Editors Note: Since this article was first published, Canadian provinces have expanded eligibility criteria to varying degrees. Ontario has opened up eligibility, for example, to all adults 18 and over. British Columbia has done the same but with the recommendation that most adults wait until the fall. Alberta’s criteria remains unchanged, but will announce eligibility updates this week.
Recent polls indicate that the majority of Canadians who have had their third dose are eager to take advantage of the fourth becoming available, though there are signs of a decreased willingness to continue boosting even among vaccinated populations.
Canadian provinces and territories have gone their own ways on the advisability and availability of fourth COVID-19 vaccine doses, or second boosters.
All are currently offering second boosters to those in long-term care and other congregate living settings. They also have expanded availability to other high-risk populations based on medical conditions, such as those living with certain severe immunodeficiencies.
But eligibility within the general population still varies significantly across the country.
Similarly, Alberta is currently recommending fourth doses to those 70 years and older and Indigenous individuals 65 and older. Labrador is offering fourth boosters to those 70 and above, and Indigenous adults 18 and over.
Manitobans aged 50 and over are eligible for second boosters and Indigenous people over age 30. New Brunswick is also offering fourth doses to those 50 years and older, and Indigenous adults over 18 years old.
Quebec and Nunavut on the other hand, have made second boosters available to all residents 18 years and older as long as their first booster dose was at least three months ago, or 4.5 months ago in Nunavut’s case.
On June 30, the U.S. Food and Drug Administration (FDA) voted to advise manufacturers to add an Omicron BA4 and B5 spike protein component to the current vaccine composition, creating a dual (bivalent) booster. The hope is that the modified bivalent vaccines could be used in early to mid-fall 2022, when another surge is expected.
With this in mind, the National Advisory Committee on Immunization (NACI) recently released its interim guidance for the fall booster vaccination program in Canada.
Experts point to the rise in case counts in Ontario through waste-water testing as indication of a rising summer wave.
So, the question remains: Should the general population (those 18 and over) be eligible for a fourth dose at this time? Or is there greater benefit to be had by waiting? We asked a panel of experts to shed some light on the issue.
The less people hear about the pandemic, the more they can assume everything is fine – it’s not.
The current criteria disproportionately discriminate against women.
Are you going to vaccinate the entire population with something that may not be useful for more than two or three months?
It’s tempting to see that as an easy question, but it’s really not.
If we want to protect the population, let’s do everything we can.