland, a senior director with Medicago, says her company has plans to test the vaccine on younger age groups as well. (Medicago)

Dr. Noni MacDonald with Dalhousie University in Halifax said vaccinating children is “incredibly important.”

She said adults were “rightly” prioritized for COVID-19 vaccines because, “children have not been shown to be the big vector of transmitting this virus from one person to another; it’s mostly adults and young people.”

However, MacDonald added, “The problem we have is we know that we need to have the community immunity happen. So, if we have big pockets of children that are not immunized, that community is not immune.”

With variants circulating, she said, the impetus to vaccinate children as soon as possible is strong.

“This is not the end,” she said. “This is a wicked virus and we need to control it in all the ways we can.”

That urgency is especially acute in households where a family member is immunocompromised.

Torontonian Amerie Alvis, 15, has been worried about bringing the virus home to her mom this past year. Her mother, Jaeda Larkin, is a single parent with rheumatoid arthritis.

“What if she does get sick, and I’m all alone?” Alvis said.


Jaeda Larkin, left, and her daughter Amerie Alvis. Amerie has chosen to do online schooling until she is able to get vaccinated, in order to minimize the risk of contracting COVID-19. (Sarah Bridge/CBC)

At nearly 16 years old, Alvis should be eligible for the Pfizer vaccine in a few months and said she is “all for it.”

In the meantime, she has chosen to do online schooling rather than go back to class, in order to minimize the risk to herself and her mom. Alvis said she won’t go back until she gets a shot, but she’s hopeful life could look different next fall.

Having lost some relatives in the U.S. to COVID-19, Larkin is similarly keen to see the two of them vaccinated against the virus.

“The thought of risking my daughter or, you know, potentially having her get sick is terrifying to me,” Larkin said.

Without available vaccine data for kids under 16, some parents of younger children are hesitant to commit just yet.

Torontonians Barry Ayow and Gina Athanasiou aren’t sure whether they’ll want to vaccinate their two youngest kids, who are 12 and 14 years old, against COVID-19 right away.

“I’m willing to experiment on myself. I’m willing to be a guinea pig. But to volunteer my children to be guinea pigs, that’s a different thing, right?” said Ayow.

At the same time, a sense of duty to their older family members and neighbours is weighing on the couple.

“Will duty outweigh our obligation to our kids to make sure that they’re safe? I don’t know,” said Athanasiou, who has concerns about possible side effects of the vaccines on her kids.

She added, “Maybe we’ll feel more comfortable when we have the studies.”


Barry Ayow, right, and Gina Athanasiou say they’re willing to get vaccinated for COIVD-19, but they aren’t sure whether they want to vaccinate their two youngest children right away. (Ousama Farag/CBC)

Dr. MacDonald said parents can be reassured that a push to vaccinate children won’t be coming “out of nowhere.”

“This is going to be based on evidence,” she said.

In fact, according to MacDonald, information about the COVID-19 vaccines will be more robust than what was initially available for previous vaccines, such as polio.

When the time comes for children to get vaccinated, she said, “literally tens of millions of doses of these vaccines will have been used in the population. We’ve never had that kind of volume whenever we’ve used vaccines in children before when we were starting.”

In a show of hands, about half the students in the Grade 7 and 8 class at Charles Gordon Senior Public School said they themselves would take the vaccine based on what they currently know, with others mostly citing the need for more information on their own age group.

What’s clear from nearly all of them during their classroom discussion, though, is that the stress of the pandemic isn’t just affecting adults.

For seventh grader Isaiah Velez, keeping his family and friends safe is a personal priority, he said, as is putting an end to the pandemic. “I miss going out in public and meeting my friends — a lot,” he said.


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Teens feeling disconnected, hopeless due to COVID-19 raises alarm for parents, experts

Ten months into the coronavirus pandemic, Toronto teen Serena Sri is sorely missing all the “amazing” things about adolescent life, from spirit days, intramural sports and learning in-person at her high school in the city’s west end to hanging out with friends and attending her beloved hip-hop dance class.

“I’m really a social person and I love being around people. With the pandemic, we can’t do that,” she said.

“I kind of feel more alone and I kind of… shut down in a sense. And I lose my motivation to do anything, even simple things in my daily life.”

The pandemic has also had a negative effect on Edmonton student Quinncy Raven-Jackson, who says a more solitary life under COVID-19 restrictions has exacerbated the anxiety disorder he’s been dealing with.

“I have difficulty with social interaction sometimes, so not seeing people, I sometimes forget how much these people care about me and stuff like that. So it was very lonely,” said the 19-year-old University of Alberta freshman. 

“I have a good relationship with both my parents and a great therapist, so I had some safe adults to speak to, fortunately. But even when you have those kinds of help, it doesn’t always really resonate.”


‘I have difficulty with social interaction sometimes, so not seeing people, I sometimes forget how much these people care about me,’ said Edmonton student Quinncy Raven-Jackson, ahead of a bit of cycling with his dad, Mark Jackson. (Peter Evans/CBC)

The COVID-19 pandemic has left many teens and young Canadians feeling disconnected, hopeless and unmotivated to navigate school and daily life — and this sentiment is causing concern for parents and experts alike.

“Everyone’s normal has now changed into something completely different from what it was 10 months ago,” said Sadia Fazelyar, a post-secondary student and youth mental health advocate for Jack.org, a national charity focused on young Canadians.

