As new variants emerge, fourth COVID-19 shots should be more accessible, experts say

ST. JOHN'S, N.L. — Keith Muise, a 41-year-old man in Newfoundland, says it's absurd he can't access a fourth dose of a COVID-19 vaccine despite the emergence of new variants — and two public health experts agree with him.

Muise said he would sign up for a fourth shot at the first availability, but he lives in Stephenville, a town in western Newfoundland and Labrador, which is one of four provinces still limiting second booster shots to those aged 70 or older. 

The province's eligibility rules, however, are in line with the current recommendations from the National Advisory Committee on Immunization. Quebec, meanwhile, is offering fourth doses to anyone over 17. 

“I want as much protection as I can get,” Muise said in a recent interview, adding that he's also worried about his mother-in-law, who is 69 and has underlying health conditions.

“Why is she sitting around waiting for this booster?” he asked. “I don't want her to have less protection for the sake of, you know, a bureaucracy-type decision.”

Colin Furness, an assistant professor at the University of Toronto's Dalla Lana school of public health and Brenda Wilson, a professor of community health at Memorial University of Newfoundland and Labrador's medical school, agree with Muise. They say it's time to allow widespread access to fourth doses of COVID-19 vaccines across Canada.

“There's a lot of really good reasons why people should be getting vaccinated, and governments should be supporting that,” Furness said in a recent interview. “I see no reason to be holding back. I'm in Ontario; I'm 54 and I'm not eligible for a fourth dose — that's stupid.”

Ontario offers second boosters to those in the general public who are 60 and older. Prince Edward Island also offers fourth shots to those 60 and older, while New Brunswick and Saskatchewan offer them to residents over 49. 

In Nova Scotia, Alberta and British Columbia — like in Newfoundland and Labrador — residents must be over 69 to be eligible. 

All provinces, however, currently offer fourth doses to select high-risk residents.

As for those good reasons to get a fourth dose, Furness noted that protection from third shots is likely waning in the population, adding that new highly contagious subvariants of the Omicron variant — BA.4 and BA.5 — are increasingly responsible for new cases of COVID-19 across the country.

Vaccines only effectively prevent transmission for two to three months, he said, but they're very good at preventing hospitalization and death. So while a well-co-ordinated effort to offer fourth doses — and to keep encouraging people to get a third dose — isn't going to end the pandemic, it could help temper another surge in cases while keeping more people out of hospital, Furness said.

Chief public health officer of Canada Theresa Tam said last week that COVID-19 case counts were generally stable or declining across the country, but she said some areas were reporting increases. Wastewater data from Ontario's COVID-19 science advisory table, for example, detected a rise in the presence of COVID-19 last week.

Hospitalization rates across the country were “elevated and variable,” the Public Health Agency of Canada said last week.

Meanwhile, the disease is still killing people — 174 Canadians died from COVID-19 in the week ending June 11, according to the country's public health agency.

Furness said he believes the National Advisory Committee on Immunization is “dragging its feet” and that it should have recommended wider access to fourth doses by now.

In a statement emailed Tuesday, a Health Canada spokesperson said that while the advisory committee provides recommendations based on available studies, “provinces and territories make their own decisions based on their epidemiological situation and vaccine availability.”

Wilson said she remains “quite concerned” about the potential for another surge in COVID-19 cases.

“It's the vaccines that are keeping most people from getting seriously ill with the virus,” she said in an interview Tuesday. “They're not going to stop transmission … but they're going to keep people from being admitted to hospital, from being seriously ill, from dying from it. And that's worth having.”

As for ending COVID-19 transmission, both Wilson and Furness said governments need to reach beyond vaccines and at least recognize the disease is airborne and plan accordingly.

“The fact of the matter is that every country that has tried to use just one strategy — be it lockdowns or vaccination or masking — has failed,” Furness said.

This report by The Canadian Press was first published June 22, 2022.

Sarah Smellie, The Canadian Press