Booster campaign in need of a boost, MDs say
Eligible Ontarians have been slow to get third shot
Uptake of COVID-19 vaccine boosters among eligible Ontarians has got off to a slow start, especially for people who recently qualified for a third dose, despite the wide availability of the shots, according to new numbers provided to the Star.
The sluggish pace to date has experts warning that while the initial two-dose regime of vaccinations provides a good defence against severe disease, hospitalization and death, eligible people who have not yet booked a third dose are missing out on a “dramatic increase in protection.”
“Our society is very open now and we have started to see cold weather, so daily COVID numbers are creeping up,” said Dr. Peter Jüni, an epidemiologist and scientific director of Ontario’s COVID-19 Science Advisory Table. “And if we want to continue to benefit from the vaccine protection, we need people who had their shots early, especially if they’re exposed, are older or immunocompromised, to get their boosters now.”
Two weeks ago, Ontario opened third-dose eligibility to about 2.75 million people, including all individuals 70 and over; health-care workers and essential caregivers in congregate settings; those who received two doses of the AstraZeneca vaccine or one dose of the Johnson & Johnson shot; as well as First Nations, Inuit and Métis adults.
That was in addition to about 250,000 immunocompromised people, transplant recipients, patients with hematological cancers, and seniors living in congregate settings, such as long-term-care homes, retirement homes and First Nations elder care lodges, who became eligible in late August.
Of these combined three million people, only about 290,000 have received third doses, most of whom became eligible in August.
Six months must have elapsed since your second dose in order to get a third one.
Jüni stressed that booster shots will help bring the pandemic under control.
“There’s a dramatic increase in protection against infection, which will not only positively impact the prognosis of every single person who gets vaccinated, but also of course contribute to the protection at the population level if people are less likely to get infected and transmit to others,” he said.
Phillip Anthony, manager of the East Toronto mobile vaccination strategy at Michael Garron Hospital, says waning immunity has been seen in some populations, so “it’s important that we do get the booster to maximize immunity and reduce breakthrough infections.”
“Public health restrictions have loosened over the last little while, so this is just another step (so) that we can make sure that we can still operate in the capacity we are right now while keeping each other safe,” Anthony said.
As part of the strategy, the hospital is offering booster doses at its outreach centres and is running mobile TTC clinics with community partners and paramedics to get shots into high-risk neighbourhoods. Teams are also visiting seniors’ congregate care settings to administer both COVID vaccine boosters and flu shots at the same time.
“When you work mobile and you’re going door to door, obviously it takes a little bit longer than running people through a mass immunization clinic,” Anthony added. “It’s more the importance of the accuracy of making sure people who are most at risk are getting their boosters through that mobile clinic.”
Gina Patricio, who received two doses of the AstraZeneca vaccine in the spring, got her booster last Thursday. She encourages everyone who is eligible to do the same.
“What are you waiting for?” she asked. “Compared to other places, we’re very, very lucky, and I don’t understand why people wouldn’t take advantage of that situation.”
Patricio, 60, was “pleasantly surprised” at how easy it was to get her third dose, securing an appointment “right away” at a near-empty clinic near her North York home after calling the provincial booking hotline.
Her parents, in their 80s, are going for their boosters Friday. At the same time, she has people she’s very close to who won’t get the vaccine.
“But I can’t force somebody to do anything. I can only encourage those who want to take it to go for it, and to make that appointment, and to take care of themselves.”
Ministry of Health spokesperson Bill Campbell said in an emailed statement that the province “continues to work with all channels within Ontario including public health units, pharmacies and primary care offices, to vaccinate as many Ontarians as possible.”
More than 22.6 million doses COVID-19 vaccines have been administered, and more than 85 per cent of the population 12 and up has received two doses.
Meanwhile, the Food and Drug Administration in the U.S. is poised to expand access to boosters to all adults. The New York Times reported Wednesday that the agency plans to authorize Pfizer booster doses to everyone 18 and up this week.
Dr. Anthony Fauci, the White House’s chief medical adviser, is arguing that boosters are needed for all to bring the pandemic under control, pointing to the emerging data from Israel.
A large Israeli study using mass vaccination data, published in late October in the medical journal the Lancet, looked at the effectiveness of the Pfizer vaccine after two doses compared to after a third dose at least five months later. It found that the third dose, compared to just two, lowered the risk of hospitalization by 93 per cent, lowered the risk of severe disease by 92 per cent, and lowered the risk of COVID-related death by 81 per cent.
“Keep in mind that we’re already well protected against severe disease after the second dose,” noted Jüni.
“But the added protection that you see is really dramatic,” he said, referring to the findings in the Israeli study.
In Canada, the Pfizer vaccine is expected to be approved for kids aged five to 11 on Friday.
Jüni urged people eligible for boosters to go now, to avoid the possibility of having to wait later when young children are getting their first shots and more adults qualify for third doses.
Ontario says eligibility for third doses will be expanded in the coming months. But some think that’s not soon enough.
Dr. Nili Kaplan-Myrth, an Ottawa family physician, believes boosters should be offered to all adults who are six months past their second dose, now that Health Canada has ruled that this is safe.
“We’re coming up on the holidays, we’ve got people who are going to be getting together and we’ve got people who are going to be travelling,” she said.
“There’s no shortage of vaccine, so why wouldn’t we give those to patients who are about to be past their six months?”
In Ontario, booster shots are currently available for eligible people at hospitals, clinics and pharmacies. Appointments can be made through the provincial booking site or by calling 1-833-943-3900.
For now, Patricio is happy to take a step that will protect her better.
“If I get sick, the chances of me landing in the ICU are less if I get the shots and the booster,” she said.
“I don’t want to die. I’ve got stuff to do.”