On Friday, BC health officials tentatively announced that adults who had their most recent dose at least six months ago can now get their fourth dose, but are strongly encouraged to wait until September. The move followed in Quebec’s footsteps as stories continued to pile up of British Columbians driving to Washington state for booster doses to better protect themselves during a growing wave of Omicron infections. Adding to the mixed messages, text alerts began arriving from the province notifying recipients that booster doses will be available in the fall, ending with the statement: “If you are 18+ and feel you have unique needs, you can get another booster sooner . This is fine, but not recommended,” echoed by the provincial immunization agency. Previously available only to people over 70 or with serious health conditions who received invitations, Dr. Penny Balem spent most of her time Friday speaking as the head of the COVID-19 vaccination program trying to convince people to wait for their shot, but she also said simply, “If you’re really worried, we’ll allow it [now].” This wave of Omicron already has a spike in hospitalizations but fewer deaths with so many people already vaccinated or with some immunity from previous infections helping to stave off the death rates of previous waves.
TO WAIT OR NOT TO WAIT?
Waiting is easier said than done as a growing number of British Columbians pass the six-month mark on their booster, and the BA.5 omicron variant is widely believed to be spreading so quickly because it has evolved in a way that evades immunity. which is already declining for many. CTV News asked Dr. David Fishman, a physician, former provincial health official and current professor of epidemiology at the Dalla Lana School of Public Health at the University of Toronto, with no ties to BC’s health care system, for his advice on what he acknowledges that it is “a dilemma” for many Canadians. “Do you think BA.5 is enough of a risk for you now that you want to take that fourth dose now or do you want to continue until the fall?” he asked rhetorically. “A lot of people, myself included, are looking at autumn and thinking, ‘Oh, autumn is when it’s going to get real,’ because we’re expecting an Australia-like scenario where we also have an early onset of flu. season after not seeing the flu for a while.” Stories of patients getting sick with Omicron for a second or third time will undoubtedly sway someone’s decision on the matter, but Fisman points out that wearing high-quality masks is something each of us can do and choosing to socialize outdoors spaces or with the windows open in the summer is much easier; Conversely, the risk will be higher in the cold months when we are indoors and rely more on the protection provided by the vaccine.
THE PROMISE FOR A BETTER VACCINE
Ballem suggested that by waiting until the fall, British Columbians have a better chance of their next vaccine being bivalent, or specially designed to include protection against the original COVID-19 virus (which current vaccines are) as well as variants derived from the Omicron may be approved by the fall. “It looks very promising,” added Dr. Martin Lavoie, BC’s acting provincial health officer. “These new vaccines and boosters will be vital in helping us maintain our trajectory – a very positive course so far in managing this pandemic.” One thing that all experts agree on, but that has not been well articulated by public health agencies in Canada, is that two doses of vaccine are not enough to provide lasting protection against a growing number of variants. BC tried to convince 1.3 million people who had had two shots to get a third. “I don’t actually think of fourth doses as a second booster, in my opinion it’s a first booster and it’s pretty clear that it’s a three-dose vaccine series,” explained Fishman, who cautioned that tolerance for bivalent vaccines does not guarantee one in the fall. “My expectation is that supply will likely be limited and people at greater risk will be prioritized, whether it’s more comorbidity or age-related disease, so I think if you’re somewhat younger and an otherwise healthy person, I doubt you’ll be in the first queue line to get this special omicron vaccine’.