“The biggest thing I hear from youth is it’s this whole new thing that nobody really knows how to navigate properly.”

Many young people aren’t comfortable speaking up about difficulties, feelings or mental health struggles they’re facing, so they look to sports, the arts, clubs or social groups as a form of support, Fazelyar says. “Now it’s all been taken away from them and it really hits them hard.” 

WATCH | What would young Canadians tell their pre-pandemic selves?

Canadian teens and young adults on mental health challenges and thoughts about living through the pandemic. 4:40

Seeing classmates, friends or family through a screen, even regularly, doesn’t offer the same opportunity for connection, added the 21-year-old Ryerson University student.

“Youth feel alone. And it’s kind of hard to have that conversation or even to bring it up … because it feels like they shouldn’t be alone. They get to talk to their classmates five days a week on Zoom in the classroom. They can call their friends. They get to be with their family, but it’s just not the same.”

Concern about the mental well-being of Canada’s youth is rising. A child mental health research team spearheaded by Toronto’s Hospital for Sick Children is currently conducting a study into the effect COVID-19 is having on the mental health of young Canadians. Ottawa clinics and support groups are seeing a spike in demand for mental health resources, while medical officials in Calgary have noted a rise in cases of eating disorders

Wanting to explore what kids and teens are thinking and feeling about COVID-19, Nikki Martyn, program head of early childhood studies at the University of Guelph-Humber, launched a research project analyzing artwork created by youngsters in response to the pandemic.

Though submissions came from children as young as two years old, the majority were by 14- to 17-year-olds, says the educator and child psychology researcher. “It shows how much teenagers really want to be heard and have so much to say.”

The artworks include illustration, painting, sculpture, mixed-media creations, even musical compositions, and the message within them is clear, according to Martyn: It’s a painful time and young people are struggling.

WATCH | Social isolation, school closures take a toll on mental health of teens:

Teenagers are struggling with mental health during the COVID-19 pandemic, even more than usual. A few of them share their struggles and a psychologist shares an art project that helps teens express themselves. 6:45

“They’re feeling sad and alone and isolated and worried and scared. They feel lack of motivation and distress and failure,” she said.

“What I worry about is the helplessness or the disillusionment about their own future. Sometimes even anger, which we all understand. It’s the same things in some ways that we’re feeling as adults, but it’s different because of where they’re at developmentally at this time of their life.” 

The writing and phrases included within some of the artwork — “What’s the point? No one cares. This is too much. I am not OK. Broken’ — speak volumes, Martyn added.

“The teens were able to share this perspective and their experience very clearly. I think it’s really important that we listen to it.”


The majority of artworks submitted to her new research project were from 14- to 17-year-olds, showing ‘how much teenagers really want to be heard and have so much to say,’ says child psychology expert Nikki Martyn, seen with her 15-year-old son Carson Capobianco in Toronto. (Evan Mitsui/CBC)

‘It’s OK to not be OK now’

Martyn says she believes these pandemic-inspired feelings go beyond the already powerful emotions and stresses teens have in regular times, but that this moment also presents families with an opportunity to normalize open discussion about mental health.

She suggests parents open up to their kids and teens about their own vulnerabilities, sharing when they themselves are feeling drained, that they’ve had enough or that they also can’t wait for this all to be over.

“It’s OK to not be OK now,” she said.


Right now, small steps like getting outdoors and talking to a counselor are helpful, says Serena Sri, seen here with her mother Ashanty. ‘Making sure that I’m still like going outside for walks, even though it’s only with my mom.’ (Turgut Yeter/CBC)

Ashanty Sri is worried about the toll the pandemic is taking on her daughter Serena, who has also been diagnosed with anxiety. She wonders about what longer term effect there may be on today’s teens, who are navigating growing up without the social, classroom and even part-time job experiences they’re used to. 

For now, the mother-daughter duo are putting the focus on mental wellbeing by taking small steps, noted the Toronto elementary school teacher. Getting active outdoors has helped, added Serena. 

“Making sure that I’m still like going outside for walks, even though it’s only with my mom… Also a great outlet is talking to somebody like a counselor or a therapist, because I feel like it helps releasing everything.”

Maintaining connections with peers is another recommendation from Fazelyar, the youth mental health advocate — things like regular phone or video calls with friends, online game nights, watching movies together via apps or, if local restrictions permit, physically distanced time outdoors.

“You should still be ‘being social,'” Fazelyar said. 

“When you’re thrown into this or you feel like you’re kind of alone because you don’t have your friends or social network, it’s just best to find new ways to adapt.”

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‘We have a youth vaping crisis’: 1 in 3 teens have tried vaping, Statistics Canada finds

More than one third of teenagers 15 to 19 have tried vaping at some point in their lives, according to a new report from Statistics Canada, the first of its kind to provide detailed information about vaping.

The Canadian Tobacco and Nicotine Survey, based on data collected from 8,600 people in November and December 2019, found that 36 per cent of teens in that age bracket had tried vaping, and 15 per cent reported doing so in the past 30 days.

“The new data reinforces the trend that we’ve been seeing over the last short while, which is that we have a youth vaping crisis,” said Sarah Butson, public policy analyst for The Lung Association.

“It demonstrates to us that vaping is in the hands of exactly the folks we are trying to protect and really emphasizes that we need to do more.”

