With the arrival of the latest COVID-19 variants within the country and the looming flu season on the horizon, many Canadians may be wondering if they should get their booster shot immediately or wait until the newest vaccine formulations arrive.
The updated booster shots are expected to roll out in the fall but are still pending approval by Health Canada. The new vaccines are also tailored to the dominant XBB.1.5 Omicron subvariants that are currently circulating in the country.
Although bivalent COVID-19 vaccines are currently available in Canada, the National Advisory Committee on Immunization (NACI) previously said in July that the fall boosters will target more recent, immune‑evasive SARS-CoV-2 variants.
Some health experts say you might be better off waiting until the updated vaccines are available, while others say not to wait. This leaves Canadians grappling with a crucial decision: whether to get their booster shot immediately or hold off.
“It is it is well and truly confusing,” Kerry Bowman, a professor of bioethics and global health at the University of Toronto, said. “I think we’re getting an incredible lack of clarity as to what should occur. I wish we had stronger guidelines from public health. I feel like we’re on our own on this one.”
Adding to the confusion, he said, is the fact that some people have said they will get both shots, one now and the reformulated version when it becomes available. However, this approach is discouraged, Bowman said, emphasizing that it is advisable to wait at least six months between vaccine shots.
Here’s what health officials are saying about the fall booster shot.
What NACI is saying
In its latest guidance on July 11, “NACI recommends a dose of the new formulation of COVID-19 vaccine for people in the authorized age groups who have previously received a COVID-19 vaccine, if it has been at least 6 months since the last COVID-19 vaccine dose or known SARS-CoV-2 infection (whichever is later).”
It noted the new formulations expected this fall should provide a better immune response to the dominant subvariants. It did not specify whether Canadians should get the current formulation of the booster if the updated version was not available by fall.
“Booster doses in the fall will be formulations updated to target more recent, immune‑evasive SARS-CoV-2 variants,” NACI said in its updated vaccine recommendations.
“Individuals vaccinated with the updated formulation are expected to benefit from a better immune response against these variants compared to current vaccines.”
It emphasized is particularly important for those at increased risk of COVID-19 infection or severe disease including those 65 and over, long-term care residents, people who are pregnant and those with underlying conditions, to get immunized.
What Health Canada is saying
In an email to Global News on Monday, a spokesperson from Health Canada said it encourages “all Canadians to make sure that their COVID-19 vaccination is up to date.”
“Vaccination is one of the most effective ways to protect against COVID-19. All approved COVID-19 vaccines used in Canada continue to be very effective at protecting against severe illness, hospitalization and death from COVID-19.”
The health agency did not specify in its response whether Canadians should wait until the updated formulations become available.
The health department’s website is in line with NACI’s guidance, stating that COVID-19 booster doses may be offered at an interval of six months after a previous COVID-19 vaccine dose (after completion of the primary series or previous booster dose) or SARS-CoV-2 infection, regardless of the product offered.
Bivalent vaccines are the preferred vaccine for booster doses among individuals in the authorized age groups, Health Canada stated on its website, in addition to containing mRNA that encodes the spike protein of the original strain, they contain mRNA that encodes the spike protein of strains of the Omicron variant of concern.
NACI’s updated guidelines have not been added to the Health Canada website.
What the WHO is saying
The World Health Organization on Thursday said it recommends getting a booster or additional dose within six to 12 months, depending on your risk category.
Those who are most at risk should get their booster right away if they are due for one, said Dr. Maria Van Kerkhove, the WHO technical lead on the COVID-19 response, during a WHO question and answer session on social media.
For those who are most at risk, it is “very critical that you get a booster, and don’t wait,” she stressed. “The big message I have for you is don’t wait for the next round of vaccines.”
Previously, on March 28, the WHO said it no longer “routinely recommends” additional COVID-19 vaccine boosters for medium or low-risk people.
The WHO recommended additional booster doses for high-priority groups such as older people, immunocompromised people of all ages, front-line health workers and pregnant people. But for those who fall under the low and medium-risk group, WHO did not recommend additional COVID-19 boosters, citing “low public health returns.”
