Dr. Dec’s Recommendations on the COVID-19 Vaccinations (as of April 20, 2021)

Many of my patients have been calling asking questions about COVID-19 vaccinations. You may be aware that I have been asked to act as the Chair of the Niagara Region Community Coordination Task Force for COVID-19 Vaccination. Information from many sources is changing rapidly regarding COVID-19 Vaccination. I will attempt to present “bullet points” that cover many of the questions people are asking.

  1. The Province of Ontario released a province-wide central booking system on March 15, 2021. It allows you to book mainly based on age categories as they are prioritized.
  2. The Niagara Region Public Health Department has started running mass vaccination clinics at locations rotating all around the Niagara Region. Right now, when in Niagara Falls, the location is the McBain Centre. These are booked through the province-wide central booking system, either on-line or by telephone. https://covid-19.ontario.ca/ontarios-covid-19-vaccination-plan   or   1-888-999-6488
  3. Niagara is following Ontario’s Vaccine Distribution Implementation Plan Ontario’s COVID-19 vaccination program and our Community Coordination Task Force for COVID-19 Vaccination is using principles set out in the Ethical Framework for COVID-19 Vaccine Distributionhttps://www.ontario.ca/page/ethical-framework-covid-19-vaccine-distribution These 2 documents set out a basic prioritization for people to get vaccinated and may be influenced by unique local/regional factors.
  4. The main prioritization of people has been based on age, and age categories have been gradually moved through, usually in 5-year intervals.
  5. Other populations have been targeted according to the above documents, including healthcare workers, developmental sectors and migrant workers.
  6. Niagara Health has set up a clinic at the Seymour-Hannah Arena in St. Catharines & they are vaccinating the different groups & populations, such as those listed above, as well some posting spots on the province-wide central booking system.
  7. Up until now, the vaccines that have been received in Niagara have been mainly the Pfizer brand and some of the Moderna brand. These vaccines are very difficult to transport, which is why they have been used in the large vaccination sites. The vaccine supply to Niagara started slowly but is steadily increasing, especially now that the Astra-Zeneca vaccine is becoming more available in pharmacies and in family doctors’ offices. 
  8. Phase 2 of the provincial vaccination plan, Guidance for Prioritization of Phase 2 Populations for COVID-19covid 19 Vaccination (PDF) starts to target those essential workers and people with underlying conditions, and younger patients with specific chronic conditions, which put them more at risk. These people will likely get moved up in priority, as clinics get scheduled and the prioritization and timelines evolve.
  9. If you are in one of the following groups: Organ transplant recipients; Hematopoietic stem cell transplant recipients; Neurological diseases in which respiratory function may be compromised (e.g., motor neuron disease, myasthenia gravis, multiple sclerosis); Haematological malignancy diagnosed <1 year ago; Kidney disease with eGFR< 30, or an Essential Care Partner of the above, then you are eligible to get vaccinated. I will provide you with a letter to confirm your eligibility, as well as that of your (one) eligible primary caregiver, which I will Fax to the Niagara Health Vaccine Scheduling Office at: 289-398-0198. You and your eligible primary caregiver will also need to bring a copy of the eligibility letter to your vaccine appointment. The Niagara Health Vaccine Scheduling Office will call you to schedule your appointment, after your letter has been received.
  10. The interval between the 2 doses of vaccine (Astra-Zeneca/Pfizer/Moderna) has been extended to 16 weeks, except in certain populations where it should be given in a 21-28 day interval. Those are: Transplant recipients (including solid organ transplants and hematopoietic stem cell transplants) and Individuals with malignant hematologic disorders and non-hematologic malignant solid tumors receiving active treatment (chemotherapy, targeted therapies, immunotherapy) excluding individuals receiving solely hormonal therapy or radiation therapy. If you fall into the above categories, I will provide you with a letter to confirm your eligibility to receive your 2nd dose sooner, which I will Fax to the Niagara Health Vaccine Scheduling Office at: 289-398-0198. You will also need to bring a copy of the eligibility letter to your vaccine appointment. The Niagara Health Vaccine Scheduling Office will call you to re-schedule your 2nd dose appointment after your letter has been received.
  11. Pharmacies in Niagara have started receiving the Astra-Zeneca vaccine which targets those people who will turn the age of 40 in 2021. If you are age 40+, want a vaccine and have the opportunity to book an appointment at a pharmacy, I strongly encourage you to sign up.
  12. Many people have expressed concerns about the Astra-Zeneca vaccine, and are thinking they wish to wait to get either a Pfizer or Moderna vaccine. There are several risks with this approach. With the variants spreading rapidly, the chances that unvaccinated people will get infected in the coming weeks to months are much higher, so getting a vaccine ASAP is paramount and delaying for even a few weeks may be costly. With so many people wanting to get vaccinated and the available appointments at mass clinics being booked rapidly, the next slots available anywhere in the region is reaching into May. Public Health only has knowledge of the amount and type of vaccine a few weeks in advance. Thus, there is a chance that the only vaccine that will be available in May for those 40+ may be the Astra-Zeneca vaccine anyway. There have been reports about “blood clots” in younger patients in Europe (the Astra-Zeneca vaccine is not recommended for people < age 40), however the incidence is extremely rare and quite frankly, the chances are very much higher that if unvaccinated, you will catch COVID, possibly be hospitalized or even die compared to the very remote chance that you will have a major, significant side effect to the Astra-Zeneca vaccine. The odds dramatically favour getting the vaccine if you are age 40+.
  13. All 3 vaccines, the Astra-Zeneca vaccine, the Pfizer vaccine and the Moderna vaccine are safe, effective and are almost 100% in preventing hospitalization and death, which are the 2 outcomes we want to avoid. Please take the first one you are offered. The provincial government has guaranteed a vaccine to everyone who wants one by Canada Day BUT it does not guarantee you the vaccine of YOUR choice, only whichever one may be available.
  14. There are almost no reasons you should not get vaccinated. People have asked whether conditions such as diabetes, high blood pressure, heart disease, cancer, lung disease, previous blood clot, having minor allergic reactions or being on certain medications are reasons not to get vaccinated. The answer is: all these things have NO impact on your ability to get vaccinated. If you had a MAJOR allergic reaction to another vaccine, you may wish to discuss it with me further. If you have a condition, or are on a medication that reduces your immune system, you should probably discuss it either with your specialist or myself. If you are allergic to polyethylene glycol, then please discuss it with me as well. Otherwise, I strongly encourage you to get a vaccine.
  15. Our office is preparing to also offer the Astra-Zeneca vaccine first to our patients aged 55-59, and then likely to those 40-55. We are initially receiving a very limited supply very soon and we do not know what we will get after that. We are creating a list, and I am reviewing everyone’s risk to determine how we prioritize people. Again, if you have the opportunity to receive the Astra-Zeneca vaccine at a pharmacy, before we can give it to you, please capitalize.