She said The Lung Association has been calling for stricter regulation of vaping products, including a wholesale ban on flavours, “which are an incredibly powerful marketing tool for young people.”

Likewise, 15 per cent of young adults ages 20 to 24 had vaped in the 30 days prior to the survey, while nearly half (48 per cent) had done so in the their lifetimes.

In comparison, just three per cent of adults ages 25 and older reported that they had used a vaping product in the previous month, while 12 per cent had tried it at least once in the past.

Among the people surveyed who had vaped in the past 30 days, about 80 per cent had vaped nicotine.

Reasons for vaping vary across age groups

Those who responded to the survey were asked to identify their main reason for vaping in the 30 days prior to the survey. Among users ages 15 to 19, 29 per cent chose “because they wanted to try” and another 29 per cent picked “because they enjoyed it.”

Only nine per cent of teens surveyed cited a desire to quit or cut down on smoking cigarettes as their main motivation for vaping.

But among the 20- to 24-year-old cohort, 28 per cent said smoking cessation was their main reaso, along with more than half of those 25 and older.


Sarah Butson, public policy analyst for The Lung Association, said the organization is calling for stricter regulation of vaping products, including a wholesale ban on flavours, which she says are very powerful for enticing young people to take up the habit. (Submitted by Sarah Butson)

When vaping products first came to market, they were billed as harm-reduction and smoking cessation tools for tobacco users. But Butson said it’s unclear they’re effective that way.

“What we’ve seen to date is that the evidence is really inconclusive to suggest that e-cigarettes can be a cessation aid,” she said.

Instead, the association urges Canadians to talk to their health care providers about evidenced-based tools that can help them quit smoking.

‘We need to do more’

Butson said there’s been good strides made at the provincial level, with some moving to restrict flavours and increase the age to purchase vaping products.

“We would like to see that happen at the federal level, to really set the benchmark and make sure that we don’t have disparity across provinces so that we’re really protecting all Canadians, in particular all young Canadians.”

Butson said youth have a number of misconceptions around vaping. “One of the most common myths is that it’s harmless,” she said. 

In fact, vaping-related illness is on the rise in both Canada and the U.S.

Also, teens often underestimate the amount of nicotine that’s in the vaping products they use, she said.

The Statistics Canada report bears that out. 

It found that one in 10 users in both the 15- to 19-year-old and 20- to 24-year-old age brackets had tried a vaping device without knowing whether or not it contained nicotine.

It also found that teens were the most likely to think that vaping is less harmful than smoking at 27.9 per cent, compared to 11.6 per cent of users 25 and up.


The Heart & Stroke Association says it wants a ‘calculated approach’ that severely curbs teen recreational use while still allowing adults to use vaping products to reduce or eliminate tobacco use. (CBC)

Lesley James, senior manager of health policy at Heart & Stroke, said it will be a decade before the health implications of vaping are truly understood.

“It took a long time to determine how harmful tobacco was. We don’t want to make the same mistake with vape products that we did with tobacco,” she said.

Vaping may have a role in helping adult tobacco users to reduce their use or quit entirely, she said, but the study confirms they’re mostly used by young people for recreational purposes.

That’s what Heart & Stroke and the Lung Association want addressed as part of a public awareness campaign launched in January.

“We’re really asking for a calculated approach that regulates these products and keeps them out of the hands of young people — that we’re not creating a new generation of people addicted to nicotine — but still allow for adult smokers who want to use the products to quit, to have access to do so,” said James.

“But right now we don’t have that calculated strategy.”

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Ontario teen’s vaping injury consistent with ‘popcorn lung,’ study suggests

An Ontario teen who was put on life-support with a severe vaping-related illness may be the first documented case of a different form of damage linked to e-cigarettes, according to a study published Thursday in the Canadian Medical Association Journal.

The study suggests the teen’s condition is more in line with “popcorn lung” — named for factory workers who developed lung disease after breathing in heated flavouring — as opposed to the illness that’s been dubbed EVALI

Medically known as bronchiolitis obliterans, popcorn lung is linked to diacetyl, a chemical that provides a buttery or caramel-like flavour. Although it’s safe to eat, it is dangerous to inhale.

The case emerged months ago, when the previously healthy 17-year-old turned up at the emergency room of a London, Ont., hospital with a severe cough, shortness of breath and a fever. 

He was initially diagnosed with pneumonia and sent home with antibiotics, but returned five days later with worsening breathing difficulties, fatigue and nausea. 

Doctors learned that in the five months leading up to his illness, the teen had vaped heavily each day, using a mix of flavoured e-cigarette cartridges bought online; his favourites were green apple, cotton candy and “dew mountain.” He also regularly added THC to the liquids.


Dr. Tereza Martinu is a lung transplant respirologist with Toronto General Hospital who was part of the teen’s care team and a co-author of the study. (John Sandeman/CBC)

The teen was admitted to hospital and placed on a ventilator, but his condition continued to worsen. Over the next two weeks, he required intubation, was placed on a higher level of life-support known as ECMO and underwent a tracheostomy. 

By Week 3, he was transferred to Toronto General Hospital for evaluation at its lung transplant program.

“It was a relatively wild story; we have not seen something like this that often,” said Dr. Tereza Martinu, a lung transplant respirologist who was part of the teen’s care team and a co-author of the study.

“The referring team was really worried that he was not going to make it.”

