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Ontario expands eligibility for 4th COVID-19 vaccine dose, but healthy adults can wait until fall

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Ontario is opening up eligibility for fourth COVID-19 vaccine dose to all adults aged 18 and up this week, however the province’s chief medical officer of health says that healthy adults may want to wait until the fall.

Dr. Kieran Moore made the announcement late Wednesday morning, saying that individuals in this age group can book an appointment using the provincial system as of 8 a.m. on July 14.

While appointments for fourth doses will be available to all adults five months after their third shot, or three months after a COVID-19 infection, Moore said it’s “not absolutely necessary” for individuals who do not have underlying health issues.

Healthy adults may want to wait until the fall when a “bivalent COVID-19 vaccine” may be available, Moore said.

“While we're making this option available, it is important to note that healthy, currently vaccinated individuals, continue to have significant, persistent protection against severe disease even six months after the last dose,” he said.

“However, there may be individuals with personal or medical circumstances in those age groups who may benefit from an additional protection of a second booster.”

Moore added that personal circumstances could also play a part in whether an individual chooses to get the second booster shot. Health-care workers and those working in busy crowded settings should get the dose while those with family members who are at risk may also choose to get a fourth shot.

Anyone with questions about whether or not they should get a fourth dose of COVID-19 vaccine is being urged to contact their health-care provider.

Moore was unable to provide much clarity on the components of the bivalent vaccine being offered in the fall, saying that depending on which subvariant it targets, it may not be available until November or December.

He also said there would be a “minimal separation” between this dose and the fall dose. Moore said normally they would recommend a five month separation, but it could be as short as three months for those at higher risk.

Prior to this announcement, fourth doses were only available to people aged 60 and older, as well as immunocompromised individuals and Indigenous adults.

Ontario epidemiologists are divided about the value of offering fourth doses in the summer. Just over four million people who got two doses of COVID-19 vaccine have not yet gotten a third, leading some experts to say that boosters should be offered due to waning immunity.

Dr. Susy Hota, medical director for infection prevention and control at the University Health Network, told CTV News Toronto last week that residents shouldn’t wait for other vaccines that may target specific variants or subvariants as it’s more important to reduce the risk of severe symptoms and death related to the disease.

Meanwhile, infectious diseases physician Dr. Dale Kalina told CP24 there isn’t much benefit from the fourth doses unless an individual has a poor immune system.

“The people that really need booster doses, in general, are people whose immune systems aren’t working particularly well. So people that are over the age of 70 or if you are taking medications that supress your immune system.”

Quebec and the United States have both already opened up fourth doses to the general population.

COVID-19 TO PEAK IN NEXT TWO WEEKS: MOORE

The news comes as Ontario enters a seventh wave of the pandemic, with a peak expected in the next in a few weeks, according to Moore.

Ontario has seen a steep increase in COVID-19 within wastewater as well as an increase in percent positivity, hospitalizations and ICU admissions in recent weeks. Moore told reporters the new wave is experiencing a “slower trajectory” compared to previous waves due to vaccination rates and the availability of new treatments.

Moore added that there could be roughly 5,000 cases of COVID-19 within the community as of Wednesday. Despite this fact, he said Ontario does not have any plans to reinstate public health measures lifted earlier this year, although he does continue to recommend wearing a mask indoors in crowded settings.

Officials have also said they will continue to provide free rapid antigen tests to the general public at grocery stores and pharmacies until Dec. 31.

No changes have been made regarding access to PCR tests.

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