Thank you for your patience as we navigate the challenges of vaccine coordination/distribution.

For additional information, I invite you to go to the Niagara Region website  https://www.niagararegion.ca/health/covid-19/vaccination.aspx &  https://www.niagararegion.ca/health/covid-19/default.aspx or the Niagara Health website https://www.niagarahealth.on.ca/

As soon as new additional information is available, it should be posted at the above locations and I will try to keep my website http://www.docdecfamilymd.ca current and up-to-date. If you still have unanswered questions, please contact the office and I will be happy to speak to you directly.

David Dec – B.Sc., M.D., C.C.F.P., F.C.F.P.

Chair – Niagara Region Community Coordination Task Force for COVID-19 Vaccination

COVID-19 UPDATE (April 5, 2021)

Dr. Dec’s COVID-19 UPDATE Information & Direction

Last updated: April 5, 2021

I know it has been a long year, following the local & global events of the COVID-19 Pandemic. These again are unprecedented times and I want to assure you that our office will continue to try its best to service you in the best possible way over the long term, as long as this outbreak lasts. For now, we all continue to be well, and we are in the office for our usual office hours to handle things like questions, medical complaints, prescriptions renewals & other medical needs.

It has been close to 13 months now that we have been tackling the challenge of the COVID-19 pandemic. We have moved back and forth between lockdowns, self-isolating and staying at home, to stages and “colours” where we can socially distance with more people in “bubbles” depending on the orders from the Provincial Government. The local, provincial, federal and global situation still continues to change if not daily, then at least weekly. The Niagara Region’s cases have fluctuated, no doubt impacted by the GTA traffic, and hospitalizations from COVID-19 have been manageable. Several of you have become infected, many of you have been tested and some of you have already been vaccinated. Our office has been trying its best, to maintain services for you. We do prioritize our in-office appointments, as we continue to monitor pregnant patients and update infant/child immunizations. COVID-19 has changed the way we handle patients with more telephone and virtual/video encounters, although we still have needed to see some of you in person, as we are adapting to the new normal environment as per the Ministry of Health and College of Physicians and Surgeons guidelines. Despite this change, your first point of contact should still be with our office if you have medical concerns. We have been maintaining basic regular office hours from 9-5 with Wednesdays 9-12 and Fridays 9-4. 


When you come for an appointment, we ask that you bring and wear a mask.


Once again, please follow these instructions:

Please DO NOT show up at the office without calling first. The accepted approach in the middle of the pandemic at this point in time, is to ensure safe, direct patient contact. We are accepting calls, triaging complaints and then deciding on who can be managed over the phone, as that is still the recommended approach, if it is appropriate. When you call, you will be asked screening questions. Then, if you have an in-person appointment, you will also be screened on-site by our nurses before entering the office. 
If you are unable to get through at (905) 356-2228 because call volumes are high, then feel free to communicate with us by either FAX (905) 356-8161 or by e-mail at reception@docdecfamilymd.ca and we will get back to you as soon as we can.