The teen, whose identity has not been released, avoided a double lung transplant, and his condition slowly improved over the next two weeks as he was treated with high-dose steroids.

After a 47-day hospital stay, he returned home, where he is still recovering, possibly with chronic lung damage.


A CT scan of the teen’s lungs show a number of ‘tree in bud’ patterns, as shown by the the white patches throughout — indicative of airway inflammation. (CMAJ)

Martinu says while the teen has improved “significantly,” four months later, his airways remain severely obstructed, he has shortness of breath and doesn’t fully respond to puffers. 

“If he truly does have this bronchialitis oblitirans scarring problem that we’re worried about, he will likely remain with some amount of lung disease,” she said. “But we won’t really know until we see how it evolves.”

Scans suggested different illness

The researchers suspected bronchiolitis after scans of his lungs showed a so-called “tree in bud” pattern: tiny nodules connected to longer bronchial “branches.”

The pattern is most commonly associated with a bacterial or viral infection, but the teen’s infection work-up was negative. 

While the scan patterns associated with EVALI (for “e-cigarette, or vaping, product use associated lung injury”) have been diverse, the study notes it most commonly presents as either “consolidation” or “ground glass opacity,” both of which suggest damage to the sponge-like lung tissue known as alveoli, or air sacs.


The results of the teen’s transbronchial biopsy are shown at various magnifications. The blue dots scattered through are indicative of inflammation of the tissue. (CMAJ)

In this case, however, Martinu said the teen’s alveoli was relatively unaffected. Transbronchial biopsies also helped to rule out other possible explanations.

“The disease that we saw both on X-ray, CT scan and a little bit on the biopsy really looked like it was centred on the airways, or … the small breathing tubes, and not further away in the air sacs,” said Martinu.  

The study notes the researchers cannot “pathologically” confirm bronchiolitis obliterans because a more thorough surgical lung biopsy was deemed unsafe. The team also did not evaluate the specific vaping products used by the teen, who had discarded his spent cartridges. 

While bronchiolitis obliterans hadn’t previously been documented in patients with vaping-related illness, health officials have considered it could be a likely consequence.

Call for ban 

The doctors say the teen’s case offers further proof that vaping-related illnesses can take different forms; they’re calling for more research to better understand an issue that has already raised alarm around the world.

In the U.S., the Centers for Disease Control and Prevention (CDC) has reported 42 deaths linked to vaping and 2,172 injuries. In Canada, there have been eight confirmed or probable cases recorded by Health Canada, though this Ontario case is not counted among them, possibly because of its different presentation. 

“We know that vaping is often seen in a younger population,” said Dr. Simon Landman, another study co-author involved with the teen’s care, and a physician at the London Health Sciences Centre. “We don’t want to see anybody sick, but it’s quite eye-opening when it’s very young people who have been previously healthy.”

In an accompanying editorial, the CMAJ again called for a Canada-wide ban on flavoured vaping liquids, stricter regulations on advertising, and standards put in place on all e-cigarette products.

“These cases have occurred because of the near-complete absence of government regulations on the composition, quality, design and manufacture of e-cigarettes and e-liquids,” the editorial said.

While investigation into the illnesses is ongoing, the CDC suggested earlier this month that vitamin E acetate — often used a thickening agent in some products — could be a primary culprit.

Health Canada said in a statement that it welcomed the study.

“Health Canada will continue to monitor all available data sources and surveillance systems and will take additional action, if warranted and as appropriate, to protect the health and safety of Canadians,” the statement said.

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Trump backing off ban on vaping flavours popular with teens

When U.S. President Donald Trump boarded Air Force One to fly to a Kentucky campaign rally two weeks ago, a plan was in place for him to give final approval to a plan to ban most flavoured e-cigarettes.

By the time Trump landed back at Joint Base Andrews outside Washington a few hours later, the plan was off. And its future is unclear.

For nearly two months, momentum had been building inside the White House to try to halt a youth vaping epidemic that experts feared was hurting as many as five million teenagers.

Both Melania Trump and Ivanka Trump, the president’s wife and daughter, pushed for the ban, which was also being championed internally by White House counsellor Kellyanne Conway, who has taken lead on some public health issues.

But as Trump sat surrounded by political advisers on the flights to and from Lexington, he grew reluctant to sign the ban, convinced it could alienate voters who would be financially or otherwise affected by a vaping ban, according to two White House and campaign officials not authorized to speak publicly about private conversations.


U.S. Secretary of Health and Human Services Alex Azar looks on as President Donald Trump talks about a plan to ban most flavoured e-cigarettes, in the Oval Office of the White House, Wednesday, Sept. 11, 2019, in Washington. (Evan Vucci/The Associated Press)

A news conference scheduled by Health and Human Services Secretary Alex Azar to announce the ban was cancelled, while more meetings with industry leaders and lobbyists were proposed, according to the officials.

Trump tweeted last week that he’ll be meeting with vaping industry representatives, medical professionals and others “to come up with an acceptable solution to the vaping and e-cigarette dilemma.”

The White House has yet to announce a date for a meeting.


This month, Trump campaign manager Brad Parscale and others showed the president polling data indicating that e-cigarette users could abandon him if he followed through with the ban, the officials said.

Campaign aides also highlighted an aggressive social media campaign — #IVapeIVote — in which advocates claimed a ban would force the closure of vaping shops, eliminating jobs and sending users of electronic cigarettes back to traditional cigarettes. Parscale also reportedly pointed out the risk that a ban could have on e-cigarette users in key battleground states that Trump narrowly won in 2016.

