June 27, 2022
Update: CIPO Statement on COVID-19
CIPO has received many inquiries related to COVID-19, most of which are related to patient medical care, provincial guidelines, or vaccine access. For specific medical inquiries, please contact your healthcare provider, or treating specialist. Please remember to check with your local public health guidelines and recommendations, as these will vary regionally.
CIPO COVID-19 Webinars:
Evusheld is currently available for PI patients in the following provinces:
- Nova Scotia
- New Brunswick
- British Columbia
PEI and Manitoba have not yet released their guidelines and process for Evusheld. Evusheld is currently not available for PI patients in Ontario and Alberta. Patients in all provinces are urged to contact their specialist treater to access Evusheld. CIPO will be launching a letter writing campaign for patients in provinces where Evusheld is not currently available.
There are many companies that are producing vaccines for COVID-19. At the moment, there are four different vaccines available in Canada. To learn more about the different vaccines, please watch our COVID-19 Vaccine Webinar
*Important* 4th Doses and Boosters
Based on emerging data and the recent statement from the NACI, CIPO recommends that all immunodeficient patients 4th dose of COVID-19 vaccine after 6 months. At this point in time, we should be seeing roll out of 4th doses now. However, the situation is evolving rapidly, and can change. Read the recommendation from NACI regarding 4th doses here: https://www.canada.ca/en/
Monoclonal Anitbody Treatment:
Currently there are several monoclonal antibody treatments available in Canada. However, the current dominant strain (ba2 variant) is resistant to monoclonal antibody therapy and therefore you may only be offered antiviral therapy NOT monoclonal antibody therapy. However, check with your local public health regulations as this may change regionally.
Typically, these treatments will work only when given within the first 5-7 days of onset. Tocilizumab, casirivimab/imdevimab (Ronapreve) and sotrovimab (Xevudy) are approved for use in Canada against the COVID spike protein. Tocilizumab is an infused medication (monoclonal antibody) which has been used in hospitalized COVID patients. It is now available for some confirmed COVID positive patients who do not require hospitalization. We are all aware that there is a lengthy delay to obtain PCR results and lengthy wait for access to rapid testing at the testing sites.
- Contact your treating specialist immediately (or your clinic nurse, if appropriate)
- If you present for PCR testing, identify as immunocompromised and indicate that you are followed by a specialist ( allergy and clinical immunology, or hematology).
There are a few studies regarding COVID-19 and primary immunodeficiency patients. We have outlined some of these studies below and the stages they are currently in:
- COVID-19 Vaccine Hesitancy in Primary Immunodeficiency Patients – pending publication
- Global Survey on COVID-19 and PIDs – phase two (physicians only)
- VISID study – currently recruiting
Dr. Kathleen Sullivan, US – https://www.cslbehring.com/vita/2021/what-is-the-covid-19-risk-for-primary-immunodeficiency-patients
Dr. Nufar, Israel – https://www.frontiersin.org/articles/10.3389/fimmu.2020.614086/full
Case report, COVID-19 in patient with GLILD and CVID: https://aacijournal.biomedcentral.com/articles/10.1186/s13223-021-00600-y
If you MUST travel, take the following precautions.
- Have your travel letter
- Take extra medication and treatment, in case you are delayed or stranded
- Take extra sanitation kits (masks, wipes, sanitizer)
- Ensure your masks fit well. CIPO recommends an N95 or medical mask. If you cannot find one or wear one, a paper medical mask under a double layer cloth mask)
COVID-19 in Canada:
Cases of COVID-19 in provinces and across Canada vary by province, with some provinces beginning re-opening phases and other provinces re-opening in certain areas only. Please continue to check your regional public health for area specific information.
For now, CIPO’s medical advisors recommend:
- Continuing to stay home, if possible
- Avoid large gatherings and crowded public spaces, if possible
- Encourage social distancing and raise awareness of PI – explain to others why you are self-isolating
- Encourage your family, friends and networks to donate blood and plasma if they can
- Help minimize workload at the hospital by arriving for your appointments on time
- Wash your hands and avoid touching your face
If you feel ill, or think you may have the virus:
- Do NOT go to the hopsital or walk-in clinic (unless instructed to by your doctor OR you cannot manage your symptoms at home)
- Self-isolate and call your doctor
- Use inhalers (if prescribed) and medications to managed symptoms
Currently, there are no plasma or plasma product shortages in Canada. However, some plasma collection companies have notified CIPO of a drop in plasma collections due to COVID-19. We do not know at this point if this will have an impact on plasma products in 10-18 months.
Recent data shows that SARS-COV2 antibodies are now appearing in plasma protein products, like immunoglobulin replacement therapy (IG). People using IG products can expect some passive immunity through the use of their products.
To learn more about antibodies and PI patients, listen to our “Ask the Experts 2” podcast (insert link)
CIPO will continue to update on this virus as necessary.
For more information, please see the following:
Canadian Blood Services
Public Health Agency of Canada https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html
Government of Canada: www.canada.ca/coronavirus
CIPO will continue to update on this virus as necessary.