Please follow the public health recommendations:

1. If you have any symptoms of upper respiratory illness, please quarantine yourself, away from others to avoid spreading what you have, which is likely another virus. We will likely advise you to get tested for COVID-19, even if you have minor symptoms.

2. If you have any classic symptoms of COVID-19, specifically new or worsening cough, fever of > 38.0°C or shortness of breath, please call in to speak to us. Or if you have other unusual symptoms (for example: loss of smell/taste or diarrhea) you can take any of the self-assessment surveys listed in the links below. If your condition is serious, please proceed to the Emergency Department.

3. There are 3 COVID-19 Testing Centres in Niagara, one at south part of GNGH beside the Emergency Department, one in Welland & one in St. Catharines, & you now do NOT need a doctor’s referral to get tested but there are no walk-in appointments & you have to call to arrange an appointment. The number is (905) 378-4647 ext. 42819. The recommendations for testing are if you are symptomatic as above, or have been in contact with a + COVID-19 case or have been in contact with a person suspected of being positive. Random testing of asymptomatic patients “just so you know” is not recommended.

4. If you have specific questions regarding COVID-19, you may call the Public Health Hotline directly @ (905) 688-8248 ext. 7019.


Other good resources are:

[a] www.niagararegion.ca/health/covid-19/default.aspx 
[b] www.ontario.ca/page/2019-novel-coronavirus
[c]  Ontario Medical Association – www.virusfacts.ca
[d] www.niagarahealth.on.ca/site/covid-19

VACCINATIONS:

Information is changing rapidly regarding COVID-19 Vaccination. The Province of Ontario released a province-wide booking system on March 15, 2021. Niagara Region Public Health Department started mass vaccination clinics a few weeks ago, starting with those people 80 years old and older and has moved through 2 other age groups, 75-79 & 70-74 and will soon be moving to the 65-70 group & eventually the 60-65 group. The specific site locations of clinics have rotated around the region & are listed on their website (see above & below). In addition, there is an ongoing clinic in St. Catharines at the Seymour-Hannah 4-pad arena, run by Niagara Health. When the clinics are in Niagara Falls, they are located at the McBain Centre. Some people were contacted by our office over the past few weeks, to be offered a vaccination appointment, when we were given short notice that there were available spots at the Seymour-Hannah 4-pad arena, and we tried to facilitate filling them. There have been some glitches with the province-wide booking system, so if you are having trouble, be persistent and keep trying! You can book on-line by going to the Niagara Region website or calling the provincial hotline. I am Chair of the Niagara Community Coordination Task Force for COVID-19 Vaccination which is following Ontario’s Vaccine Distribution Implementation Plan and is using principles set out in the Ethical Framework for COVID-19 Vaccine Distribution.

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwigp9XRweDvAhWQXc0KHfAiBScQFjAAegQIBBAD&url=https%3A%2F%2Fwww.ontario.ca%2Fpage%2Fethical-framework-covid-19-vaccine-distribution&usg=AOvVaw3p-GI4SssglEMlahyTkWlt.

These 2 documents set out a basic prioritization for people to get vaccinated and may be influenced by unique local/regional factors. This prioritization has initially been age-dependent regardless of any underlying conditions, and recognizes that the most significant risk factor for COVID-19 hospitalization and death is age. Prioritizing by any other factor is just hard to do, however younger patients with specific chronic conditions which put them more at risk, are covered in Phase 2 of the distribution plan, and will likely get scheduled in some way, as clinics continue to get added and the people put in the cue. Up until now, the Niagara Region has mainly received the Pfizer vaccine and small amounts of the Moderna vaccine. However, we anticipate that Pharmacies in Niagara, as well as some Family Doctors offices will soon be getting a shipment of the Astra-Zeneca vaccine. This vaccine is presently recommended for those aged 55 an over, and in almost 100% effective against hospitalization and death. Our office may get a small limited amount of Astra-Zeneca vaccine in the coming weeks and we will plan to look at those people who are 55+ and have not yet received a vaccine, likely those who are housebound or have bad underlying health problems which put them at higher risk. Please do not call us asking about this, if you are eligible, we will connect you as soon as we have more details. If you wish a vaccine and can get a spot at a pharmacy, please take it. The BEST vaccine is the one you can get as soon as possible, because this virus is spreading fast and if you decide to wait, you are at risk of infection. My recommendation is that you get vaccinated. I have done so, my staff has done so, my eligible family members have done so. I would not recommend anything to you that I would not do myself. If you have any concerns on anything vaccine related, we can point you to good resources or I can speak to you briefly to answer questions.