Others in the West Wing, including Conway, have argued that a ban could be a winning issue with suburban voters, including mothers, who have fled the president in large numbers. Few would predict where Trump — who is known to abruptly change his mind — would end up on the issue since he recently has been consumed with other matters, notably the impeachment hearings.

Industry opposition

The vaping industry’s largest trade group said Monday the administration was heading “in the right direction for adult smokers and their families.”

“Bans don’t work, they never have,” Tony Abboud, executive director of the Vapor Technology Association, said in a statement.

Gregory Conley, president of the American Vaping Association, an advocacy organization, added that the government should put in place “sensible and targeted regulations” before it resorts to prohibition. Opponents of a ban say that could lead to the creation of an underground market for electronic cigarettes.

But Matt Myers, president of the Campaign for Tobacco-Free Kids, said Trump would be guilty of “terrible public policy” and “bad politics” if he backs down.

“This is one of the very few issues on which public views are unified,” said Myers. “There are a small number of vape shop owners who are loud and don’t care. But there are millions more moms and dads who are deeply concerned.”

Robin Koval, president and CEO of the Truth Initiative, a non-profit, anti-tobacco organization, called on Trump to implement the original plan.

“The health of America’s youth must come first and is not for sale or political gain,” Koval said in a statement.

Melania Trump a major proponent

Melania Trump had opened the White House to a group of young people from the Truth Initiative in October, who told her about their experiences with vaping.

Trump’s initial pledge on Sept. 11 to ban virtually all flavoured e-cigarettes stunned vaping proponents and was immediately embraced by anti-tobacco advocates. In an Oval Office appearance with his wife and Azar, Trump said the government would act within weeks to protect children from fruit, candy, dessert and other sweet vaping flavours, including mint and menthol.

The announcement followed a tweet two days earlier by Melania Trump expressing concern “about the growing epidemic of e-cigarette use in our children.”


“We need to do all we can to protect the public from tobacco-related disease and death, and prevent e-cigarettes from becoming an on-ramp to nicotine addiction for a generation of youth,” she said.

Protests, online campaigns push back

But within days, Trump tweeted that e-cigarettes might be a less harmful alternative for smokers, a point long made by the industry. Meanwhile, vaping lobbyists, conservative groups and Republican lawmakers from key states warned Trump that a crackdown could cost him with voters.

The Vapor Technology Association launched ads and an online campaign promising to punish Trump and other politicians who support vaping restrictions. Conservative groups that have long promoted vaping as an alternative to smoking, including Americans for Tax Reform, joined the criticism.

That group and others helped organize protests against banning flavours, including one outside the White House. Trump supporters also showed up at some of his campaign rallies holding signs expressing their opposition to a ban.

The industry warned some 15,000 to 19,000 vaping shops across the country — and jobs — could be wiped out if flavours were eliminated.


Vaping advocacy groups and storeowners around the country held a rally outside of the White House to protest a proposed vaping flavor ban on Nov. 9, 2019. (Jose Luis Magana/AFP via Getty Images)

The administration was widely expected earlier this month to announce a scaled-back flavour ban that would exempt menthol, citing research that the flavour was not widely used by children. But no decision came.

Trump instead told reporters on Nov. 8 — four days after his political advisers buttonholed him on the Kentucky trip — he was considering new approaches to curbing teen use, including raising the minimum age for purchasing tobacco from 18 to 21.

Last week, Wisconsin Republican Sen. Ron Johnson sent Trump a letter warning against “unchecked government action that stifles innovation and restricts adults’ freedom to choose safer alternatives to smoking.”

Asked how disappointed Melania Trump would be if the president did not follow through with a ban, spokesperson Stephanie Grisham, who also speaks for the president, said the first lady’s priority is the health and safety of children.

“She does not believe e-cigarettes or any nicotine products should be marketed or available to children,” Grisham said.

Underage vaping has reached what health officials call epidemic levels. In the latest government survey, one in four high school students reported using e-cigarettes in the previous month.

Anticipating a ban on flavours, Juul Labs, the country’s largest e-cigarette maker, said this month it would stop selling its bestselling mint-flavoured nicotine pods.

U.S. considering flavored e-cigarette ban 5:42

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Health Canada investigating ads for natural health product targeting anxious teens

A new natural health product aimed at teens may be marketing itself as a treatment for anxiety, counter to Health Canada guidelines.

The federal department is investigating the advertising for Veeva Teen, an herbal supplement it approved for sale in April to treat “nervousness and/or restlessness.” Under Health Canada rules the product cannot be marketed as a treatment for anxiety.

Veeva Teen’s promotional materials claim it is the first product of its kind for teens that’s licensed by Health Canada “for the relief of nervousness and agitation due to mental stress … all without any scary side-effects.”

The product’s website had said, “Veeva Teen has been professionally formulated as a powerful blend of botanicals, minerals and vitamins to help teens suffering from anxiety.” The word “anxiety” was removed some time after 6 ET on Friday, and one day after CBC News spoke with Veeva’s founder.

Mental health advocate Erin Kendal, 16, is concerned about the way the product is being marketed and fears teens could find it confusing.