Because of this, Bowman said part of the confusion surrounding the COVID-19 fall booster is “understandable.”
“This is a very different pandemic profile than what we’ve been dealing with in the past, and whether to get a booster now or later could depend on the risks that that you are facing,” he explained. “So the short answer is, if you have risk factors, go ahead and get it now. ”
But there’s a lot of grey area.
For example, he said if someone is a healthy 25-year-old, but is living with a person who has advanced cancer and is going through chemotherapy, this creates uncertainty.
“We’re getting an incredible lack of clarity as to what should occur,” he said, adding that because there are new variants circulating, the level of risk and appropriate precautions have become even more challenging to determine.
With so much uncertainty, Bowman argued now is not the time for public health to go quiet, but instead, it’s a time for more guidance.
“I think most of us understand it’s no longer one size fits all, but we still need a lot more help with it than what we’re getting,” he said.
Dawn Bowdish, an immunologist at McMaster University in Hamilton, told the Canadian Press the mutating virus puts vulnerable populations, including the elderly, most at risk of infection.
Anyone starting chemotherapy or having major surgery may consider getting a booster before the reformulated vaccines are available but it’s otherwise best to wait, Bowden stressed.
However, for most people, “waiting for that new formulation of a booster dose in the fall will be the way to go because they already have enough immunity by having COVID-19 or having all of their complete vaccine doses and they’re otherwise healthy,” explained University of Saskatchewan epidemiologist Dr. Nazeem Muhajarine.
For those who are at higher risk, he said to get a booster shot as soon as possible.
Dr. Gerald Evans, an infectious disease specialist at Queen’s University in Kingston, Ont., said it would be ideal if XBB vaccines were available now before the flu season began.
“It would be great to have it as early as possible,” he said. “Once Health Canada says ‘yes we approve,’ then the manufacturer is the part that creates a bit of a delay. My hope is that delay will be extremely short-lived as there are a lot of people who are due for boosters now, including young, healthy people, where we say just get it once a year.”
He added that if “we can get those out and into people’s arms in September,” it could potentially help curb the ongoing surge in COVID-19 cases.
What is the status of the fall COVID-19 booster?
Health Canada is currently reviewing three new vaccine vaccines containing the XBB.1.5 Omicron subvariant, for those six months and older. It is reviewing submissions from Pfizer-BioNtech, Moderna and Novavax.
While no specific rollout date has been established, it is anticipated that Pfizer and Moderna vaccines will likely receive approval in the fall, with the Novavax shot following at a later date, Health Canada said in an email Monday.
“The authorization and availability of new vaccines will depend on many factors including the submission date, the review timelines, the acceptability of the information submitted and the supply of the vaccine by the manufacturer. If authorized, Canada will have ample supply of the new formulation of mRNA vaccines available in Fall 2023,” the spokesperson stated.
Canada will also have access to non-mRNA vaccine (Novavax) for those who are unwilling or unable to receive an mRNA shot, Health Canada said.
“We are anticipating it will be available later this year, pending a submission to, and authorization by, Health Canada.”
Public Services and Procurement Canada told Global News in an email Monday that it has agreements in place to procure the latest COVID-19 vaccines, ensuring Canada has the right quantity of doses it needs for 2023 to 2024.
“This includes agreements with Pfizer, Moderna and Novavax, currently allowing for up to 33 million doses that will be manufactured from their respective off-shore facilities and delivered in the fall/winter 2023, pending Health Canada regulatory approvals,” the spokesperson said.
Where do other countries stand on COVID-19 boosters?
Like Canada, the rollout of the COVID-19 booster shots in the United States is expected in the fall, according to the U.S. Food and Drug Administration (FDA).
The updated booster is expected to be cleared by the FDA ahead of a Centers for Disease Control and Prevention (CDC) vaccine advisory panel, which is scheduled to meet on Sept. 12 to vote on whether to recommend the updated vaccines, NBC News reported.
In England health officials on Wednesday said vaccinations will be available starting Sept. 11 (rather than the original October release date) as a precautionary measure intended to protect the most vulnerable as the winter months approach.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
