Published July 13, 2022

Ontario expands fourth dose eligibility to all adults

Anyone aged 18 and older will be able to book a fourth shot starting Thursday

By Holly McKenzie-Sutter in Toronto

Ontario is widening access to fourth COVID-19 vaccine doses to all adults, but the province's top doctor says some may want to wait for a new shot that's expected to better target Omicron variants.

Chief Medical Officer of Health Dr. Kieran Moore said Wednesday that anyone aged 18 and older who had their first booster five months ago will be able to book a fourth shot – or second booster – starting on Thursday. 

But he noted that people who don't have underlying health conditions can choose to wait for the fall, when vaccines specifically targeting the Omicron variant may become available.

"While my call for arms remains the loudest for the most vulnerable in our communities, we've made the decision to expand the eligibility for second boosters," Moore said.

Most residents aged 18 to 59 have strong protection against the virus more than six months after their first booster, he said, but expanding fourth-dose eligibility will ensure they can make an "informed decision" looking at personal risk factors, pointing to smoking or diabetes as examples.

"It's not a 'should,' it's absolutely a 'may' depending on your personal circumstances," Moore said of the second boosters. 

He encouraged Ontarians to speak with their health-care providers about whether getting a second booster "is right for them." 

People who choose to take the second booster this summer may have to wait five months for their next shots, or three if they are immune suppressed, Moore said.

He said province will likely start vaccinating high-risk individuals with the proposed bivalent vaccines earlier in the fall, so most Ontarians likely wouldn't be eligible until closer to November or December anyway. The National Advisory Committee on Immunization is currently awaiting more evidence on bivalent vaccines.

"That timing will not interfere or slow down if you get your second booster dose in July," he said.

Ontario had been under pressure to expand eligibility for fourth doses beyond people aged 60 and older, immunocompromised individuals and Indigenous adults. Quebec opened second booster access to all adults in May, while New Brunswick, Nova Scotia, Newfoundland and Labrador and Prince Edward Island also recently announced plans to lower the age threshold for fourth doses.

Moore said Ontario wanted to encourage the most vulnerable to get boosters, and for people to catch up on earlier COVID-19 vaccines before opening up eligibility.

The province is currently experiencing a summer wave of virus infections driven by the BA.5 Omicron subvariant that Moore said could peak within the next few weeks.

"We know it's the summertime and people want to move on past the pandemic, but it's a clear reality now that we have to deal with this BA.5 variant," he said. 

Some welcomed the expansion of fourth doses. Doris Grinspun, CEO of the Registered Nurses' Association of Ontario, tweeted her support of the expansion, while calling for a reinstated mask mandate. 

Justin Bates, CEO of the Ontario Pharmacists Association, said pharmacists have been fielding more questions about availability and effectiveness of the fourth shots amid the BA.5 wave. 

Pharmacists are anticipating a rush in the first few weeks after access widens, Bates said, with a better sense of demand expected to emerge in the coming days.

"It's going to take better part of a week for a lot of the pharmacies to restock and be prepared for the increase in demand," he said in an interview. "We would ask patients to understand that we're doing everything we can to turn this back up, but it's going to take a few days to get all the supply in the pharmacies."

Interim New Democrat Leader Peter Tabuns said the province should work to "reduce barriers" for vulnerable people by ensuring the role of family doctors in the rollout and in-home vaccinations for people who need them. 

"We need to make it as easy as possible for people to get their shots, and not repeat the usual inconvenient and confusing vaccine rollout that may have contributed to five million Ontarians skipping their first booster," Tabuns said in a written statement. 

About 60 per cent of Ontarians had received third COVID-19 shots according to the latest data made available last week. 

Meanwhile, some Toronto residents who had otherwise kept up with COVID-19 vaccinations said they were unsure about whether to get a fourth dose. 

Sherry Yuan Hunter said her family all received third doses, but that they would likely spend some time discussing whether to make appointments for the fourth shots. 

"I think that making it available is probably a good thing, everyone has to make their own decisions, but at a personal level, I don’t know what the right thing to do is anymore," she said. 

Christopher Fladd, a researcher at SickKids hospital, welcomed the news on expanded boosters and said he would likely get the shot soon, even with his curiosity about the bivalent vaccines expected later this year.

"I will probably get this when it’s available," he said, adding that he'd like to see more public health measures like masks in public spaces still in place. "I just think that people have become a little bit complacent and that they’ve probably dropped their guard."

Despite the ongoing wave, Moore said he wasn't currently considering recommending a return to mask mandates or other public health restrictions that were lifted earlier this year, though he said should consider masking in indoor crowded spaces "if they feel it's right for them." 

Ontario also announced Wednesday that it would extend a program providing free rapid antigen tests for COVID-19 through venues that include grocery stories and pharmacies until Dec. 31. 

Banner image: Dr. Kieran Moore speaks at a press conference, at Queen’s Park in Toronto on Monday, April 11, 2022. Ontario's top public health doctor is set to share details today on the province's plans to expand access to fourth COVID-19 shots. THE CANADIAN PRESS/Nathan Denette.

This report by The Canadian Press was first published July 13, 2022.

- With files from Tyler Griffin

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