“If Health Canada is saying that they can’t say it’s an anxiety medication, they need to say it in big [letters] that this is not an anxiety medication — otherwise, you’re going to assume that it is,” said Kendal, who works with Jack.org, a nation-wide youth group that works to tackle the stigma around mental health issues.

A screenshot of a section of Veeva’s product page for its Veeva Teen formula. The word ‘anxiety’ appears four times. (veeva.ca/teenformula)

 

In an email to CBC News, Health Canada said it “approved specific claims for this product, including ‘to help relieve nervousness and/or restlessness’ but not to help relieve anxiety.”

It said it is looking into Veeva Teen and will ask the company to take corrective action if it finds any non-compliance.

‘I think it’s confusing’

The founder of B.C.-based Veeva Inc., Alain Roy, said the language on the bottle was approved by Health Canada and that he will follow any recommendations made by the agency.

“What’s on the label is a copy/paste job of what’s on the licence,” Roy said from a natural health store and pharmacy in Vancouver.

But Roy acknowledges some news releases for the product specifically mention anxiety studies. He says he thinks the public will be able to make the distinction.

Alain Roy, founder and president of Veeva, says the company’s adult products sparked demand for a product for teens.

 

“‘Nervousness’ is a term that should be clear to a lot of people, I think, and ‘restlessness’ and ‘agitation’ and ‘mental stress.’ I think people know what these words mean,” said Roy. “Will they think that therefore it’s a product for anxiety? I don’t know, but that’s not what it’s for.”

Clinical psychologist Dr. Melanie Badali, of Vancouver, isn’t so sure.

“I think it’s confusing,” Badali said. “This is what I do: I’m a clinician. I do research. And I’ll say I’m nervous when I’m anxious — I will often use those terms interchangeably.”

‘We’re not licensed doctors’

Kendal thinks most teens won’t be able to distinguish between anxiety and the symptoms Veeva Teen says it can help.

“What I don’t love is that it does seem to be promoted as almost like a magic drug fix,” Kendal said.

“Their website, you know, it’s bright, it’s colourful, it’s ‘Hey! This is going to help you. This is gonna make you feel better.’ But I personally don’t like the way that it’s advertised.”

WATCH: Erin Kendal says there isn’t enough information about Veeva Teen

Erin Kendal, 16, says there is not enough information available about Veeva Teen mental health supplement for teenagers 0:45

Kendal has been on prescription medication since she was 13 and says she worries that there haven’t been any clinical trials to support Veeva Teen’s claims — something Health Canada does not require for natural health products.

Kendal is also concerned there isn’t enough information about the scientific basis for the product’s claims, or about how it may interact with other medications.

Roy said he doesn’t have any data on how Veeva Teen might interact with other medications.

“When people ask us those questions, we tell them that they have to check with their health care professional,” he said. “We’re not licensed therapists or licensed doctors.”

Dr. Melanie Badali says anxiety is normal and even necessary at times, and it’s important for teens to develop ways to deal with it.

 

Roy has worked in the natural products industry for decades. He says was inspired to create natural products specifically for mental health after his mother’s suicide in 2012.

His company sells 10 other natural health products that Health Canada has licensed to help with a range of issues, like improving sleep or lowering stress.

Veeva launched the product aimed at teens in late August to coincide with the start of the school year.

Roy said Veeva Teen’s claims are based on Health Canada’s publicly accessible online  “monographs” for ingredients, which outline information on risks and directions of use.

“We developed it with the science that Health Canada gives us,” Roy said.

The company’s adult supplement is permitted to say it helps with anxiety because it has a different formula.

Regulation of natural health products ‘faulty’

The ingredients in Veeva Teen may be on Health Canada’s approved list, but the bigger issue is the agency’s approach to regulating natural health products, says Tim Caulfield, research director at the University of Alberta’s Health Law Institute.

“I don’t think that people should take comfort in the fact that Health Canada is merely looking into this, because the entire regulatory regime is faulty,” Caulfield said.

“Just because it’s an herb doesn’t necessarily mean it’s safe and effective,” he said. “This is the naturalistic fallacy that is so often associated with these kinds of products.”

Caulfield worries about the message a natural supplement in pill form is sending to nervous teens.

“I kind of have a problem with the general marketing approach because they’re basically saying we should medicate our kids,” he said.

Roy says his product is not meant as a teen stress cure-all but is intended to help supplement other activities.

Timothy Caulfield, a health law and policy expert at the University of Alberta, says the bigger issue is how Health Canada regulates natural health products.

 

“We would hope that teens resort to other lifestyle strategies first to deal with their nervousness or restlessness, mental stress,” Roy said.

Badali says anxiety may not necessarily be a bad thing for teens.

“I don’t know that we need to try to relieve anxiety if it’s not causing any problems,” says Badali, who specializes in treating anxiety and depression and is a director of Anxiety Canada.

She says it is important for teens to learn to live with a certain amount of stress and develop coping mechanisms that don’t require pills.

Kendal says she likes to try a variety of activities to cope with stress, and natural supplements isn’t one of them — at least for now.

“I feel like it could be a great idea and it could be very helpful. But, again, it’s not quite there yet,” Kendal said.

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Vaping industry insiders demand to know brand in London, Ont., teen’s near-fatal illness

London, Ont.’s medical officer of health says he won’t give in to vaping industry demands that he release the name of the brand used by a high school student who was on life-support after using a vaping device, the first such reported illness linked to the practice in Canada. 