Thank you for your patience as we navigate the challenges of vaccine coordination/distribution.

For additional information, I invite you to go to the Niagara Region 

website  https://www.niagararegion.ca/health/covid-19/vaccination.aspx &  https://www.niagararegion.ca/health/covid-19/default.aspx

As soon as additional information is available, it should be posted at the above locations and I will try to keep my own website current and up-to-date.

I know everyone continues to be concerned about the future and how long COVID-19 will last, how it will impact all of us from a health and economic standpoint, and how quickly we can start to get back to somewhat of a normal life, or at least whatever the “new” normal will be. The provincial government is guiding everyone, so we are following their direction. I think the best advice is to still take things a few weeks at a time and see how things develop. Much of this we cannot change but we can all do our part, so please follow instructions, use common sense and stay safe. Stay well.

Dr. David Dec & Staff

Dr. Dec’s COVID-19 UPDATE Information and Direction

Last updated: June 21, 2020


It has been over 3 months now that we have been tackling the challenge of the COVID-19 pandemic. We have moved on from self-isolating and staying at home, to stage 2 where we can socially distance with 10 people and “bubble” with another family, as per orders from the Provincial Government. The local, provincial, federal and global situation still continues to change, especially for our neighbours in the United States. Fortunately, the Niagara Region has had a relatively sparse number of cases and hospitalizations from COVID-19 have been steadily decreasing over the past 2 months. Our office has been trying its best to maintain services for you, and have started increasing in-person appointments as per the Ministry of Health and College of Physicians and Surgeons guidelines. We have spoken to many of you over the phone or by video link and have still seen some of you in person, now that we are adapting to the new normal environment. COVID-19 has changed the way we see patients with more telephone and virtual encounters, but despite this change, your first point of contact should still be our office. We have been maintaining basic regular office hours from 9-5 with Wednesdays 9-12 and Fridays 9-4. We have been handling questions, medical complaints, prescription renewals & other medical needs. We will be seeing a higher volume of in office appointments, as we continue to monitor pregnant patients and update infant/child immunizations. We are starting to bring in more regular visits for things such as diabetes, high blood pressure, vitamin B12 injections and other acute complaints.

When you come for an appointment, we ask that you bring and wear a mask.

Once again, please follow these instructions:

Please DO NOT show up at the office without calling first. The accepted approach in the middle of the pandemic at this point in time, is to ensure safe, direct patient contact. We are accepting calls, triaging complaints and then deciding on who can be managed over the phone, as that is still the recommended approach, if it is appropriate. When you call, you will be asked screening questions. Then, if you have an in-person appointment, you will also be screened on-site by our nurses before entering the office.
If you are unable to get through at (905) 356-2228 because call volumes are high, then feel free to communicate with us by either FAX (905) 356-8161 or by e-mail at reception@docdecfamilymd.ca and we will get back to you as soon as we can.

Please follow the public health recommendations:

1. If you have any symptoms of upper respiratory illness, please quarantine yourself, away from others to avoid spreading what you have, which is likely another virus. We will likely advise you to get tested for COVID-19, even if you have minor symptoms.

2. If you have any classic symptoms of COVID-19, specifically new or worsening cough, fever of > 38.0°C or shortness of breath, please call in to speak to us. Or if you have other unusual symptoms (for example: loss of smell/taste or diarrhea) you can take any of the self-assessment surveys listed in the links below. If your condition is serious, please proceed to the Emergency Department.

3. There are 3 COVID-19 Testing Centres in Niagara, one at the Allied Health Building behind GNGH, one in Welland & one in St. Catharines, & you now do NOT need a doctor’s referral to get tested but there are no walk-in appointments & you have to call to arrange an appointment. The number is (905) 378-4647 ext. 42819 .The recommendations for testing are if you are symptomatic as above, or have been in contact with a + COVID-19 case or have been in contact with a person suspected of being positive. Random testing of asymptomatic patients “just so you know” is not recommended.

4. If you have specific questions regarding COVID-19, you may call the Public Health Hotline directly @ (905) 688-8248 ext. 7019.
Other good resources are:

[a] Ontario Medical Association – www.virusfacts.ca

[b] www.ontario.ca/page/2019-novel-coronavirus

[c] www.niagararegion.ca/health/covid-19/default.aspx

[d] www.niagarahealth.on.ca/site/covid-19

I know everyone continues to be concerned about the future and how long COVID-19 will last, how it will impact all of us from a health and economic standpoint, and how quickly we can start to get back to somewhat of a normal life, or at least whatever the “new” normal will be. The provincial government is guiding everyone in this regard. I think the best advice is to still take things a few weeks at a time and see how things develop. Please follow instructions, use common sense and stay safe. stay well.

Dr. David Dec & Staff