Last week, Dr. Chris Mackie of the Middlesex-London Health Unit said the teenager’s near-fatal respiratory illness was linked to vaping. During Wednesday’s news conference, Mackie was asked what brand was used when the student fell ill, but Mackie refused to release the information.

Since then, industry insiders, including manufacturers and store owners, have written emails to Mackie — copying Ontario Health Minister Christine Elliott, a number of government health agencies and media outlets — demanding he release the name of the vaping product. 

But Mackie said Monday: “The reality is their customers are at risk regardless of what brand they are vaping. People are getting sick from vaping and it’s not associated with one brand.

“Manufacturers and distributors want us to be believe this is some kind of bad actor. The reality is it seems to be more about the consumer, that certain people are more vulnerable. It does not appear to be a brand-related issue.”

Industry members, however, are still intent on finding out the name of the brand used by the student.

“I am deeply concerned,” Thomas Krisop, owner of Alternatives and Options Vaporizers and eLiquids, a vape store based in Morinville, Alta., told CBC News on Monday.


Thomas Krisop, the owner of Alternatives and Options Vaporizers and eLiquid based in Morinville, Alta., says he has customers who have returned to smoking after hearing about the London teen’s illness. Industry members want to know the name of the brand used by the London teen, but medical officials in London won’t release it. (Supplied)

“I have customers that have gone back to smoking. They’re getting messages from their family members saying they should go back to smoking because smoking is better than vaping. Vaping will kill you.”

Mackie offered to review Krisop’s inventory list, and has since informed him his Alberta store does not carry the product linked to the teenager’s illness. 

Now, others have sent their inventory lists to Mackie, wanting their products to be ruled out. 

‘I’m concerned’

Among them is Charles Byram, the founder and CEO of Moncton, N.B.-based e-liquid manufacturer FOV Labs. 

“The reason I wrote to Dr. Mackie is because I’m concerned, I want to know what made people sick,” he told CBC News on Monday. “If we keep that information away from the public, then we’re not serving the public.

“Once we find out what it is, we can act upon it,” he said, noting he believes his product is not linked to the London teen’s respiratory illness. 

“I’m 100 per cent sure our products weren’t sold in London.”

Byram said Mackie should have clarified what product was behind the teen’s illness so people aren’t led to believe all vaping is a health risk. 

“When you keep that kind of information from the public, it tends to scare smokers away from choosing a healthier product,” he said, adding “the term ‘vaping’ is being used very loosely.”

Call from health coalition comes after officials announce first Canadian case believed to be linked to vaping. 2:03

In the United States, there have been hundreds of cases of respiratory illnesses linked to vaping and at least seven deaths.

Health officials said the London teen is reportedly doing well since his release from hospital.

Mackie said that when compared to smoking, which still kills 20 million people a year worldwide, vaping is relatively safe.

“You’re setting the bar pretty low.”

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Cannabis product not the culprit in Ontario teen’s vaping-related illness, health official says

The teen who was hospitalized with a severe, vaping-related respiratory illness in London, Ont. did not use a cannabis-related product, the region’s medical officer of health told CBC News.

The high-school aged person who fell ill earlier this year was in intensive care and has recovered. 

Dr. Chris Mackie, medical officer of health and CEO of Middlesex-London Health Unit, said the person hadn’t been vaping cannabis.

“This person was not using those products” that include tetrahydrocannabinol (THC, the main active ingredient in cannabis that gives users a high), Mackie said in an interview Friday. “The person was vaping fairly heavily with a nicotine-based product.”

It is important for people to understand that the severe respiratory illness associated with vaping “is not a remote risk” but very real in Canada, he said.

A local physician reported an “incident” involving an e-cigarette product to a voluntary national database to flag potential problems related to consumer products.

But the database isn’t detailed enough to classify someone as a confirmed or probable patient, said Dr. Theresa Tam, Canada’s chief medical officer of health. 

There are three incident reports from across the country under investigation from the database, with at least one dating back to 2018, Tam said.


Simah Herman, 18, was in a medically induced coma and treated for pneumonia due to vaping. The Los Angeles, Calif., woman posted an image of herself in a hospital bed holding a sign that said ‘I want to start a no vaping campaign’ that went viral as vaping advocates also take to social media. (Lucy Nicholson/Reuters)

Tam did not reveal the health status of the individuals, their ages or where they’re located. Rather, provinces still need to gather a thorough history of a patient’s potential vaping, clinical symptoms and information on the products and devices used before any cases in the country could be confirmed.

Based on a Canadian version of the U.S. Centers for Disease Control’s case definitions, Tam said physicians are on the lookout for patients with a history of vaping or e-cigarette use in the previous 90 days reporting respiratory illness such as:

  • Cough.
  • Shortness of breath.
  • Chest pain.
  • Fever.
  • Sometimes nausea and gastrointenstinal upset.

Doctors would first rule out any other infectious diseases before considering it a vaping-related case. As more health-care providers routinely ask people whether they vape, more suspected cases are expected to come to light. 

“If you don’t vape, don’t start,” Tam said. “Youth, pregnant women and non-smokers should not vape. Those who do vape should get their product from a regulated, approved source — for example for nicotine-vaping products. There are no current regulated sources of cannabis or THC-containing products.”

Tam said while cannabis and THC-containing products are readily available on the grey market, next month’s regulations should afford protections. For instance, Health Canada will introduce rules on what ingredients can be in THC vape liquids and on how the products and devices are produced and monitored. 

In the U.S., 530 confirmed and probable cases have been reported in 38 states and one U.S. territory, up from 380 a week ago. The country’s eighth death was reported by state officials in Missouri on Thursday. 

The CDC said most patients have reported a history of using e-cigarette products containing THC, many reported using THC and nicotine, and some have reported the use of e-cigarette products containing only nicotine.

‘Paddling upstream’ against marketing

No single device, ingredient, additive or pathway to illness has been identified in the U.S., federal officials there stressed.

Similarly, Mackie said his health unit is not identifying the brand used in the London case, because doing so could implicate one specific product when the international evidence isn’t pointing that way.

Mackie said since Wednesday’s news conference, he’s received a backlash on social media from people who support vaping.

“There is really a firm — I would say vicious — campaign on social media to criticize anyone speaking out against vaping,” Mackie said.

Given that up to 90 per cent of teens in some of his city’s schools report vaping, Mackie isn’t deterred.

“We’re really paddling upstream with the amount of marketing of vaping that there is, and especially of those flavoured products which really appeal to youth.” 

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Many women say 1st sexual experience was forced in teens, U.S. study says

The first sexual experience for 1 in 16 U.S. women was forced or coerced intercourse in their early teens, encounters that for some may have had lasting health repercussions, a study suggests.

The experiences amount to rape, the authors say, although they relied on a national survey that didn’t use the word in asking women about forced sex.

Almost 7 per cent of women surveyed said their first sexual intercourse experience was involuntary; it happened at age 15 on average and the man was often several years older.

Almost half of those women who said intercourse was involuntary said they were held down and slightly more than half of them said they were verbally pressured to have sex against their will.

“Any sexual encounter [with penetration] that occurs against somebody’s will is rape. If somebody is verbally pressured into having sex, it’s just as much rape,” said lead author Dr. Laura Hawks, an internist and Harvard Medical School researcher.

In the years after coerced or forced sex, affected women had more sex partners, unwanted pregnancies and abortions, and more reproductive health problems including pelvic pain and menstrual irregularities than women whose first sexual experience wasn’t forced. Almost 16 per cent reported fair or poor health, double the rate of other women. The study couldn’t establish whether forced sex caused or contributed to any of the health or other problems.

“Experiencing rape at first sexual encounter is an extreme loss of autonomy over one’s sexuality,” Hawks said. She said it’s not surprising that it might lead to later mental and physical health problems, given other studies on lasting effects of trauma.

The results were published Monday in JAMA Internal Medicine.

Poorer psychological well-being

Other studies have found that long-term effects of sexual assault may include social isolation, feelings of powerlessness, stigmatization, poor self-image and risky behaviour, which all may increase risks for depression and other mental health problems, a journal editorial said.

Research published last year also found worse psychological well-being and physical health among women whose first intercourse was forced or coerced.

The new study is an analysis of responses from 13,310 adult women who participated in nationally representative U.S. government health surveys from 2011-2017, before the emergence of the “Me, Too” movement.

The researchers focused on a survey question that asked during in-person interviews if women’s first vaginal intercourse experience with a man “was voluntary or not voluntary, that is, did you did you choose to have sex of your own free will or not?”

The results suggest that for 1 in 16 American women — or 3 million — the first sexual encounter was not voluntary.

According to the federal U.S. Centers for Disease Control and Prevention, nearly 1 in 5 women have been raped in their lifetimes. For almost half of those women, it happened when they were younger than 18.

The study, which asked women from ages 18-44 to recall their first sexual experience, has no information on women’s relationship with the men, who could have been boyfriends, relatives or strangers. Men were not included in the study.

Inadequate sex education

Hawks said boys need to be taught communication skills to prevent them from pursuing sex “with someone who is an unwilling participant.” The onus should not be on the victims, she said.

“The ‘Me, Too’ movement is a promising sign that we’re more willing as a society” to address sexual violence she said.

The journal editorial notes that the study lacks information on women’s health and any abuse before their first sexual encounter. There also is no data on any later sexual violence — which all might contribute to health problems, the editorial said.

“Such research is needed to understand and address the full range and consequences of these experiences,” the editorial said.

Sex education specialist Dan Rice said inadequate sex education in U.S. schools contributes to the problem.

“Our culture teaches people not to be raped instead of teaching people not to rape,” he said.

Close calls

Consent isn’t always on the agenda and boys often aren’t taught how to express their emotions in healthy ways, said Rice, interim executive director at Answer, a Rutgers University group that provides sex education training for teachers and oversees Sex, Etc., a teen-run sex education magazine and website.

Sarah Emily Baum, 19, a staff writer for Sex, Etc., said the study results ring true.

“Almost everyone has a story or a close call like this one or knows someone with a story or close call,” said Baum, a sophomore at Hofstra University in Hempstead, New York.

Baum recalls that a police officer invited to discuss sexual consent and assault at her high school focused only on girls, telling them, “‘You’ve got to make sure you say no and say it loud enough for people to hear.”‘ There was little mention of boys’ responsibility, and no discussion of same-sex assaults or even girls being the aggressors, said Baum, who is gay.

“If I go on a date with another girl, I also have to make sure there is clear consent and clear boundaries,” she said. “It goes both ways.”

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